Türkiye’de Yumurta Dondurma Politikası: Karşılaştırmalı Perspektiften Eleştirel Bir Değerlendirme

Medikal teknolojilerdeki gelişmeler sayesinde tıbbi olmayan nedenlerle yumurta dondurma son on yılda dünya genelinde etkin ve yaygın bir yöntem olarak belirmeye başladı. Böylelikle doğurganlıkta yaşa bağlı azalma durumuna karşı bir kadının önceden yumurtalarını dondurması ve ileride tüp bebek yöntemiyle hamile kalabilmesi amaçlanıyor. Türkiye’de ise 2014 yılında yapılan mevzuat değişikliğiyle yumurta dondurmaya izin verilen tıbbi zorunluluk halleri daha geniş tanımlandı. Daha önceden kemoterapi gibi üreme hücrelerine zarar verebilen tedaviler ve yumurtalıkların alınması gibi üreme fonksiyonlarının kaybedilmesine yol açabilecek operasyonlar öncesinde yumurta dondurmaya izin veriliyordu. Mevzuattaki değişiklikle ve klinik uygulamaya göre, yumurta rezervleri azalmış, ailesinde erken menopoz öyküsü olan ve/veya belirli bir yaşın üstünde olan, dolayısıyla doğurganlıkta yaşa bağlı azalma riskiyle karşı karşıya olan kadınlar da artık yumurta dondurabiliyor. Ancak mevzuata göre bekarken yumurta dondurabilen bu kadınların, dondurulmuş yumurtalarını tüp bebek yoluyla kullanmak istediklerinde evli olmaları gerekiyor. Diğer yandan, ülkemizde sperm ve yumurta donasyonunun mümkün olmadığını hatırlamakta fayda var. Bu kısıtlamalar dikkate alındığında, mevcut yumurta dondurma politikası nasıl değerlendirilmeli? 2014’teki mevzuat değişikliği ilk bakışta kadınların üreme haklarının genişlemesi olarak görülebilir, ama gerek başka ülkelerdeki politika yaklaşımları ile karşılaştırmalı düşünüldüğünde gerekse ülkemizde yumurtalarını donduran kadınların deneyimleri ve tercihleri düşünüldüğünde sorunlu olduğu görülmektedir. Makalede, önce yumurta dondurma literatürüne ve “tıbbi – tıbbi olmayan” ayrımına değiniliyor. Ardından başka ülkelerde görülen politika yaklaşımlarının çeşitliliğine dikkat çekiliyor. Daha sonra ülkemizdeki uygulamalara eğilip, mevzuatın mevcut araştırmalarda beliren yumurta donduran kadın profiline uygunsuzluğuna işaret ediliyor. Bu doğrultuda, 2014 yılı mevzuat değişikliği iktidarın pronatalizm ve kültürel muhafazarlık kaynaklı kaygıları ile açıklanıyor: genç yaşta ve henüz yumurtalar sağlıklı ve bolken yumurta dondurmaya izin verilmemesinin ardında evliliğin ve anneliğin ötelenmesi konusundaki endişelerin yattığı iddia ediliyor. 2014 düzenlemeleri ancak sınırlı bir grup kadına belirli şartlar çerçevesinde bir nevi son çare olarak yumurta dondurmaya izin verilmesi olarak yorumlanıyor. Yoksa bu kadınların hamile kalma şanslarını büsbütün kaybedebilecekleri düşünülüyor olabilir ki bu da pronatalist gündem ve toplumsal normlar açısından arzu edilebilir bir ihtimal olarak görünmüyor. Dolayısıyla, hayat seyirleri açısından bu zamana kadar toplumsal normlara uygun yaşamamış kadınlara, mevcut yumurta dondurma politikası gecikmiş olarak da olsa normlara uyabilmek için bir fırsat sunuyor, ekstra zaman tanıyor denilebilir. Yazıda son olarak bir feminist politika konusu olarak yumurta dondurma konusunda dikkate alınması gereken kurumsal meselelere işaret ediliyor.

Anahtar Kelimeler:

yumurta dondurma, üremeye yardımcı teknolojiler, üreme sağlığı politikası, pronatalizm, toplumsal cinsiyet

Egg freezing policy in Turkey: A critical analysis in comparative perspective

Egg freezing for non-medical reasons has emerged as an effective and increasingly common procedure thanks to recent advances in cryotechnologies. This procedure aims to enable women to get pregnant in the future by having their eggs frozen as a measure against age-related decline in fertility. In Turkey, egg freezing was only allowed for medical reasons such as chemotherapy treatment and fertility-threatening operations until 2014. Women now also can have their eggs frozen in case of diminishing ovarian reserves, family history of premature menopause and the risk of age-related decline in fertility. While single women can have their eggs frozen, only the married ones can use their frozen eggs via in vitro fertilization. It is important to note that gamete donation is not legally allowed in Turkey. How should we then explain the egg freezing policy in Turkey given such limitations? At first look, the 2014 policy change might seem like an expansion of women’s reproductive rights. However, it looks more problematic when we consider it in comparison to policy approaches from other countries and in relation to women’s experiences of egg freezing and preferences concerning the use of reproductive technologies. The article first provides an overview of the egg freezing literature, with a focus on the binary of the medical and the non-medical. It then points at the diversity of policy approaches across the world. This is followed by an elaboration on the egg freezing policy in Turkey and how it does not seem conducive to the profile of women who have their eggs frozen according to the extant studies. Accordingly, the 2014 policy change is linked to anxieties stemming from the government’s pronatalist and culturally conservative agendas. Egg freezing is not allowed for women who are young and healthy with plenty eggs, because of, it is argued, the concerns about the postponement of marriage and childbearing. Hence, egg freezing is allowed as a last resort only for a small group of women under certain circumstances. Otherwise, this group of women could have no chances of pregnancy, a scenario which would not be desirable from the perspective of pronatalism and social norms. In other words, the current egg freezing policy provides extra time for women who, to date, have not conformed to social norms in their life courses to conform. Finally, the article points at institutional issues concerning egg freezing as a matter of feminist policy advocacy.

Keywords:

egg freezing, assisted reproductive technologies, reproductive health policies, pronatalism, gender,

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