In the first half of the 20th century, the onset of menopause was welcomed by many women as a release from continuous pregnancies caused by unprotected intercourse. With effective contraception and the social trend of delaying childbirth till the late thirties or even forties many women find themselves subfertile towards the time and would want to try conceiving till or even after menopause. Utilizing the continuous advances in assisted reproduction technologies, physicians are now able to achieve conception in many couples who would have been incapable of doing so a few decades ago.
A woman’s reproductive age, once a dictate of nature, has now been artificially extended. The reported success of oocyte donation to older women makes pregnancy feasible in virtually any woman with a normal uterus, regardless of the age or absence of ovaries and ovarian function. With many of their career responsibilities behind them, older parents often have more time available to devote to raising their children. With the improved standard of living and increase in life span, a woman who becomes a mother at 50 could raise a child for much longer than was true before.
Egg donation is one of the newest forms of family building and many of these couples are able to conceive a child who is genetically related to one of them. The intended parents attempt to achieve a pregnancy using the male partner’s sperm and eggs provided by an oocyte donor.
Pregnancy complications in older women It is important to pay attention to pregnancy complications in older women. Some of the common risk factors are increased propensity to develop hypertension, gestational diabetes, preterm delivery, cardiovascular complications, risks related to multiple pregnancy and operative delivery.
However, in a study published in the Journal of American Medical Association researchers concluded that postmenopausal women aged 50 and older have success rates similar to those of younger women when they become pregnant through oocyte/embryo donation. Though the study did note a greater risk of complications during pregnancy than their younger counterparts they concluded that there does not appear to be any definitive medical reason for excluding these women from attempting pregnancy on the basis of age alone.
Medical, psychological and ethical factors weigh heavily in the decision to have a child at any age. Assisted reproduction technologies have created choices for everyone. Proper selection of cases should be made after considering the woman’s health, medical and genetic risks and provision for childbearing. Post-menopausal women should be aware of their weaning fertility potential and counselled about the realistic chances of success with each of the possible treatment options.
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