There is a fine line between technology and ethics. If it’s possible, should it happen? If technology allows a 74 year old woman from Andhra Pradesh to choose to have twins via IVF, then should the doctors go ahead and help her exercise that choice?
In Vitro Fertilization or IVF as a technology is available for the past 40 years in the world and here in India. So should post menopausal women, at any age, not be allowed to exercise it?
FIT reached out to a number of gynaecologists and fertility specialists to get their opinions:
"The prime dictum of medicine is ‘primum non nocere – first do no harm.’ I believe that any such medical treatment or pregnancy that puts the woman at grave risk as in this case contravenes that basic rule of medical care. " - Dr Noser Sheriar
Dr Noser Sheriar is a gynaecologist based out of Mumbai, and a prominent pro women voice when it comes to reproductive rights. When asked if what happened in this specific case, possibly a world record, was ethical, this is what he had to say.
“I believe it is ethical for a post menopausal woman to have a child. Healthy women in their 40s, or even early 50s do have healthy deliveries, and we shouldn’t deny them that right. But as a doctor you have to set limits.” He adds that there is no medical justification for what happened.
Dr Rishma Pai, immediate past president of Indian Society for Assisted Reproduction, agrees.
" Look, social dynamics are changing. Women are healthier, they are fitter. So if a post-menopausal woman wants to have a child, and she is healthy enough, we do stretch it to 50 on case-to-case basis. But at some point you have to draw a line."
“As responsible doctors and clinics, that line should be up to 50 years, as suggested by Indian Council of Medical Research,” she adds, where in exceptional cases it can be extended to 52.
Why This Emphasis on Age Limit?
"We are creators, but we have to be responsible creators," says Dr Surveen Ghumman Sindhu, Director & Head, IVF Max Multi-Speciality Centre.
So why is it okay for 50 year old to have children via IVF and not a 74 year old? There are sociological and economic reasons that are given, ‘like how long with the mother live,’ ‘will the children become care givers to aging parents at the age of 9 or 10,’ ‘who will look after them after,’ etc.
But purely in terms of medical reasons, all doctors we spoke with clearly say it’s irresponsible and dangerous. Not just for the children, but for the woman herself.
"While technology may have allowed it, and donor eggs that were implanted may have been those of a younger person, but her heart, her kidneys, her uterus is still that of a 74 year old! " - Dr Surveen Ghumman Sindhu
Grandparents are left to take care of their grand kids all the time, so it’s not the sociological reasons that concern me, says Dr Sheriar, adding “It’s the health and the rights of the woman per se that should be the focus.”
In this case, the patient had to be kept in intensive case, was monitored through out and needed a battery of doctors on stand by. Would her body, at her age, recover sufficiently from the caesarean and having to carry the twins for 9 months? Would her heart, her kidneys her bones survive the recovery process?
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