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How old is too old? Age limits for access to assisted reproduction

20 July 2015
By Associate Professor Hana Konečná
Faculty of Health and Social Studies, University of South Bohemia, Czech Republic
Appeared in BioNews 811

In 2011 the Czech Republic was preparing to change the law regulating assisted reproduction technologies (ART). One of the first proposals was to impose an age limit for women of 55 years (but no age limit for men). Before this, there was simply a recommendation from the Czech ART Ethics Committee that access to such treatments should be limited to women under the age of 47. The main arguments for the higher age limit was that it would respect women's reproductive rights and also there are benefits to late parenthood. But, in the words of the 1980s Czech hard-rock band Katapult, 'How about the children – do they have a place to play?' My colleagues and I decided to ask the children.

In a short questionnaire, respondents were asked the following questions: 'Thanks to the technological advances of contemporary medicine, people have a chance to freely decide when they want to have children. However, children cannot choose the age of their parents. How old would you like your mother and father to be when you turn 20 (for respondents younger than 16 years) or 25 (for those aged 16 and over), if you had a magic wand? Why?' Almost 1,200 children and young adults aged between 11 and 25 years old responded to the survey. We were taken aback by the results: 89 percent of respondents would prefer their mother to have had them before the age of 30 (the most preferred ages were 20–24), and 94 percent of them would prefer their father to have had them before the age of 35 (the most preferred ages were 25–29). The older the respondent's parents, the younger they were made by the magic wand. It was very touching to read the answers to the open-ended question 'Why?'. Children's responses were sometimes loving, sometimes critical and sometimes harsh. Even though they were often child-like in their formulation, we found them mature, valid and wise. (You can read them for yourself in our article 'How old is too old? A contribution to the discussion on age limits for assisted reproduction technique access'.)

Reactions of our Czech as well as foreign colleagues and other specialists to the research were more surprising than the results. Interestingly, the results themselves were not challenged – we all somehow think that it is better to have young parents. But we were questioned on our methods – the magic wand cannot be a tool for serious research, it was argued. Then the validity of the results – its practical value – was questioned. The most common objections were: 'Children have a poor perception of time', 'Children do not understand the course of life', 'Kids are not rational', 'We should not jump just because kids whistle'.

The methodological doubts have been countered in our previous article 'Can a magic wand plausibly be used in serious psychological research?'. Before our research was complete, the Czech law regulating ART was approved with an age limit of 50 years for women and none for men – a whole generation above the age preferences of the children we surveyed. We do not suggest that society should crawl into people's bedrooms and determine when they can or cannot have children. But we believe that if society (in the form of technology) intrudes into people's lives then the discussions about risks and consequences cannot be limited to the question 'Is a person in this age able to bring a child to adulthood without any serious damage?'. The parent-child relationship is much more complex and not limited to a period of 20 years.

When dealing with bioethical problems, ethicists stress the necessity of balancing gains and losses for individual. Professor Salman Rawaf, at the Seventh Geneva Conference on Person-Centred Medicine in 2014, identified 'high expectations and increasing demands' as one of the biggest challenges for health systems. 'Managing patient expectation' in fertility treatment is assumed to be one of the most effective support techniques. Maybe the discussion about the age limits for ART should be broadened even further, taking into account society as a whole – including what our children think.

