How old is too old to have a baby?

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Age limits needed
My proposal is that anyone over 65 who is single should not be allowed to use reproductive technology to have a child. If you have a partner, then your total ages should not be more than 130. And if you are a female at or near 55 years of age and hoping to become pregnant, then you should only be allowed to use reproductive technology if you can pass a rigorous physical examination. At age 66, forget it.

So, who will enforce this age limit? Should we enact a law or can we leave it up to doctors at individual infertility clinics?

As it happens, I co-authored a recent survey of American reproductive technology programs led by Andrea Gurmankin of Harvard Medical School, which was published last week in the journal Fertility and Sterility. The survey asked a number of hypothetical questions of clinic directors to try and figure out which values doctors use to decide who can and cannot use reproductive technology to become a parent in the United States.

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One question we asked was whether clinics would turn away couples in which both parents were 43 years old. Most would not turn them away, but a surprising 18 percent of clinic directors said they would. Twenty percent said they would not help a woman who was single become pregnant, while 53 percent said they would not deal with single men.

Age was not the only disqualifier. Three percent of programs said they would not accept a couple who were both blind from an accident. Seventeen percent would turn away women who state they are lesbians, while 38 percent said they would not help a couple who were on welfare and using social security checks to pay for infertility treatment.

Government should step in
Clearly there is quite a lot of screening already going on at fertility clinics. Some programs don’t care much about age or whether a patient is single or not, but others do.

If there is an age at which it makes sense to declare someone too old to use reproductive technology — and I strongly believe there is — then who should enforce this age limit? If you leave enforcement up to individual clinics they may decide to implement the rule, but given that their current screening practices are all over the map, this seems unlikely.

In light of the high risks at stake, the medical profession or state legislators should act. The race to create the world’s oldest mom should be declared over.

Arthur Caplan is director of the Center for Bioethics at the University of Pennsylvania.

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