A 74-year-old woman from Andhra Pradesh was recently recorded as the oldest in the world to give birth to twins through in-vitro fertilisation or IVF. While her doctor has said both babies and mother are stable, the medical community has expressed ethical and medical concerns over conception at such an advanced age.

Why this is a concern
The average life expectancy of an Indian woman is 70 and of a man 69, and the medical community has expressed concerns over future of children born to such an elderly couple. The very day after the delivery, the twins’ father, 80, suffered a stroke.

Pregnancy in old age poses multiple risks — hypertension, diabetes, convulsions, bleeding, and cardiac complications to name a few. Moreover, the womb of an older woman has to be prepared by injecting hormones to the foetus to grow for nine months. Also, a woman of that age cannot breastfeed.

Can a doctor face action?
Several experts have demanded punitive action, saying the Indian Council of Medical Research (ICMR) should deregister his Andhra Pradesh centre. But with no law in place — a Bill is pending — the assisted reproductive technology (ART) industry continues to operate in a grey zone.

In 2005, when ICMR drafted guidelines for ART, it had not set an age limit keeping in mind that reproductive rights were a fundamental right for a woman.

In the absence of a law
Globally, an estimated 15% of couples are infertile. The Assisted Reproductive Technologies (Regulation) Bill, 2010, states that in the Indian social context, children are “old-age insurance”. The Bill proposes the upper age limit at 45 for women and 50 for men to undergo the IVF procedure. As of now, several centres rely on ICMR’s 2017 guidelines that recommend the same age limits. Even for adoption, the total age of the couple must not exceed 110 years.

With increasing life expectancy, doctors are in talks with the government to increase the IVF age limit to 50-52 years for women. Until then, several experts self-regulate, some counsel senior citizens to drop the idea, and others refuse them IVF treatment.

The counter-view
Societal pressure to have children, the fear of living without support in old age, and the loss of an only child often encourage couples. Some doctors argue that childbirth is a personal decision and each individual has the right to make that choice after counselling.

Still, a doctor has to conduct tests for the heart, bone structure, diabetes, blood pressure to judge the feasibility of pregnancy.

Laws in other countries
Most countries that have a law range the upper limit for IVF between 40 and 50 years. In the US, the upper limit for IVF is 50, and for ovum donation, 45. In Australia, guidelines prohibit IVF beyond menopause (52 years). In the UK, 42 is the age limit for women to seek free insurance under National Health Service. In Canada, the age limit is 43.

Source: The Indian Express