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Archive for January, 2010

Yesterday I talked about how loathe I am to have government legislation involved in my fertility decisions.  I promised today I would finish that train of thought with “how old is too old” for IVF.   

So, what about age limits on fertility treatments?  Many countries have a limit of 48 or up to 50-something years old.  Some clinics also have their own limits (not mandated by the government).  What is fair?  What is ethical? 

Of course we have to consider the children born to these mothers.  What is the impact on them?  Again, I think it isn’t a one size fits all answer.  

By the way, I completely support that a clinic should have the right to have age limits based on their medical judgement – and I’m even happier when I hear that they consider it on a case by case basis.  I just feel that is how medicine should be approached since everyone and every circumstance has different nuances.

Men have certainly been procreating well past 50 years old, and no one bats an eye.  I’ve never heard of a fertility clinic refusing to take sperm from a male over 50…or over 60, or at any age.  Granted, the genetics are different for men.  But let’s be realistic – most women in their 50s are using donor eggs – so the genetics are of a 20-something year old woman’s DNA which reduces the likelihood of birth defects.  So, if it isn’t the genetics, is having an age limit for women and not for men a double standard? 

I certainly know plenty of women in their early 50s that are far healthier than many women in their 30s. And I know a lot of older women that are much better mothers at 40 and 50 than they would have been at 20.  So, should age really be the primary deciding factor?    

Some would argue that the mother in her 50s is likely to die sooner and leave the child motherless.   However, a healthy 20 year old could die tomorrow too.  What about a young woman who has unhealthy habits that put her at risk (smoking, drugs)?  Or a 20 year old woman who has had cancer that may have a greater risk for early death?  Would we consider limiting their access to fertility treatments because of what “could” happen?  Surely not.   

There are no guarantees that any of us will live to a certain age.  And does the answer change if a women is single with a great support system or one that has a younger husband or partner to also parent the child?  I think it isn’t realistic that any of these other critical factors would be considered if an age limit were legislated or mandated.  

I would hope that any woman considering fertility treatments would work with her doctor to assess her current health and her ability to safely carry a baby to full term and care for it – then use that information to make a well-informed and thoughtful decision.  Additionally, anyone (male or female and at any age) expecting a child should be thinking about protecting that child and planning for their future – including creating a plan in the event that the parent dies.   

And for the people who say that pursuing any kind of fertility treatments (at any age) is just interfering with God’s will, I would like to point out that most medical technologies were met with early resistance.  Yet, most of us would not think twice about using antibiotics, cancer treatments, viagra, insulin for diabetes or other medical intervention. 

We have been given the intelligence to discover these technologies, so aren’t we showing a disregard for life if we don’t allow access to them? Your opinion may differ, and I respect your right to have that opinion. But I am frustrated when I hear that someone is willing to use birth control or other medical intervention & treatment, but is vocal that fertility treatments are unconscionable and wrong- not just for themselves, but for everyone else too.    

So, back to my original thought.  Is some arbitrary age really something that we want as part of a legally mandated reproductive criteria?   

I truly believe that reproductive treatments should up me and to my doctor’s medical and ethical judgment based on my specific case, rather than mandating across the board rules and regulations.  So, even though today I don’t personally think I’d want to have a child in my late 50s, as long as society is trying to take away my reproductive choices, I think I will likely fight to retain that ever so tiny level of control and choice in this completely out of control journey that is infertility.

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The recent news of the milestone birthday of the Octuplets, and the story of a 59 year old British women electing to do IVF seems to have the online world all a-buzz  about fertility regulation.  And so many people are coming out with very strong opinions demanding regulation. 

What happened to the concepts of “my body, my choice”?  Why doesn’t that apply to fertility treatments too? 

Many voices seem to be calling for greater oversight and regulation of IVF – both in the US and abroad.  But really, is that what we want or need?  I’m not so sure. 

In many countries that have tightened their fertility regulations, they have literally forced patients to go abroad for services.  Either because certain procedures were no longer allowed or severely limited, or because the wait lists became so long that patients with ticking biological clocks simply can’t wait for years to have their treatments.  Do we want the US (or global) regulations to reduce access for everyone?  I don’t think so! 

Let’s tackle the concern about how many embryos should be transferred.  In my opinion, it should be however many embryos my doctor and I decide is best for my case at that time–not what Senator X or Government Organization Y decides (neither of whom generally have a clue about this technology).  Do I think it is prudent to only put back as many embryos as a mother can carry?  You bet!  But I want the right to make that decision with my doctor.

I also think that if IVF was less expensive (by insurance coverage or other methods to bring down the cost), more patients would take a more conservative approach and maybe even opt for E-SET (elective single embryo transfer).  But let’s be fair – if you only have enough money for one IVF cycle, the chances are you may be more aggressive and try to put back more embryos to increase your odds of success.  

I think cost has been one of the main reasons why so many patients are turning to countries in Europe & other areas for IVF services.  The costs are most certainly lower than in the US – but each country (and clinic) may have their own regulations about what is allowed, so it is always best to do your research in advance so you are well-informed about what is legal and available.  

Bottom line, I don’t want the rare exception (like Octomom) to create an outrage that generates legislation that effectively impacts the ability of the rest of us to make our own well-informed and well-reasoned choices.   Do you?

This has turned into a rather long post, so I’ll postpone sharing my thoughts on the “how old is too old” dilemma until my next post.

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Well, I’m back after a long radio silence.  Do you ever just need some time to process and re-group?  Well, that’s my excuse. 

So, I’m back, but this time, I’ve decided to take a slightly new approach to this blog.   Instead of just talking about my journey, I want to start sharing more about what I’ve learned about doing IVF outside of the good ole USA. 

Perhaps something I say will in some way help other fertility warriors along the way–those exploring or doing IVF,  donor egg IVF, donor embryos, surrogacy or any other fertility treatments abroad.  And I welcome your comments or questions as we go along together in this journey.  

One thing I want to say up front…I will try very hard to ensure that there are no judgments here. I truly believe that each person has their own path and you should feel comfortable exploring your options and then making informed decisions about your fertility choices based on what feels right to you for your family. I have realized after many years in infertility circles, the controversies abound and the passions run high – after all, most of us are in some phase of disrupting our hormones.  So, while I may touch on “hot topics” or controversial topics (such as “how old is too old”, single mothers by choice, donor disclosure, pre-implantation genetic testing, gender selection, selective reduction, what to do with frozen embryos, etc.) my goal will be to present balanced information and let you, the reader, make your own decisions.

I have now personally worked with more than 50 women (and often their partners) helping them facilitate their IVF treatments abroad. In addition, I have recently started a big research project about “fertility tourism” – exploring the treatments, costs, success rates and other details about ART (assisted reproductive technology) across the globe.  Along the way, with much time, money & research invested, I’ve learned (and continue to learn) more about this subject than I ever would have imagined when I started this journey planning my own treatments.

As a thank you to those who have generously shared with me along the way and as a sort of “pay it forward” to anyone else in this process, I hope that what I’m sharing will be valuable and help you in some small way in your path of achieving your dream of having a baby.

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