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Times of India
21 June 2010
By Priya M Menon
Chennai, India

Doctors Debate Medical, Ethical Issues Of IVF For Older Couples
Less than a week ago, 66–yearold Bhateri Devi of Haryana gave birth to triplets with the help of in vitro fertilisation (IVF). A few days later, a 55–year–old woman from Maharashtra gave birth to a boy after undergoing the same procedure.

An increasing number of elderly couples are turning to IVF to have babies. Though the success stories are hailed as medical achievements, doctors are divided on the ethical and medical issues. Are parents truly keeping in mind the interests of the child? What impact does this have on the elderly mother and child?

"Scientists the world over are divided on the issue," says fertility expert Dr Priya Selvaraj of GG Hospitals. "Some doctors feel every woman has the right to give birth, but the interests of the child should not be ignored."

Her centre refuses cases where the mother–to–be is over 50. "You have to take into consideration the longevity of parents and the security they can offer the child," says Dr Priya. "The future of the child is all–important."

Dr T Kamaraj of Akash fertility centre and hospital has a different take. "My oldest patient was 60. As long as the woman is healthy, she can try IVF," he says. He doesn’t see the age of the parents as a problem. "People have greater life expectancy now. When they finally have a child after years of trying, parents find the energy to look after their new–born," he says.

At present, there is no law that specifies an upper age limit for parents. The Indian Council of Medical Research has a set of guidelines but no age bar. And that’s what some doctors are asking for. "There should be some kind of upper age limit, maybe 60, in the interests of the baby," says fertility specialist Dr Geetha Haripriya.

With more awareness, IVF specialists are seeing more elderly patients even though the process costs upwards of Rs 1.5 lakh. "We get at least five requests a month from patients aged between 45 and 58," says Dr Geetha. At her centre, the cutoff age for prospective mothers is 58.

"We assess the health and longevity of the parents and ask what family support they have," she says. "We need to know who will take care of the child in case of any eventuality and what financial arrangements will be made."

Though they are informed about other options — like adoption or using a surrogate — most patients insist on bearing their own children. "People in their 50s want to have children who will inherit their property," says Dr Geetha. "We also get cases where couples who have lost their children want another baby."

For most of the elderly, adoption is not an option. "Most older couples are not open to it," says Dr Priya.

Dr Kamaraj adds that older couples have already explored other options. "A 55–year–old has already thought about adoption and ruled it out. They have made up their minds to try IVF," he says.

Doctors are worried about the health implications since the chances of miscarriage are higher. "When you use the husband’s sperm, chances of genetic birth defects can increase as paternal age has an impact on genetic integrity of the foetus," says Dr Priya.

The birth weight of the babies is also slightly lower than that of other new–borns and chances are that they will be delivered earlier, adds Dr Geetha.

Psychiatrist Dr Vijay Nagaswami says pressure to bear children is high in India, but couples who insist on having their own child at an advanced age have unresolved issues. "There is nothing wrong with having aspirations but they have to be congruent to the stage of life you are at," he says. "Such couples have not come to terms with their life. You should have a child for the right reasons."

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