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How Old Is Too Old for Fertility Treatments?

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by Rachel Lehmann-Haupt, Jan. 27, 2010

Rumors are flying that Madonna, 51, has sought consultation with a fertility doctor because she wants to have a baby with her 22-year-old boy friend, Jesus Luz. If true, she could join the ranks of the growing number of women in their late 40s, 50s and even 60s who try – and often succeed (mostly using donor eggs) -- to get pregnant. In the U.K., a fertility clinic recently made headlines by offering to treat a 59-year- old woman, causing a stir among those who believe it is ethically wrong for a woman closer to the age of a grandmother to become a mother.

Even if a woman in this age set can physically handle a pregnancy, the decision raises a whole host of ethical issues from risk of premature births to whether it's fair to the child to be born to a woman of advanced age. Many of these issues came to a head last July, when Maria del Camen Mousada, a Spanish woman who gave birth to twins at the age of 67, died of cancer when her children were two-and-a-half.

In the U.K., the National Health Service has a recommended cut off age of 39 for fertility treatments. In the U.S. many clinics will not treat a woman over the age of 45, while the current American Society of Reproductive Medicine position “discourages” fertility clinics from treating post-menopausal women. But, so far, neither country has established a legal cut off age for a woman to become a mother. Men have been fathering children into their 70s without regulatory question, but the issue with women is now causing a heated debate.

At a December meeting on the regulation of Advanced Reproductive Technology held by the American Society for Reproductive Medicine, Linda MacDonald Glenn, J.D., L.L.M., of the Women’s Bioethics Project, spoke about the “moral panic” that has occurred as the media tends to focus on the extreme cases of women in their 50s and 60s having children. The reality, however, that these women represent less than one percent of all ART cases. "The flip side of pro-Choice is a woman’s right to have a child, regardless of her advanced age,” she said. But she does believe that when an older patient looks to a fertility clinic to conceive, doctors should investigate whether there is “social support” for the child.

Dr. Robert Bryzski, the chair of ASRM's Ethics Committee and a professor of Obstetrics and Gynecology at the University of Texas, says the Ethics Committee is currently grappling with revising the current statement on "Egg Donation in Post Menopausal Women."

"The problem is that menopause happens at different ages even though it happens on average at age 51," says Dr. Bryzski. So the change in the new statement, the Committee believes, has to be that it will focus on age, but not exclusively.

"There are other factors that are involved in obstetric risk for the woman," Bryzski says. "Age, of course, is a big factor, but age discrimination is a question that's troubling. This is why we keep circling back to considering individual circumstances."

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Rachel Lehmann-Haupt (www.lehmannhaupt.com) is a journalist and the author of In Her Own Sweet Time: Unexpected Adventures in Finding Love, Commitment and Motherhood (Basic Books, 2009).