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How old is too old?

Yesterday I talked about how loathe I am to have government legislation involved in my fertility decisions.  I promised today I would finish that train of thought with “how old is too old” for IVF.   

So, what about age limits on fertility treatments?  Many countries have a limit of 48 or up to 50-something years old.  Some clinics also have their own limits (not mandated by the government).  What is fair?  What is ethical? 

Of course we have to consider the children born to these mothers.  What is the impact on them?  Again, I think it isn’t a one size fits all answer.  

By the way, I completely support that a clinic should have the right to have age limits based on their medical judgement – and I’m even happier when I hear that they consider it on a case by case basis.  I just feel that is how medicine should be approached since everyone and every circumstance has different nuances.

Men have certainly been procreating well past 50 years old, and no one bats an eye.  I’ve never heard of a fertility clinic refusing to take sperm from a male over 50…or over 60, or at any age.  Granted, the genetics are different for men.  But let’s be realistic – most women in their 50s are using donor eggs – so the genetics are of a 20-something year old woman’s DNA which reduces the likelihood of birth defects.  So, if it isn’t the genetics, is having an age limit for women and not for men a double standard? 

I certainly know plenty of women in their early 50s that are far healthier than many women in their 30s. And I know a lot of older women that are much better mothers at 40 and 50 than they would have been at 20.  So, should age really be the primary deciding factor?    

Some would argue that the mother in her 50s is likely to die sooner and leave the child motherless.   However, a healthy 20 year old could die tomorrow too.  What about a young woman who has unhealthy habits that put her at risk (smoking, drugs)?  Or a 20 year old woman who has had cancer that may have a greater risk for early death?  Would we consider limiting their access to fertility treatments because of what “could” happen?  Surely not.   

There are no guarantees that any of us will live to a certain age.  And does the answer change if a women is single with a great support system or one that has a younger husband or partner to also parent the child?  I think it isn’t realistic that any of these other critical factors would be considered if an age limit were legislated or mandated.  

I would hope that any woman considering fertility treatments would work with her doctor to assess her current health and her ability to safely carry a baby to full term and care for it – then use that information to make a well-informed and thoughtful decision.  Additionally, anyone (male or female and at any age) expecting a child should be thinking about protecting that child and planning for their future – including creating a plan in the event that the parent dies.   

And for the people who say that pursuing any kind of fertility treatments (at any age) is just interfering with God’s will, I would like to point out that most medical technologies were met with early resistance.  Yet, most of us would not think twice about using antibiotics, cancer treatments, viagra, insulin for diabetes or other medical intervention. 

We have been given the intelligence to discover these technologies, so aren’t we showing a disregard for life if we don’t allow access to them? Your opinion may differ, and I respect your right to have that opinion. But I am frustrated when I hear that someone is willing to use birth control or other medical intervention & treatment, but is vocal that fertility treatments are unconscionable and wrong- not just for themselves, but for everyone else too.    

So, back to my original thought.  Is some arbitrary age really something that we want as part of a legally mandated reproductive criteria?   

I truly believe that reproductive treatments should up me and to my doctor’s medical and ethical judgment based on my specific case, rather than mandating across the board rules and regulations.  So, even though today I don’t personally think I’d want to have a child in my late 50s, as long as society is trying to take away my reproductive choices, I think I will likely fight to retain that ever so tiny level of control and choice in this completely out of control journey that is infertility.

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