Maternal age no barrier to ART?
Women who conceive and deliver after the age of 50 years, following egg donation, do not have a reduced parenting capacity compared with younger women, according to new study findings.
Researchers found no significant differences between age groups in physical and mental functioning, and parenting stress, leading them to conclude that advanced maternal age alone should not be a reason to restrict access to assisted reproduction technologies (ART).
The researchers, from the University of Southern California Keck School of Medicine, in Los Angeles, USA, assessed and compared three groups of women: a study group of 18 women who conceived in their 50s after IVF at the center and who subsequently delivered one or more viable infants, plus two control groups of 22 women in their 30s and 24 women in their 40s, matched for a similar date of embryo transfer and for gestational order.
The women completed questionnaires which included the short form of the Parenting Stress Index (designed to measure the degree of stress related to parenting) and the SF-36 Health Survey (to evaluate physical and mental well-being).
In their paper in the current issue of the journal Fertility and Sterility, the researchers report that they found no significant differences between the groups in any of the measures, although the women in their 50s showed a nonsignificant trend towards lower physical functioning scores and higher mental functioning scores compared with the women in their 30s.
The percentage of women with high total parenting stress, above the 80th percentile, varied between the three groups but was not highest in the oldest group: the percentages were 0 percent, 22 percent and 6 percent for women in their 30s, 40s, and 50s, respectively.
Implications for ART access?
Concluding, the researchers write: “In this first study examining physical and mental functioning among women conceiving after the age of 50 years, we did not find significant differences between this group and their younger counterparts.
“Based on these findings and our previous report on the obstetric and neonatal outcomes associated with postmenopausal reproduction [Paulson RJ et al, JAMA 2002;288:2321-3], we submit that there continues to be a lack of data justifying the restriction of access to ART services based on maternal age alone.”
To read more about the effect of advanced maternal age see the related articles Maternal age and Stillbirths (from the ORGYN Online Magazine issue of 27 March 2006) and Pregnancy in Older Women (from the issue of 6 June 2006). The first study, based on analysis of almost 6 million deliveries in the USA, found that women at the extremes of maternal age (younger than 20 years or older than 34 years) were significantly more likely than women of intermediate age to have a stillbirth. The researchers said the increased risk in women aged 40 or over in particular suggested that frequent antepartum fetal monitoring may be warranted.
The second study found that a maternal age of 40 years or over was not associated with adverse maternal and perinatal outcomes, although these women did have higher rates of cesarean section compared with younger women.
Issue 12: 11 Jun 2007
Source: Fertility and Sterility 2007;87:1327-32
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