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How Old is Too Old to Get Pregnant?

By David Kreiner MD, and Tracey Minella

January 17th, 2012 at 11:44 pm

I’m the first to admit it would’ve been easier on many levels if infertility hadn’t delayed motherhood for me. I’d have a kid in college instead of a third grader. Sure some days I feel like I’m aging in dog years… but on others I’m sure chasing him keeps me young.

I can make judgments about myself. We all do. But if someone else were to judge whether or not I was too old to become a mother…now that’s a whole different story!

We can probably all agree that, say 65, is too old. But is 60? Or even 55? As we slide that scale downward, we get into a gray area. But what’s a fertility doctor to do?

Read on for Dr. Kreiner’s thoughtful post on how he has handled this controversial issue:

When I saw that Maria de Carmen Bousada (the oldest mother to conceive at the time with donated eggs and the help of an IVF program) had died, my first thought was to extend my sincere condolences to her family and in particular to her two year twin boys. My heart truly went out to them. It is a great tragedy when a death occurs especially when it is the mother of such young children. I hope and pray that Maria’s family and friends find the strength to replace the love and nurturing typically given by a mother to her child. My second thought as a fertility doctor was that once again – the world of infertility was making the news because we continue to push the edges of what society views as acceptable.

This is one of the hardest things about being a doctor in a cutting edge field such as reproductive medicine. We are often put in the position of making decisions with our patients that have even bigger implications to society than the individual patient. I do my best to look at each patient, and each situation individually, but I do rely on my patients to treat me as honestly as I treat them. It is a two way street – and unfortunately, Maria lied to the clinic about her age, telling them she was only 53 years of age.

Questions are being raised regarding the responsibility of the IVF program to verify the veracity of information supplied to them by their patients in addition to confirming their health condition to carry a pregnancy.

Others add that beyond a certain age, it is unnatural to become a mother and it puts the family at risk that she may not be around to help raise the child as what occurred in this case, or even if she is perhaps she lacks the energy and stamina to raise the child properly.

At East Coast Fertility, we had a cutoff of age 50 which was admittedly random and that limit was often broken when faced with an energetic couple with a woman who passes her stress test, medical and high risk maternal fetal medicine clearances. We recently celebrated our latest 54 year old patient’s delivery of a healthy baby that was highly reported in the press.

As I said, it is a struggle to separate my own personal feelings about the proper age to have a child which may be inappropriate for others who have a completely different perspective. My responsibility as the physician offering assistance to patients in need of help with procreation is to the health of my patients, the well being of the child and for the good of society.

Many women in their 50’s have the health and energy to carry a pregnancy and bear a child with no more increased risk than many woman 10-20 years younger whose interest in achieving pregnancy we would never consider questioning. That being said what about the risk that the mother may not still be around to raise the child to maturity.

There is no question that a young healthy couple with sufficient financial support and emotional maturity is ideal for raising a family. But, happy, successful families can take on many different faces. Single parent families exist, survive and often thrive. One can never be certain that the condition of the couple at the time of conception will continue through the child’s birth or for that matter until the child has reached maturity. We do not know that a healthy woman of 30, 40 or 50 may not develop a lethal disease before a child has grown up. In addition, at least 50% of couples in the United States become divorced. One can argue that couples at risk of divorce should not get pregnant. I do not think that society is ready to conclude that any of these women should not be allowed to procreate.

So, what about the clinic’s responsibility regarding confirming that a patient is giving them truthful information? We have been deceived in the past that a couple who is requesting fertility assistance was unmarried when in fact at least one partner was married to someone else. This issue is especially acute as it can raise potential liability to the clinic. As in the case of Maria de Carmen Bousada, she lied about her age and perhaps was beyond the limit the doctors and society was comfortable assisting.

For me and for our program we have raised our bar to do the proper due diligence realizing that we will not be able to get the truth in all cases but minimize the risk that we missed picking up a crucial lie. But I don’t want to be “The Fertility Police”. I am a fertility doctor – and my job is to help people have families no matter how different those families may look to you and me.

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What’s your opinion? Should there be an age limit? Or should it be determined on a case-by-case basis?

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