In 2017, a woman in Haryana, believed to be at least 70 years old, reportedly gave birth to a son. Incidentally, this was the first baby for Daljinder Kaur and her 79-year-old husband Mohinder Singh Gill after nearly 50 years of marriage. In fact, the clinic where Kaur underwent in vitro fertilization (IVF) had also helped another woman, Rajo Dev, give birth to her daughter in 2006 at the age of 70. Similarly, in 2019, a 73-year-old woman, Mangayamma Yaramati of Andhra Pradesh, gave birth to twins with her 82-year-old husband Sitarama Rajarao, thanks to IVF. gave birth to a girl.
In vitro fertilization, a type of assisted reproductive technology (ART) used for infertility treatment and surrogacy, is seen as a boon for women trying to conceive, especially in countries where being unable to bear children carries stigma. However, considering ethical boundaries and health;
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Doctors say the main reasons for the age restriction are poor fertility and egg quality, problems with sperm quality and production, and comorbidities associated with advanced age, which put pregnancy at risk for both mother and child. At the same time, legal experts are of the view that the rights of everyone, including the rights of children born from such pregnancies, make age limits an important factor. Within this black-and-white distinction between biology and law lies the gray area of sociology, where personal autonomy and reproductive rights are also a cause for concern and deserve attention.
Related factors
Although many factors come into play, including the patient's age, health status, and type of treatment, experts believe that traditional IVF treatment has a success rate of 25 to 40 percent, and patients with unexplained infertility or infertility35 It is said that it is suitable for women over the age of 3. Blockage of the fallopian tubes. There are various methods of IVF that are customized to meet specific demands. This treatment uses drugs to increase egg production. Natural cycle IVF is also an option for ovulating women, where eggs are collected in sync with a woman's natural menstrual cycle.
There is also the option of minimally stimulating IVF, which uses fewer drugs and is less expensive and risky. If the sperm count is low, there is an option called intracytoplasmic sperm injection (ICSI), which involves injecting live sperm into a person's eggs in a lab. If an older mother's eggs are of substandard quality, IVF using donated eggs can increase success rates. In the case of azoospermia, where there are no sperm in the ejaculate fluid, treatment is performed using ICSI, testicular sperm aspiration/microtesticular sperm extraction (TESA/microTESE), etc. For couples with genetic problems or recurrent miscarriages, doctors say preimplantation genetic testing (PGT), a type of prenatal genetic diagnosis that identifies abnormal embryos, can help identify genetically normal embryos. It is now possible to transfer embryos, potentially improving outcomes.
Despite all these medical options, doctors are discouraging women from pregnancies at older ages because comorbidities such as high blood pressure, diabetes, heart disease, and osteoporosis become more common with age, increasing maternal health risks during pregnancy. Warnings about the potential health risks involved.
“As we get older, egg quality decreases (increasing the risk of chromosomal abnormalities), increasing the chance of miscarriage and chromosomal abnormalities. Additionally, reproductive medicine may reduce the body's aggressive response. Yes, there's no doubt that age is important, but it's not the only factor.
In older women, low birth weight or preterm birth, diabetes during pregnancy (gestational diabetes), high blood pressure (preeclampsia), other pregnancy problems such as caesarean section or caesarean section, and stillbirth are more common, and the loss of the embryo The number will also increase. They are more likely to have chromosomal abnormalities, which can cause genetic problems in their offspring, such as Down syndrome.
“Despite the fact that assisted reproduction techniques make it possible to become parents later in life,
Modification of age limit
Doctors agree that it is difficult to set a general age limit, but the age limits set by the government under the ART Act include risk factors for older couples as parents and the rights of their children. I am aware that this is true. The greater good of society, and most importantly, what is “appropriate” for people in general. They point to general life expectancy, physical fitness level, education, awareness, and morality as factors in setting age limits, while also recognizing that everyone's health condition is different and that doctors can assess and advise accordingly. are doing.
“It is difficult to determine the upper age limit for pregnancy through IVF. Due to the potential risks to the health of the mother and child, India's ART Act has set an age limit of 50 years for women undergoing ART treatment. Compliance with these standards is essential for those considering imposing general age restrictions on consulting a certified IVF specialist or fertility specialist. It is important to assess the suitability of IVF according to each person's health status and circumstances, rather than the individual,” says Dr. Bajaj of Nurture IVF Clinic.
Does this mean that people over 50 should not have children? “That's not true,” says Dr. Rajeev Agarwal, an IVF expert and medical director of Renew Healthcare in Kolkata. “You also have to look at the government's perspective because the government has to make laws that suit everyone. Especially in India, the moment you make exceptions, people find loopholes and abuse the system. ” he added.
Dr. Rupali Goyal, gynecologist and infertility specialist at Apollo Hospitals
Legal objections and reproductive rights
Legal experts have said that imposing limits on age limits raises issues of reproductive autonomy, privacy and family life, all of which are not guaranteed under the article. It is an essential part of rights. Article 21 of the Constitution.
Jaina Kothari, a senior advocate at the Supreme Court, points out that setting an upper age limit is arbitrary. “The right to reproductive autonomy is an integral part of the right to life. Fixing upper age limits for women and men is a violation of this right because it deprives people of their right to reproductive autonomy. Age “Rather than setting an upper limit, the limit could be decided on a case-by-case basis, based on the doctor's judgment of the woman's health and ability to bear a child,” says Kothari.
Recently, the Union Ministry of Health and Family Welfare, in its reply filed in the Supreme Court to a PIL challenging several provisions of the Surrogacy and ART Act, including the upper age limit, stipulates the upper age limit for ART. The reason was as follows. Services under section 21(g) of the ART Act 2021 include ensuring the well-being of the child throughout their care up to the age of 18 and require parents who are healthy and financially stable But this is a responsibility justified by India's average life expectancy of two years. About 70 years.
Incidentally, the 2005 Indian Council of Medical Research (ICMR) guidelines issued by the Union Ministry of Health do not have any recommendations regarding the upper age limit of recipients of egg or embryo donations for IVF.
Advances in science and technology have changed the natural limits of women's fertility, says SC advocate Mohini Priya
“Ferility issues, women's reproductive rights, age limits, consent, evolving laws and regulations regarding human rights, and women wishing to become pregnant beyond the current legal age limit of 50 and men reaching the age of 55. “There is an increasing trend towards over-the-counter pregnancies, which makes the delicate balance between protecting individual autonomy and safeguarding the welfare of children born through assisted reproductive technology (ART) important.” says Priya.
Meanwhile, Kashish Aneja, a Delhi-based advocate who works on national and international health law and policy issues, says the current age limit is based on both the parenting needs of the elderly and the health concerns of the children involved. He says he maintains a balance between the two.
“Although the argument in favor of raising children in the elderly is the principle of reproductive freedom, the right to reproduce without interference or restriction, the right is not without limits, and the state must protect the health of both parents. “We have the right to impose reasonable restrictions, taking due account of health, especially the health of the child, the rights of the child, and the obligations of parents,” he said.