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Chapter-19 Pregnancies in Postmenopausal Women

BOOK TITLE: Ethical Dilemmas in Perinatal Medicine

Author
1. Schenker Joseph G
2. Eisenberg Vered H
ISBN
9789380704050
DOI
10.5005/jp/books/11363_19
Edition
1/e
Publishing Year
2010
Pages
6
Author Affiliations
1. Hebrew University, Hadassah Medical Centre, Jerusalem, Israel, Hebrew University-Hadassah Medical Center, Jerusalem, Israel, Hebrew University, Hadassah Medical Center, Jerusalem, Israel, International Academy of Human Reproduction; Hebrew University, Hadassah Medical Center, Jerusalem, Israel
2. Hebrew University-Hadassah Medical Center, Jerusalem, Israel
Chapter keywords

Abstract

Changes in modem society have made it more common and acceptable for older women to bear children. Scientific advances and the advent of ovum donation have made pregnancies in older women feasible. The impact of advanced maternal age on the outcome of pregnancy remains controversial. When considering the contradictory physiological processes in pregnancy versus aging it appears that pregnancy in the elderly menopausal woman could constitute a major maternal health risk. On the other hand older women are better educated, have a better economical situation, and are better prepared emotionally to care for a child. Patients should undergo medical and psychological evaluation before participation in an OD program. With appropriate ante-partum and intra-partum surveillance a successful pregnancy outcome can be expected in most cases. The success of oocyte donation is not limited by age. Any woman with an intact uterus is a potential candidate. This raises the question whether certain limits should be imposed in applying the method in older women. Any possible restrictions which may be desired in cases of OD must be based on medical, psychological, and ethical ground. Reproduction is a fundamental right in a free society. Denying oocyte donation to a population of women who must rely upon it to procreate essentially negates freedom and harms women’s reproductive choices. It is essential that guidelines are established so that pregnancy can be achieved with minimal harm to mother and child. Nevertheless, taking into consideration the mother and child’s welfare an age limit should be applied. We believe that this should be 52–54 years of age.

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