March 30, 2017
The inside view from a reproductive endocrinologist
New mother-to-be at age 66. What do you think?
I feel bad for her child, as she will likely not live to see her child enter adulthood. While there’s no guarantee that any of us will live long enough to see our children into adulthood, starting at 66 seriously decreases the odds.
i agree…but totally jelous too
Here is my take on the subject of post-menopausal childbearing.
Older mothers: When is late too late?
Ever since Sara in the Book of Genesis purportedly gave birth at the age of ninety, women who conceive and manage to carry their pregnancies to term after the so-called change of life have fascinated the public. Their resulting childbirths have been viewed as “lusi naturae” (Latin for “jokes of nature”) or, for the religiously inclined, signs of divine intervention. In the last two decades or so, though, the feats of these contemporary Saras have been seen less as acts of nature or God than of modern medical technology. Thanks to a procedure called ovum donation, whereby an egg is extracted from the ovaries of one woman (the “donor”), fertilized by a man’s sperm, and implanted into the uterus of another woman (the “recipient”), infertile women unable to produce eggs of their own can now bear children. The children themselves of course will be the genetic offspring not of the recipient who gives birth but of the donor who provided the egg in the first place.
When the procedure first emerged in the 1980s most recipients were married women in their thirties and forties who had experienced premature menopause. Now however a considerable number of them are single and in their fifties and sixties. (There was one report of a woman who bore a child at seventy, but as she lacked a valid birth certificate her age could not be verified.) An example was Maria del Carmen Bousada de Lara, a Spanish woman who gave birth at sixty-six to twin boys. Trailing close behind her was Adriana Iliescu, a Romanian professor who at the same age minus some days had a little girl.
These post-menopausal matriarchs have, not surprisingly, stirred up considerable controversy. A frequent comment is that childbearing in the sixth decade of life and beyond is unnatural. Some critics, such as the Roman Catholic Church, oppose all artificial reproduction. On the other hand, many people who would have no problem with a thirty-year-old woman turning to in vitro fertilization in order to conceive might draw the line at a fifty- or sixty-year-old doing the same.
I must admit being a bit disconcerted by a recent picture of Adriana Iliescu at seventy, walking hand in hand with her three-year-old daughter and looking like a caricature of an elderly woman desperately clinging to youth with her bright red lip gloss and dyed black hair over her wrinkled face. That she is the young girl’s “mother” rather than grandmother does seem to violate the natural order. Yet a part of me bristles at the word “natural.” Much of what women do in their reproductive lives today, from using birth control to terminating pregnancies to conceiving via artificial insemination, is hardly natural. My own procreative odyssey veered from the natural when I gave birth to my daughter by caesarean section. If we had simply let nature take its course would likely have meant death for us both. Therefore it might be hypocritical of me to criticize women who also seek the services of what modern medicine has to offer.
Another area of concern has to do with the age of the women in question. Is a fifty- or sixty-year-old really up to the task of walking a colicky baby, running around the local park with a toddler, or playing ball with a six-year-old? Many would answer “no.” More importantly, the risk of a post-menopausal woman dying before her child reaches adulthood is statistically speaking much greater than that of a twenty-, thirty- or even forty-year-old. This fear was borne out by the recent death of Maria del Carmen Bousada, who died of cancer at 69 leaving her two-year-old twin sons behind (fortunately a nephew of hers, the boys’ godfather, will be taking care of them).
A counterargument is that men can and do become parents in their twilight years without much commentary. A famous example was the late actor Tony Randall, who fathered two children with his second wife when he was in his late seventies. One difference is that the majority of elderly fathers have pre-menopausal wives, so there is a good chance of there being one parent around for the children as they grow up. However, even in this case one could say that because it is difficult for a young child or teenager to lose either parent, women shouldn’t be condemned any more – or less – than men should for deciding to procreate at an advanced age.
Women who resort to egg donation are occasionally asked why they don’t adopt instead. Some people with reservations about older women deliberately getting pregnant are more accepting of the latter providing a home to an existing child. In reality, though, adoption is complicated even for couples in their twenties and thirties (shortage of available children, huge expenses, and the possibility of the birth mother changing her mind); with the added burden of age limits set by many adoption agencies and some source countries, achieving parenthood via this route may be virtually impossible for a woman of sixty, especially if she’s not married.
Yet sometimes one gets the impression that even if adoption were more feasible many of these women would still choose to undergo egg donation so as to experience pregnancy and childbirth. I personally fail to see the psychological advantages of egg donation over adoption. Women like Iliescu and Bousada have no genetic relationship to the children they bear – barring the rare occasion where the egg donor is a blood relative of the recipient – and other than gestating and giving birth do little that an adoptive mother can’t. (By the way, adoptive mothers can breastfeed – though they usually have to supplement their own milk with formula.)
One might also wonder why older egg donation recipients did not try to reproduce in their younger years when they were physically capable of doing so. Maria del Carmen Bousada claimed she was taking care of her own mother until the latter’s death at 101, which may have led Bousada to believe that she herself would have lived long enough to at least see her kids off to college. Adriana Iliescu had two abortions during a brief marriage in her twenties. Though Bousada may have had a point when she told a British newspaper that “everyone should become a mother at the right time for them,” I can’t help thinking that it might have been easier for everyone involved – the women themselves, the babies, and their extended families, who, as in Bousada’s case, will often be the ones taking charge of the kids in the event of their mother’s demise – if their reproductive careers had begun sooner than they actually did. An added bonus of earlier childbearing too, for those to whom heredity is important, is a genetic connection to the resulting offspring.
The question of post-menopausal reproduction is of some personal interest to me as my naturally fertile years draw to a close (I’m forty now). I am fairly certain that in the very minute likelihood I try to have more biological children, if I find myself unable to do so I won’t turn to medicine to help me achieve this goal. At thirty or even thirty-five I might have done so, but at this point in time forcing a pregnancy when my body is saying “no” does appear to be pushing the limit. If I ever decide to expand my family, adoption – giving a home to a child already in the world – strikes me as the more sensible option.
For all my ambivalence, I cannot condemn women who undergo egg donation after menopause. I’ve certainly defied nature enough during my own reproductive life (using birth control, having a caesarean, etcetera). And I don’t think the law should become involved in the matter. Fertility clinics can use their own judgements as to whether or not to accept women past a certain age. But between proclaiming there is a set timeframe to procreate and encouraging people of any age in any circumstance to have babies should lay a happy medium.
I find it interesting that we do not have this conversation when it comes to male reproduction. Why do we want to discriminate on the female side of reproduction? What if she does not survive tosee her child grow up? What about the dads? We should be looking at this equally from a female and male perspective. Men should not get preferencial treatment just because they don’t need help after 50. It seems society thinks reproduction for men in this age group is acceptable just because they can.
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