Journal of Assisted Reproduction and Genetics

, Volume 11, Issue 4, pp 177–182

Regulation of oocyte donation to women over the age of 50: A question of reproductive choice

  • Richard J. Paulson
  • Mark V. Sauer
News and Views Reproductive Health Care Policies Around the World

Conclusions

As in most situations involving medial ethics, we believe that it is best to individualize. Categorical exclusions or rules preclude the possibility of individual histories or details which may be sufficiently compelling to overrule the rationale used to establish the rules in the first place. We believe that no medical therapy should be categorically denied to any subgroup of the population based on age alone, including oocyte donation. Individuals should be able to seek assistance and have available to them the full spectrum of medical knowledge and technology. As with any new form of therapy, the exact risks or long-term consequences remain unknown. Accordingly, this method should be applied only under carefully controlled protocols, preferably approved by local institutional review boards. Only in this manner can we hope to collect data which will eventually lead to a better understanding of the efficacy and clinical utility of this treatment. The establishment of reasonable guidelines, not absolute rules, regarding any form of medical therapy including oocyte donation should be based on scientific knowledge, not politics.

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References

  1. 1.
    Rosenwaks Z: Donor eggs: Their application in modern reproductive technologies. Fertil Steril 1987;47:895–909.PubMedGoogle Scholar
  2. 2.
    Sauer MV, Paulson RJ: Human oocyte and preembryo donation: An evolving method for the treatment of infertility. Am J Obstet Gyncol 1990;163:1421–1424Google Scholar
  3. 3.
    Sauer MV, Paulson RJ, Lobo RA: A preliminary report on oocyte donation extending reproductive potential to women over 40. N Engl J Med 1990;323:1157–1160PubMedGoogle Scholar
  4. 4.
    Sauer MV, Paulson RJ, Lobo RA: Reversing the natural decline in human fertility: an extended clinical trial of oocyte donation to women of advanced reproductive age. JAMA 1992:268:1270–1275PubMedGoogle Scholar
  5. 5.
    Serhal PF, Craft IA: Oocyte donation in 61 patients. Lancet 1989;1:1185–1197PubMedGoogle Scholar
  6. 6.
    Pantos K, Meimeti-Damianaki, Vaxevanoglou T, Kapetenakis E: Oocyte donation in menopausal women aged over 40 years. Hum Reprod 1993:8:488PubMedGoogle Scholar
  7. 7.
    Sauer MV, Paulson RJ, Lobo RA: Pregnancy after age 50: Application of oocyte donation to women after natural menopause. Lancet 1993:341:321–332PubMedGoogle Scholar
  8. 8.
    Antinori S, Versaci C, Gholami GH, Panci C, Caffa B: Oocyte donation in menopausal women. Hum Reprod 1993;8:1487PubMedGoogle Scholar
  9. 9.
    Sauer MV, Miles RA, Dahmoush L, Paulson RJ, Press M, Moyer D: Evaluating the effect of age on endometrial responsiveness to hormone replacement therapy: A histologic untrasonographic, and tissue receptor analysis. J Assist Reprod Genet 1993;10:47–52PubMedGoogle Scholar
  10. 10.
    Hansen JP: Older maternal age and pregnancy outcome: A review of the literature. Obstet Gynecol Surv 1986;41:726–742PubMedGoogle Scholar
  11. 11.
    Buehler JW, Kaunitz AM, Hogue CJR, Hughes JM, Smith JC, Rochat RW: Maternal mortality in women aged 35 years or older: United States. JAMA 1986:255:53–75PubMedGoogle Scholar
  12. 12.
    Rochat RW, Koonin LM, Atrach HK, Jewett JF: Maternal mortality in the United States: Report form the maternal mortality collaborative. Obstet Gynecol 1988:72:91–97PubMedGoogle Scholar
  13. 13.
    Grimes DA, Gross GK: Pregnancy outcomes in black women aged 35 and older. Obstet Gynecol 1981;58:614–620PubMedGoogle Scholar
  14. 14.
    Kirz DS, Dorchester W, Freeman RK: Advanced maternal age: the mature gravida. Am J Obstet Gynecol 1985;152:7–12PubMedGoogle Scholar
  15. 15.
    Berkowitz GS, Skovron ML, Lapinski RH, Berkowitz RL: Delayed childbearing and the outcome of pregnancy. N Engl J Med 1990:322:659–664PubMedGoogle Scholar
  16. 16.
    Friede A, Baldwin W, Rhodes PH, Buehler JW, Strauss LT: Older maternal age and infant mortality in the United States. Obstet Gynecol 1988;72:152–157PubMedGoogle Scholar
  17. 17.
    Office of Population Censuses and Surveys: Birth Statistics 1990 Series Fm 1 No. 19. London, HM Stationery Office, 1991Google Scholar
  18. 18.
    Paulson RJ, Sauer MV, Lobo RA: Embryo implantation following human in vitro fertilization: Importance of endometrial receptivity. Fertil Steril 1990;53:870–874PubMedGoogle Scholar
  19. 19.
    Butler RN: Ageism: Another form of bigotry. Gerontologist 1969;8:243–246Google Scholar
  20. 20.
    Wetle T: Age as a risk factor for inadequate treatment. JAMA 1987;258:516PubMedGoogle Scholar
  21. 21.
    Edmunds LH Jr, Stephenson LW, Edie RN, Ratcliffe MB: Open-heart surgery in octogenarians. N Eng J Med 1988;319:131–136Google Scholar
  22. 22.
    Thibault GE: Too old for what? N Engl J Med 1993:328:946–950PubMedGoogle Scholar
  23. 23.
    Wong JB, Salem DN, Pauker SG: You're never too old. N Eng J Med 1993;328:971–975Google Scholar
  24. 24.
    Taylor PJ, Gomel V: “Abraham ... laughed.” Int J Fertil 1992;37:202–203PubMedGoogle Scholar
  25. 25.
    Lancet editorial: Too old to have a baby? Lancet 1993;341:344–345Google Scholar
  26. 26.
    Flamigni C: Egg donation to women over 40 years of age. Hum Reprod 1993;8:1343–1344PubMedGoogle Scholar
  27. 27.
    Benagiano P: Pregnancy after the menopause: a challenge to nature? Hum Reprod 1993;8:1344–1345PubMedGoogle Scholar
  28. 28.
    Antinori S: A child is a joy at any age. Hum Reprod 1993;8:1542Google Scholar
  29. 29.
    Edwards RG: Pregnancies are acceptable in postmenopausal women. Hum Reprod 1993;8:1542–1544Google Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Richard J. Paulson
    • 1
    • 2
  • Mark V. Sauer
    • 1
    • 2
  1. 1.Department of Obstetrics and GynecologyUSC School of MedicineUSA
  2. 2.USC IVFCalifornia Medical CenterLos Angeles
  3. 3.Women's HospitalLos Angeles

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