In a little-noticed move, the leading body for US fertility clinics has given a green light to helping women over 50 to become pregnant. The former policy of the American Society for Reproductive Medicine, formulated in 2004, was that just as “fertility is the norm during reproductive years… infertility should remain the natural characteristic of menopause”. The physical and psychological risks were too great.
But now the ethics committee of the ASRM says that helping postmenopausal women – especially those between 50 and 54 -- to bear a child conceived with a donated egg “is not such a significant departure from other currently accepted fertility treatments as to be considered ethically inappropriate.”
What prompted the bracket creep? It was not more information about the health outcomes for mother and child. A report from the ethics committee frankly acknowledges that “The medical risks associated with oocyte or embryo donation to women of advanced age are still largely undetermined because of the limited amount of available data.” Perhaps it was a new-found disdain for the concept of “naturalness” – a word which the new guidelines place in scare quotes.
There may also be more demand. With changing social mores, women who marry after 50 may want a child and women who are marrying for a second time may want a child with their new partners.
The ethics committee supports the new policy by appealing to changing community standards, gender equality, and reproductive freedom. “Given the possibility that postmenopausal reproduction may satisfy the strong desire of a couple or individual for offspring, it would be wrong to deny women the use of donated oocytes or embryos solely because of their age,” it says.
What about the children? A woman who conceives at 50 could die when her child is a teenager. This, the ethics committee acknowledges, is “one of the most stressful life events for children or adolescents”. The statement leaves the question unanswered. It simply says that this is a problem which parents will have to deal with.
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