News that IVF doctors have enabled a seventy year old woman in India to give birth to a baby will undoubtedly provide countless women worldwide with false hope about their own chances of using reproductive technology to become pregnant and give birth. This comes amidst existing critique of the fertility industry regarding its lack of transparency about success rates of treatment.
Jivunben Rabari and her husband Maldhari had been trying for a baby for almost fifty years, and despite being warned of the risks, made the decision to proceed with IVF, resulting in the recent birth of their baby boy, whom they named Lalo.
This makes Jivunben one of the oldest first time mothers in the world. Her doctor, Naresh Bhanushali, was initially reluctant to take her on as a patient:
They came to me a year ago. Initially we were reluctant to do this because of the woman’s age. But they were anxious to have a child, so we decided to go ahead. This case is the rarest of the rare. It is a miracle to see a woman giving birth without any complication.
Not surprisingly, Jivunben was required to undertake intensive preparatory medical procedures to enable her to be able to carry a pregnancy to full term at her advanced age. She was prescribed fertility hormones before the couple’s doctor performed surgery on her uterus in preparation for the pregnancy:
We first made her menstrual cycle regular by prescribing oral medicines. Then we widened her uterus which had shrunk due to menopause. We fertilized her eggs, created a blastocyst and transferred it to the uterus.
Following prenatal screening confirming the absence of deformities, the decision was made to proceed with the pregnancy. The woman delivered the baby by Caesarean section at eight months gestation.
The birth itself was also high risk:
Her blood pressure was high, and we had to deliver the child via C-section in the eighth month of the gestation period.
We had a team of doctors including a cardiologist and a physician on standby … anything could have gone wrong because of her age.
The couple’s story has drawn criticism from fertility doctors who consider that there should be age limits on the availability of IVF for women. Dr Kamini Patel, a doctor working in South Africa has criticised the procedure and stated that in his opinion, IVF is not suitable for women over the age of 52:
There are no rules and regulations yet but there should not be IVF treatment beyond 52 years of age. If a woman is physically, mentally and medically fit ... the chances of getting pregnant is 50 per cent if the uterus is fine.
The doctors in this case must have carried out the treatment on moral and emotional grounds but it is not safe for a woman of that age.
The really taxing part begins after the procedure because the pregnancy itself risks the heart and other organs as it is an extra burden on the body.
The circumstances surrounding this woman’s pregnancy and birth at age 70 are unique and complex. Without assistance, she would never have been able to fall pregnant or give birth. The pregnancy and birth were extremely high risk and required close medical supervision and intervention. Such rare cases however, promoted by the media, can provide women who are desperate to conceive with a false sense of hope about what is possible. After all, if a seventy year old woman can give birth, perhaps someone ten or twenty years younger could as well?
It is incumbent upon the fertility industry to ensure that they provide women with realistic information about their prospects of success or otherwise regarding ART. The reality is that the likelihood of success once a woman is past a certain age is very rare. IVF Australia’s website states that for women under 34 years of age, the success rates for clinical pregnancy and live birth following an embryo transfer using their own eggs is 38.8 per cent, dropping to 5.2 per cent for the likelihood of a live birth for women aged over 43 years. Even these figures are much higher than those published elsewhere.
In Australia, there are no age limits regarding access to assisted reproductive technology, with the states and territories separately regulating this industry. Federally, a national framework has been developed by the National Health and Medical Research Council to provide guidelines regarding the use of IVF more broadly.
One of the focus areas within the framework is the impact on children conceived as a result of ART:
ART may have serious consequences for the person born. Therefore, ART activities should not commence without serious consideration of the interests and wellbeing of the person who may be born as a result of that activity.
In other words, it’s not just women's interests that need to be considered. The interests of the child that may be born as a result of these interventions must also be taken into account. Is there a responsibility to not deliberately bring a baby into the world who is at a high risk of being orphaned at a young age? Is there also a duty to consider what burdens will be placed on a child who will most likely be the sole carer for his or her ageing parents?
Just because technology exists to enable humans to bring about a certain result does not necessarily follow that it should be used to do so. The likelihood of harm to the women and children involved must always precede questions of pushing technology to its utmost limit.