A phenomenal event happened a few months ago in the world of science, catching the attention of international newspapers and media outlets – Daljinder Kaur, a 72-year-old woman from India, gave birth to a healthy baby boy following two years of IVF treatment at a fertility clinic. However, this is not the first time such an extraordinary incident has occurred. In 2008, Rajo Devi gave birth at the age of 70 through the same clinic, The National Fertility and Test Tube Centre. The clinic’s owner (embryologist Dr. Anurag Bishoi) defended his decision to help both Kaur and Devi, stating that “a woman’s age is no factor for me” and that only the “pre- and post-pregnancy health” of the woman concerns him.
Similarly, scientists in a Greek fertility clinic claim to have discovered a technique that has allowed them to restore the ovaries of post-menopausal women, leading to the subsequent release of fertile eggs. This procedure relies on a blood treatment used to speed up the healing of wounds and soft tissue injuries, using platelet-rich plasma (PRP) created via centrifugation. The team found out that injecting PRP into the ovaries of post-menopausal women restarted their menstrual cycles. Konstantinos Sfakianoudis (of Genesis Athens) led the study, reporting that the technique worked in approximately two-thirds of cases. “We see changes in biochemical patterns, a restoration of menses, and egg recruitment and fertilization,” he said. The method could also prove to be desirable for reasons other than fertility; injecting PRP into the ovaries has the potential to increase the concentration youthful hormones, and thus delay the symptoms of menopause.
In spite of this, the team has not managed to successfully implant any embryos in post-menopausal women. Additionally, they have not yet published any of their findings, as they are waiting to conduct their studies on a larger scale before confirming treatment efficacy. As a result, other researchers have voiced concerns about procedural safety. Embryologist Virginia Bolton from Guy’s and St Thomas’ Hospital elaborated, “it is dangerous to get excited about something before you have sufficient evidence it works”.
Moreover, this procedure also raises an extremely important and highly debated question – should women over a certain age be able to have children? According to the American Society for Reproductive Medicine, a woman’s best reproductive years are in her 20s (with fertility declining significantly after the age of 35). It must also be considered that women do not necessarily remain fertile up until the onset of menopause, with many being unable to have a successful pregnancy in their mid-40s. This is due to two factors; the first is egg quality (which decreases as the woman ages), and the second is a decreasing quantity of egg-containing follicles, commonly known as ‘loss of ovarian reserve’ (occurring prior to the onset of infertility).
It is for this reason that post-menopausal birth can be viewed as somewhat “unnatural” – as it occurs after the cessation of menstruation, it raises a host of moral questions. Conversely, there are a number of aspects of modern medicine that are also “unnatural”, but that are nonetheless framed as life saving rather than abnormal – organ transplants are just one example. If a particular assisted conception method (such as that discovered by Sfakianoudis) can help a woman become a mother, it should not be considered controversial.[spacer height=”20px”]
“it is dangerous to get excited about something before you have sufficient evidence it works”
[spacer height=”20px”]Additionally, an ONS report showed that in 2015, the fertility of women over 30 increased, whilst that of women under 25 dropped (relative to 2014); in fact, the largest percentage increase in fertility rate was for women aged 40 and above (3.4%), and the largest percentage decrease was for women under 20 (7.1%). Furthermore, women aged between 30 and 34 were found to be the most fertile of any age group since 2004! According to the report, these trends are due to the fact that a large number of women are focusing on higher education and pursuit of careers, thus causing childbearing to no longer be an immediate priority. This notion is supported by another 2013 report, in which about 67% of women aged between 16-64 were said to be employed, working an average of 40 hours per week. These statistics suggest that many women do not consider themselves ‘too old’ to bear children.
On the other hand, there are a number of risks and complications that women and couples should be aware of whilst considering a late pregnancy. The most obvious is the initial difficulty in conceiving a child, which has the potential to lead to further complications for the mother and child during delivery (such as prolonged labour). In post-menopausal pregnancy there is also a higher risk of pre-eclampsia, diabetes, cardiac disease and maternal morbidity. Thus, many doctors and scientists consistently advise women to have children by the age of 35, their “period of optimum fertility” according to the Royal College of Obstetricians and Gynecologists. The college has previously remarked that after the age of 35, it is “increasingly difficult to fall pregnant, and the chance of miscarriage rises”.
Furthermore, parenting is an extremely demanding process and requires immense physical and emotional commitment (something that older parents may not be able to provide). Young children need constant attention and parental guidance, and if the parents are simultaneously battling an illness, there is a chance that they will not be able to properly satisfy the needs of the child. Increased maternal age is also clearly linked to an increased chance that the child may lose one, or both, of the parents before adulthood, potentially disrupting their childhood and leading to abnormal psychological development.
Some may argue that societal acceptance is the most important factor linked to this issue. If it is acceptable for men such as Mick Jagger to father children at the age of 72, then surely a woman is also justified to have children at a similar age, once biology is no longer an issue? As a matter of fact, it could even be considered highly discriminatory to impose such double standards between the sexes! A woman’s decisions about her life, her future and, most importantly, her body should be her own, and this is just one example of where this might not currently be the case.