Exploiting Fertility Technology: (Rapid Fire Rant)
Posted by realityrounds on July 15, 2009
The world’s oldest woman to have given birth at the age of 66, has just died at the age of 69. In order to become pregnant the Spanish woman lied to a California fertility clinic and told them she was a mere 55 years young (their cut off age for treating single women). The doctors gave her hormones to “rejuvenate” her uterus after having” suffered” 20 years of menopause, and she was able to conceive with the help of IVF treatments. The woman was quoted as saying: “I think everyone should become a mother at the right time for them.” She leaves behind two toddler boys.
I have been criticized by some for being so harsh on women over 50 who seek out extensive fertility treatments in order to conceive. Why am I not so hard on elderly men, ala Larry King and Mel Gibson, who become fathers in their 70’s and 60’s? Well, I am not a fan of them either, but the cold harsh reality is they did not seek out advanced reproductive technologies, and lie and exploit the medical system in order to sire children.
I unapologetically think it is wrong for women in their mid 50’s and beyond to be seeking out fertility clinics and cajoling them to treat them. I also think it is wrong for these fertility doctors and clinics to treat them. These women may feel young and look young, but they are not young. Their cells and hormones are those of a 50+ year old. Being pregnant at such advanced ages is science fiction and high risk. For the mother it can lead to high blood pressure, stroke, blood clots, C-sections, etc. For the baby it can lead to premature birth, low birth weight, developmental delays, etc.
It is interesting to me that a study has just come out linking hormone replacement therapy in women with an increased risk of cancer. Just what are the risks of the extensive hormone treatments for 50 year old plus women?
*End rant*
RR
pinky said
No sh1t, huh?
QoB said
The UK Times has an article which says that she died of breast cancer : http://www.timesonline.co.uk/tol/news/world/europe/article6714820.ece
I’m not against fertility treatment, but at this age it is ridiculous, and tragic for those children.
Diana J. said
I completely agree. My main reason is that simply that it is selfish for a woman to intentionally give her child an elderly mom who will be unable to parent effectively and will probably die when her children are very young. That’s just self-gratification at the expense of the child and is not justifiable.
Pattie, RN said
ITA.
Pattie, RN said
Maybe, just maybe, the Creator or the Universe or what ever you want to call him or her had some pretty good guidlines going all these millenium??
Like, 99.99999% of the time throughout history, Moms (or their female relatives) were the caretakers of small children, which is labor intensive [no pun intended!] and exhausting work if you are doing it correctly. IE–not work for an old woman.
Men, meanwhile, could go on to mates number 2,3,and more as mate #1 died from childbirth or disease…and continue to impregnate young healthy women. So Papa dies…as long as the clan is there, no big problem. Mama dies = baby dies too. So the factory shuts down long before Mama runs out of natural time. It is not nice to fool Mother Nature, especially not to make a child who is created for YOUR needs, not for his or her own intrinsic value.
Carrie said
I wonder if her death was related in any way to the pregnancy and subsequent childrearing. I have twins, and I cannot imagine -caring- for them as a single woman pushing 70, never mind gestating them beforehand.
Julie said
I had a patient who was 63 and had also lied to the infertility clinic. There needs to be accountability…somehow, someway. She looked every day of her 63 years. Gimme a break. These clinics are unethical!
Rose said
http://www.roanoke.com/news/roanoke/wb/210692
article about a 50 year old who had a baby then had a heart attack a few days later!
Emma B said
You say you’re not so harsh on older men who father children because they don’t lie and exploit the system. Honestly, though, what difference does it make to their children? Spontaneously conceived children whose parents die at an early age are just as orphaned as IVF babies.
I’m also skeptical about the risks of IVF hormones in older women. “Extensive hormone treatments” sounds scary, but when you look at the actual drugs and procedures, it’s not as bad. HRT is used for many months or years, while each IVF cycle only involves one to two weeks of ovarian stimulation, and two more weeks of progesterone supplementation (unless pregnancy is achieved). Furthermore, the estrogen levels are only raised above a normal ovulatory level according to how many follicles are produced, which is determined by the woman’s age and ovarian reserve. Menopausal women are hard to stimulate and frequently produce no more than three or four eggs, meaning that their E2 levels max out at only 3-4x normal. Perimenopause itself can cause that kind of transient elevation — it’s not uncommon for women to produce multiple eggs toward the end of their reproductive years, which is why twins are more common in this age group. The hormone elevations of pregnancy itself are orders of magnitude above and beyond that produced by the IVF process, and again, for much longer periods than brief IVF cycles.
Ovulation induction certainly is no picnic — I’ve had ovarian hyperstimulation, so I have a personal appreciation of the finer points. Nor am I a fan of late-life pregnancies in general, although I don’t think IVF clinics should be legally prevented from doing them. However, I do think that an IVF pregnancy at 50 is not qualitatively worse than a spontaneous one, and that talking about the “extensive hormone manipulation” involved is somewhat exaggerated.
Emma B said
Gah, I totally forgot to mention one other very important thing, which is what I get for posting too late at night.
Late-life pregnancies are, almost without exception, donor-egg pregnancies. That means that the woman who gets pregnant doesn’t actually undergo the ovarian stimulation that is necessary to produce multiple follicles for IVF — some other, younger woman does. The intended mother merely takes a short course of estrogen, two weeks or so, which causes her uterine lining to grow enough to make pregnancy possible, and two weeks of progesterone after embryo transfer. The estrogen levels aren’t raised higher than normal as with ovulation induction — they are raised just enough to mimic a normally ovulating/menstruating woman.
So, the “extensive hormone maniuplation” we’re talking about, for donor egg late-life pregnancies, is roughly on par with a single month of HRT. It’s not really something to get that excited about.
realityrounds said
Emma,
Thanks so much for your comment. I was really curious about the cancer related risks with infertility treatment in women greater than 50. Do you know what the article meant when it said the 66 year old woman had “uterine rejuvenation”?
Emma B said
Just what I said, I think. Two weeks or so of estrogen therapy in order to cause the uterus to grow an endometrium, then add progesterone to cause the endometrium to transform from the proliferative to secretory phase and support an early pregnancy. Estrogen supplementation is done with something like Estrace or Estragel, and it’s pretty straightforward — estrogen produces endometrium if given in sufficient amounts, and blood tests and transvaginal ultrasounds are used to monitor blood estradiol levels and endometrial thickness. I suppose a uterus which had long since quit producing estrogen could require a longer duration, but we’re still talking weeks. I once needed six weeks of estrogen therapy for a non-age-related problem, and my RE indicated that he’d never seen another patient of any age require such a long treatment.
Progesterone supplementation is standard in both regular IVF, frozen embryo cycles, and donor egg transfers. Either the follicles are punctured for egg retrieval, or the woman didn’t ovulate at all that cycle and is getting an embryo produced at an earlier time or by someone else. It’s usually done with progesterone in oil shots in the US, but it’s also done with vaginal suppositories or gels like Crinone, and occasionally even with oral Prometrium.
I think the doctor in question phrased it as “uterine rejuvenation” because that sounded better than “regrowing uterine lining with estrogen”, or possibly the reporter took liberties with the description (media coverage of infertility is pretty terrible). I checked with my mom, who has 25 years’ experience as a reproductive endocrinology nurse; that’s how they treat their menopausal patients, and she’s not aware of any protocol other than standard estrogen/progesterone supplementation that would qualify. They’ve never treated anyone in her 60s, but they have treated women in their late 40s and early 50s, as well as younger women in menopause. The numerical age is less important than the hormonal profile, and a 50-year-old menopausal woman is no different from a 30-year-old with premature ovarian failure.
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