Advanced maternal age: ethical and medical considerations for assisted reproductive technology
Brittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2017-08-01
|
| Series: | International Journal of Women's Health |
| Subjects: | |
| Online Access: | https://www.dovepress.com/advanced-maternal-age-ethical-and-medical-considerations-for-assisted--peer-reviewed-article-IJWH |
| _version_ | 1819267790322794496 |
|---|---|
| author | Harrison BJ Hilton TN Rivière RN Ferraro ZM Deonandan R Walker MC |
| author_facet | Harrison BJ Hilton TN Rivière RN Ferraro ZM Deonandan R Walker MC |
| author_sort | Harrison BJ |
| collection | DOAJ |
| description | Brittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada; 3Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada; 4University of Ottawa Interdisciplinary School of Health Sciences, Ottawa, ON, Canada; 5Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, CanadaObjectives: This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs) make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved.Methods: A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical) were included in the review.Conclusion: There are significant ethical considerations and medical (maternal and fetal) complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old). This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a pregnancy with a similar risk profile to that of her younger counterparts when using donated oocytes.Keywords: maternal age, medical, ethical, assisted reproduction, menopause |
| first_indexed | 2024-12-23T21:22:46Z |
| format | Article |
| id | doaj.art-85affd231fb34979a4fe9a8ea51c7eea |
| institution | Directory Open Access Journal |
| issn | 1179-1411 |
| language | English |
| last_indexed | 2024-12-23T21:22:46Z |
| publishDate | 2017-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Women's Health |
| spelling | doaj.art-85affd231fb34979a4fe9a8ea51c7eea2022-12-21T17:30:42ZengDove Medical PressInternational Journal of Women's Health1179-14112017-08-01Volume 956157034249Advanced maternal age: ethical and medical considerations for assisted reproductive technologyHarrison BJHilton TNRivière RNFerraro ZMDeonandan RWalker MCBrittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada; 3Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada; 4University of Ottawa Interdisciplinary School of Health Sciences, Ottawa, ON, Canada; 5Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, CanadaObjectives: This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs) make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved.Methods: A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical) were included in the review.Conclusion: There are significant ethical considerations and medical (maternal and fetal) complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old). This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a pregnancy with a similar risk profile to that of her younger counterparts when using donated oocytes.Keywords: maternal age, medical, ethical, assisted reproduction, menopausehttps://www.dovepress.com/advanced-maternal-age-ethical-and-medical-considerations-for-assisted--peer-reviewed-article-IJWHmaternal agemedicalethicalassisted reproductionmenopause |
| spellingShingle | Harrison BJ Hilton TN Rivière RN Ferraro ZM Deonandan R Walker MC Advanced maternal age: ethical and medical considerations for assisted reproductive technology International Journal of Women's Health maternal age medical ethical assisted reproduction menopause |
| title | Advanced maternal age: ethical and medical considerations for assisted reproductive technology |
| title_full | Advanced maternal age: ethical and medical considerations for assisted reproductive technology |
| title_fullStr | Advanced maternal age: ethical and medical considerations for assisted reproductive technology |
| title_full_unstemmed | Advanced maternal age: ethical and medical considerations for assisted reproductive technology |
| title_short | Advanced maternal age: ethical and medical considerations for assisted reproductive technology |
| title_sort | advanced maternal age ethical and medical considerations for assisted reproductive technology |
| topic | maternal age medical ethical assisted reproduction menopause |
| url | https://www.dovepress.com/advanced-maternal-age-ethical-and-medical-considerations-for-assisted--peer-reviewed-article-IJWH |
| work_keys_str_mv | AT harrisonbj advancedmaternalageethicalandmedicalconsiderationsforassistedreproductivetechnology AT hiltontn advancedmaternalageethicalandmedicalconsiderationsforassistedreproductivetechnology AT rivierern advancedmaternalageethicalandmedicalconsiderationsforassistedreproductivetechnology AT ferrarozm advancedmaternalageethicalandmedicalconsiderationsforassistedreproductivetechnology AT deonandanr advancedmaternalageethicalandmedicalconsiderationsforassistedreproductivetechnology AT walkermc advancedmaternalageethicalandmedicalconsiderationsforassistedreproductivetechnology |