How old is too old?

Photo by www.bbc.co.uk
Women are leaving it later and later to have children, and thanks to advances in fertility treatments, women in their 60's or older now have the chance of giving birth. But should IVF be used in this way?

Older mothers
No one could deny the joy and love on the faces of Patricia Rashbrook and husband John Farrant as they presented their newborn baby, JJ, to the world in July 2006. A mother for the fourth time, aged 62, she earned the tabloid title of 'Britain's oldest mum'.

In December 2006, a 67-year-old Spanish woman was reported to have given birth to twins, and in January 2005, Romanian academic Adriana Iliescu became a mother at 66.

The verdict from most of the public and media was that sexagenarian parenthood was a step too far.

But whatever your opinion of Dr Rashbrook and Adriana, there's no doubt they're outriders in a growing trend towards late motherhood.

Waiting game
In 2004, more babies were born to women in their early 30s in England and Wales than to any other age group, overtaking 20-somethings for the first time. The birth rate is also rising fastest among women in their late 30s and early 40s.

In 2005, 22,246 women over the age of 40 gave birth, a figure that has almost doubled in a decade. Regardless of doctors' warnings about the risks of delaying childbirth, more women are choosing to fit in having babies when it suits their career and life plans.

As a result, women in their late 40s and 50s are turning to those same doctors for assistance in rewinding the biological clock.

Current age limits
There are no hard and fast rules governing age eligibility for assisted reproduction, and neither is being postmenopausal a barrier. The guidelines simply require clinicians to take account of the welfare of the child.

While the NHS imposes an age limit of 39, the financial reality is that only about 25 per cent of fertility treatments are state-funded. So it comes down to biology and finance - can the woman cope with the rigours of pregnancy and can she pay?

In vitro fertilisation (IVF) success rates decline with age and most clinics won't treat patients over 45, but a handful of British units take a more flexible approach. Since the 1990s, there has been a dramatic rise in IVF mums over the age of 50. Just three were treated in the UK in 1992, but by 2002 that figure had jumped to 96, resulting in 24 births. Women treated overseas aren't included in these figures.

Playing catch-up
While society is getting used to an increase in 40-something childbearing, it's the postmenopausal pregnancies that stir up media commentators. But are these women really going against the natural order, or is it Mother Nature who's failing to keep up with the pace of human development?

That's the argument of Mr Laurence Shaw from The Bridge Centre, a London fertility clinic. He points out that 150 years of improved nutrition, hygiene and medicine have extended our lifespan well beyond the menopause, to 80 and older.

But while our longevity has increased, the reproductive cut-off remains stalled at 50. "It's the menopause that's not natural," Mr Shaw argues. "Before we criticise 62-year-old women who want babies, we should remember that not so long ago women would only have had about 20 or 30 years to care for their offspring.

"Nowadays, 60-year-old women in many industrialised countries have a life expectancy of 80 or 90 [the average is 82], so there's no difference in terms of length of their survival after the birth of the baby."

News: Surge in older women seeking IVF
HFEA
NICE
British Fertility Society

Full article: http://www.bbc.co.uk/health/fertility/bigissues_age1.shtml

Category: AMA, Donor Egg, menopause, Old Eggs, perimenopause, Too Old