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Understanding postmenopausal conceptions

18 November 2002
By Juliet Tizzard
Director, Progress Educational Trust
Appeared in BioNews 184
In this week's BioNews, we report on a paper published in the Journal of the American Medical Association which shows that postmenopausal women having egg donation are just as likely to conceive as younger women. Although we've known it for some time, the study confirms that it is the age of the donor eggs, rather than the age of the recipient womb, which is the important factor in conception. As long as a younger woman's eggs can be used, their postmenopausal sisters can be mothers too.

Following the publication of the findings, many American newspapers have reviewed the ethics of postmenopausal mothers.

Roberta Springer Loewy of the University of California at Davis, disapproves of such uses of reproductive technology. 'Simply because we find we can and want to do something doesn't mean we ought to do it,' Loewy said. Meanwhile, Ruth Faden, a bioethicist at Johns Hopkins University, observed: 'We're trying to improve people's quality of life as they age on every dimension. Why should the reproductive arena be different?'.

Of course, one thing that this study does not do is to resolve the ethical disagreements. But it does clarify some of the issues for older women thinking about using IVF and egg donation to become a mother. As the study shows, conception rates in younger and older American women using egg donation may be comparable, but the associated risks of pregnancy in women over 50 are considerably higher. The incidence of caesarean sections, pre-eclampsia and gestational diabetes are all higher in postmenopausal women.

This information is useful for older women thinking about whether or not to proceed with postmenopausal egg donation. But British women may wish to consider one further thing: the women in the American study had, on average, three to four embryos transferred to their wombs in order to achieve a pregnancy. The maximum number of embryos which can, by law, be transferred to a women receiving treatment in the UK is three - and one or two is becoming the norm. As a result of the higher numbers of embryos transferred, a third of the births in the American study were of multiple babies. In a country like the UK, where clinicians more often seek to avoid multiple births, the success rate of postmenopausal egg donation is likely to be lower.

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