1 August 2016 - by Dr Nitzan Peri-Rotem 
An international forum on 'Changing Fertility - Social, Demographic and Ethical Consequences of Assisted Conception Technologies' held in Cambridge explored changing fertility trends amid the rapidly growing industry of assisted reproductive technologies...
10 August 2015 - by Kirsty Oswald 
All this talk of the age a woman's fertility 'drops off a cliff' is just a distractor from the truth – this phenomenon of women finding themselves 'up against' the biological clock is a cultural one, not a biological one....
3 August 2015 - by Ruth Retassie 
Researchers have developed a mathematical model for determining what age women should start trying to conceive...
13 July 2015 - by Dr Sarah Martins da Silva 
Kevin Smith should be applauded for raising awareness of men's biological clocks, but his proposal to 'genetically improve' the human population through sperm banking seems preposterous...
10 February 2014 - by Patricia Cassidy 
A recent poll conducted ahead of a television documentary has shown that one quarter of respondents believed women should stop trying to 'trying to bring babies into the world' past the age of 40...
20 January 2014 - by Professor Cathy Warwick 
The pressure on the UK's midwives is at its highest for decades. In England, for example, there were more babies born in 2012 than in any year since 1971...
2 September 2013 - by Daniel Malynn 
This episode of the BBC's 'The Midwives' documented some of the varying difficulties experienced by older and younger mothers...
1 February 2010 - by Jenny Dunlop 
I have a feeling that whether you work in the fertility field or not everyone has a strong point of view about the upper age that a woman should have fertility treatment and become a mother. Maybe this thought was behind the producers of this BBC documentary that they could challenge all our firmly held beliefs? Or maybe they just thought that it would make contentious sexy television?...
Comment ( - 23/07/2015)
What reproductive rights are there to be exercised by a person who has been diagnosed as incapable of human reproduction?  

Nobody is offering elderly women any assistance in reproducing they are offering them the children of other women who are able to reproduce and are giving them the option of gestating and delivering those other women's children for them, but they are not exercising any reproductive rights by gestating other women's pregnancies.

We can only exercise our own reproductive rights not those of other people.  A woman does not have a right to reproduce another woman's body.  She has the right to gestate someone else's pregnancy if they allow her to but that is not reproduction that's gestation and child birth.  The person whose genes are reproduced is reproducing and exercising their reproductive rights.  Generally they are young and healthy enough for reproduction.  There should be no restriction or age limit on a person's reproductive choice but that choice and those rights don't extend beyond their own body and their own reproductive ability.

The argument that a 65 year old woman is exercising her reproductive rights is absurd unless her own frozen embryo is implanted into her body producing her own genetic offspring.
I agree I'd have made mine younger too but that's not at issue here ( - 23/07/2015)
My parents were really old when I was born, nearly 40.  My brother is fifteen years my senior.   My mother's mother was nearly 40 and her father was 45 when she was born.  My father's parents were both in their 30's when he was born.  I always wished they were younger, but they really are my parents I'm their offspring and they did a fine job of raising me.  I've known older adoptive parents who do a wonderful job as well.  People should not be restricted from having children based on their age.

People should be restricted from pretending they had children at any age when really they are just delivering and raising some other person's kid but failed to write the truth down.  Having children at 50 is fine if you are really having your own children good for you.  Adopting them at 50 is fine as well but don't do one but lie and say you did the other just because you gave birth - that's a shady and inaccurate definition of the term "to have children".  Who reproduced, who has offspring, who had but relinquished rights, title and custody?  If it were the old people having kids there  would be no contracts right?
good questions ( - 23/07/2015)
Is a person of this age able to bring a child to adulthood without doing any serious damage is an interesting question but it has nothing to do with fertility or biology and so can hardly be a subject for bio ethicists to ponder, like whether its ethical to fertilize monkey eggs with human sperm or something - that has biological and ethical components as a topic.

Also if you were venturing a guess on the damaging potential of being raised by an old drunk child molester or a young drunk child molester, age really becomes irrelevant doesn't it?

The question isn't what age is it wrong to 'use' an egg donor to get a baby, it's wrong to commission the absence of a parent from a person's life and it's wrong to be absent from your child's life as a parent as some kind of altruistic or commercial exercise.  Children are people who have a right to care by their own parents rather than some person that wanted them so badly they would special order a tragic separation of a child from his or her biological parents.

Commodification of human beings and their identities is wrong no matter what the age of the parent or the would be commissioning care giver or birth giver.
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