IVF for aged couples remains a question of medical ethics, child rights

The news of a 74-year-old woman becoming mother for the first time after delivering twins in Andhra Pradesh has triggered a fresh round of debate over the ethical issues concerning in vitro fertilisation (IVF) procedure for aged couples beyond 50 years of age.

The woman, and her 80-year-old husband were yearning for having children for over five decades. And on September 5, E Mangayamma and E Raja Rao of Draksharamam in East Godavari district of Andhra Pradesh became parents to twin girls, following a caesarean section in a private hospital in Guntur.

At 74, the woman is said to have broken the Guinness World Record set by a Spanish woman who had a similar pregnancy and was delivered her first child at the age of 66, in 2006.

In the last three years, this is the third such case in India. In 2016, a 72-year old from Hisar (Haryana) and in 2018, a 63-year-old from Erode (Tamil Nadu) realised their dreams of having their own children through advanced medical technology.

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While in such cases the parents often have to battle social stigma of being childless, doctors and activists point out to the lack of ethics that concern late pregnancies.

According to Dr. Kanimozhi K, a senior consultant at Apollo Hospitals, there is absolutely nothing to be happy about the 72-year-old delivering twins in Andhra Pradesh.

Stating that the incident has now become a talking point in groups of fertility experts on social media, she says, “When a woman becomes pregnant after 40, we say it has severe health implications. How will they provide care and nourishment are huge concerns. In this case, how is she going to be feeding them or raise them until they turn 18 years?”

Another doctor, who was instrumental in helping the couple from Erode have their first child last year, says that it is up to the aspirations and desires of individuals. “Such couples are counselled about the medical and social implications of such pregnancies. The Erode couple were willing to go ahead with their decision,” adds Dr. Senthamarai Selvi.

Dr. Selvi also shares the example of a 60-year-old woman whom she helped with IVF to have a child — a boy — in 2011. “She is still healthy and visits me every year on the boy’s birthday. When the parents are psychologically prepared for it, who are we to deny them the dream they have been yearning to realise,” she adds.

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A clear violation of ICMR guideline?

According to Dr. Nandita Palshetkar, president, Federation of Obestetric and Gynaecological Societies of India (FOGSi), the case is a “terrible example”. She says that it is a blatant violation of the Indian Council of Medical Research (ICMR) code that has a guideline for restricting IVF cycles to 50 years.

“There are around one-two lakh IVF cycles being carried out in the country. A case like this can set a bad precedence and put the whole technology under a cloud of doubt. We need to stop glorifying them to send across a strong message,” she adds.

Across the world, there are stringent rules when it comes to age restrictions for assisted reproductive technology, says Dr. Priya Selvaraj, scientific and clinical director, GG Hospitals. “And it’s time for India to be prudent with such rules as well,” she adds.

“We can call it an achievement or record only when there is benefit of health — in the form of a cure or new procedure. Such cases bring shame to the technology and is a clear violation of guidelines just to prove that the couple is not barren. There is no concern for the children,” Dr. Selvaraj adds.

According to experts, the Assisted Reproductive Technology Bill aims to set an age limit for such procedures, ensuring a better compliance.

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Disregard for child rights

As per child experts, this case is one of the most glaring examples of how child rights are thrown to the wind for the benefit of individuals. Further, they note that even adoption rules in India are clear about having an age cap of 55 years for parents.

Even doctors question the lack of sensitivity when it comes to the fulfilling the needs of the children. “Who will take care of them in the event of their parents’ death?” questions Dr. Selvaraj.

It’s not about the possibility of the children being ridiculed or facing insults, points out Girija Kumar Babu, secretary, Indian Council for Child Welfare, Tamil Nadu. But, she says it’s a violation of child rights.

“I hope they have nominated someone to take care of them in the event of their passing away. I am not even talking about the possibility of the society ridiculing them or making fun of them — it might or might not happen. And, it will be a tough life for the children as well,” she adds.