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Long Life, Medical Ethics, and Pregnancy
Even more disconcerting, say experts, is that many prospective parents -- and in particular single, older moms -- may fail to recognize the simple realities of raising children in your 60s and 70s. Indeed, at an age when most of their peers will be selling off their homes and businesses and retiring to Leisure City, many older parents will be knee deep in soccer games, PTA meetings, and making cupcakes for the class bake sale.
An even more sobering thought: How many will actually live long enough to do any of these things with their kids -- and if they don't, how will that affect their children's lives?
"Ultimately you can do all the testing and assess people's health and make a judgment, but you cannot predict longevity," says Lockwood. While the donor egg procedure -- and even the pregnancy itself -- may succeed, Lockwood tells WebMD that none of that means much if the couple is not prepared to deal effectively with life after giving birth.
"If you have a family history of relatively short lives for example, you need to think about that -- just as you need to think about financial and emotional resources to support this child, particularly if there is a handicap involved, when you are not around," says Lockwood.
Indeed, even comic David Letterman -- who became a dad at the age of 56 -- frequently jokes about teaching his toddler how to push a wheel chair as he wonders aloud if he'll even be around to see baby Harry become a man.
Admittedly, however, experts do concede there are many positive aspects to raising a child in your 50s. Brodman points out the value of life wisdom and what you can pass on to a child as an older parent is priceless.
Additionally, he says that most women who go through the rigors of getting pregnant at a late age are generally so highly motivated, they make excellent parents.
But both ethicists and medical experts alike say the point no one can ignore is how little we know, not only about the immediate health implications of late-age pregnancy, but how it will affect family structure, as well as the mother's future health.
Some studies have already shown that the risk of breast cancer increases the older a woman is when she has her first child and her last child. Lockwood says his files are brimming with anecdotal stories of women who got pregnant in their late 40s with the help of what he calls "unscrupulous medical care" -- and are now severely disabled with advanced lupus, an inflammatory autoimmune disease that affects various part of the body.
Pisarska also expresses concern: "We already know by the increased risk of complications that the body is telling us to some degree that it is not comfortable sustaining a pregnancy at a later age -- but in reality it will likely be 10 or even 15 years or more before we have the kind of data that tells us what this really means -- and what the true risk picture really looks like for late-stage motherhood."
For Brodman, the bottom line is this: "At the end of the day, all things being equal, it's better to have kids at 25 than 45; it's better to have one kid at a time than three times at a time; it's better to use your own egg than somebody else's egg. But it's also safer to walk than drive -- and in the end much of what makes life worthwhile involves taking risks."
The older women who are doing that now, he says, are the ones who will ultimately tell us whether or not we are pushing the envelop too far, and if so, when we should stop.
While some fertility centers already refuse patients older than 49, others have more open policies, choosing to make decisions on a case-by-case basis.
However, all our experts told WebMD that any woman seeking to get pregnant after 40 should seek the guidance of a reputable fertility center, as well as getting a clean bill of health supported by reliable medical testing, including a Pap smear, mammogram, electrocardiogram, blood screening, and an extensive family and personal health history. In most instances, doctors say a psychological profile and at least one meeting with a reproductive psychiatrist or therapist can help a couple further determine if advanced age parenting is really right for them.
Colette Bouchez is the author of Getting Pregnant: What You Need To Know Now.
Published Dec. 23, 2004.
SOURCES: Frederick Licciardi, MD, associate director, NYU Program for IVF, Reproductive Surgery, and Fertility, New York City. Michael Brodman, MD, chairman, obstetrics, gynecology and reproductive science, Mount Sinai school of Medicine, New York City. Margareta D. Pisarska, MD, co-director, Center for Reproductive Medicine Div. of REI, dept. of ob-gyn, Cedars-Sinai Medical Center, Los Angeles. Charles J. Lockwood, MD, chair, department of obstetrics and gynecology, Yale School of Medicine, New Haven, Conn. Centers for Disease Control. CDC, "Births, Preliminary Data for 2003." Obstetrics and Gynecology, 2004, vol 104: pp 727-733. "Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age," The Journal of the American Medical Association, November 2002; vol 288: pp 2320-2323.