A key group representing fertility specialists in the U.S. has shifted its messaging and now says that healthy women over the age of 50 should not be discouraged from trying to become pregnant using donor eggs or embryos.
The American Society for Reproductive Medicine has long said that women older than 50 should be "discouraged" from seeking fertility treatments. But new guidelines, published this month in the Journal of Fertility and Sterility, reverse that stance.
The group now says women between 50 and 55 who are healthy and "well prepared" for child rearing should be allowed to receive donated eggs and embryos.
鈥淭he Committee believes that achieving a pregnancy through egg donation after age 50 is not such a significant departure from other currently accepted fertility treatments as to be considered ethically inappropriate in postmenopausal women,鈥� the group says in the paper.
For most women over 50, pregnancy is not an option, since the average of menopause is 52. While most women wouldn鈥檛 even want to become pregnant after that age, some do, and the ASRM says there is no reason why these women can鈥檛 raise children, as many already do as grandparents.
鈥淭here is, therefore, no reason to assume that society will be harmed by allowing older individuals to procreate, or that older women and their partners lack the physical and psychological stamina for raising children,鈥� the ASRM says in its paper.
鈥淎lso, because older men may father children, denying women a successful alternative for reproduction at ages equivalent to men is prejudicial.鈥�
Nonetheless, the ASRM notes there are physical risks to becoming pregnant after 50.
Dr. Tom Hannam of Toronto鈥檚 Hannam Fertility Centre explains that it鈥檚 not the conception process that鈥檚 risky; in fact, that stage is fairly simple. The prospective mother takes hormone pills for a few days to build up her uterine lining and then the fertilized embryo is transferred to her uterus in a simple in-office procedure.
But it鈥檚 the pregnancy itself that can be difficult, Hannam says.
鈥淭he risks from the conception are not that high. It鈥檚 the complications-risk during the pregnancy that can be concerning,鈥� he told CTV New Channel.
鈥淚t鈥檚 clear that as women age, the health concerns that women have over the age of 50 are more likely to be amplified during pregnancy.鈥�
Those concerns include the risk of hypertension, gestational diabetes and the need for caesarean section. Studies on the small number of women who have achieved pregnancy after 50 suggest all these risks rise for older mothers.
Hannam says it would have to be up to a fertility specialist to decide if a patient over 50 is fit enough for pregnancy.
鈥淯ltimately, it has to be individualized. And when we look to women over 50, one would have to be very careful indeed,鈥� he says.
While the ASRM guidelines are meant for U.S. fertility specialists, Hannam says they will affect Canadian women too. That鈥檚 because since 2004, it鈥檚 been illegal to offer egg donors financial compensation in Canada, so the vast majority of egg donation takes place in clinics in the U.S.
鈥淏ecause it鈥檚 illegal to pay a woman for her eggs, most women who want to use donor eggs are going to the U.S.,鈥� Hannam says.
But he says the guidelines will also help doctors like him in Canada because they give him some literature to refer to patients who are considering pregnancy after menopause.
鈥淚鈥檓 glad there are articulated limits in the U.S. It鈥檚 going to help people make choices,鈥� he said.
