Fertility Society Meeting, Aging Parents, and Dr. Richard Scott Jr.
Good news for those of us pursuing families when our 30’s are just a memory. Dr. Richard Scott, of Reproductive Medicine Associates of New Jersey (and Laboratory and Practice Director of RMACT) , in a lecture presented at ASRM (American Society of Reproductive Medicine), had this to say,
"When we counsel our patients, we should tell them that there are significant risks that come with age for pregnancy-induced hypertension, gestational diabetes, preterm delivery, intrauterine growth restriction, and placentation disorders," Dr. Scott said. "However, none of these are of an order of magnitude where we would counsel our patients not to pursue planning for a family."
This comment was made after discussing the risks associated in becoming pregnant and delivering a child slightly later in life. A little disheartening that not only is it more difficult to become pregnant after we have turned 40, it is also more of a risk to carry the baby to term. Dr. Scott also had this to say:
“We don't necessarily understand whether an older woman's maternal environment is intrinsically different at age 48 or age 52 or whether we just see differences in outcomes because she is more likely to have hypertension, diabetes, be overweight or have hypothyroidism,"
Let’s look at the conversation around the age of our eggs and the information that our general health does not necessarily affect the quality. In other words, we can be fit, eating properly, exercising properly, and abstaining from drugs and alcohol and still have eggs that are of poor quality. Not exactly empowering, nor particularly motivating. Then reread the statement above from Dr. Scott. What is encouraging to me in his statement is that here is where how we are caring for ourselves, our bodies, our minds does matter tremendously. If it is not intrinsic that being older when carrying a pregnancy creates a higher risk, than the state of our health does come into play and is something that we can do something about. It’s a reason to make changes in our lifestyles, a way to become proactive in our treatment.
The name of the session we’ve been discussing? "Wrinkled Parents: Medical, Ethical, and Psychosocial Issues of Parenting at an Older Age." Reported in ASRM news, Andrea Braverman, PhD, also from RMANJ, made this eye opening comment:
"There's more to parenting than just having a pulse," she said. "The thing that we come back to over and over again is not that you just have a pulse but rather how active are you."
Dr. Braverman went on to discuss the advantages as well as the disadvantages of older parents.
Financial considerations that older parents often encounter include balancing conflicting financial demands of saving for college tuition versus retirement savings. Dr. Braverman said social issues for older parents will include the challenges of socializing with parents who may be a decade or two younger and therefore have different life and career demands. Older parents may also approach parenthood with disparate needs with one parent ready for retirement at an earlier age than the other.
Dr. Braverman additionally listed the advantages versus the disadvantages of older parenting. Advantages of older parenting include readiness, maturity, financial stability, and enjoyment, while the disadvantages included lower energy level, social stigma, a generation gap, and lack of a peer group with fellow parents.
This session also included the ethical and even touches upon some of the legal issues involved in treatment for older patients. Judith Daar, JD, discussed some of the restrictions and policy issues.
In addressing the legal and ethical perspectives, Judith F. Daar, J.D., Associate Dean, Whittier Law School, and Clinical Professor, University of California-Irvine School of Medicine said that no federal or state law prohibits delivery of assisted reproductive technology (ART) based on the age of a patient.
Where does this leave us? Why did I choose to write about this, out of all the different aspects being presented at ASRM?
This is the good news. We do get pregnant, that’s why. Despite the statistics being lower and having to use more procedures, we do get pregnant. And we do parent children, even when we don’t become pregnant. We parent children through surrogacy or adoption. So shouldn’t we know what the issues of parenting are past the age of 40?