The news from India this week that a 74-year old woman named Erramatti Mangayamma had given birth to twin girls via IVF, after five decades of trying to conceive, has forced an ethical dilemma upon us. Is the healthy arrival of these two babies a ‘medical miracle’, or a moral outrage?
Even as a feminist and vocal advocate of a woman’s right to choose, my first reaction was one of horror. While there is no upper age limit as yet for IVF treatment in the UK, generally the NHS will only support treatment for the women up to the age of 42, citing health issues for the mother and child after this deadline.
Perhaps I’ve been socially conditioned to see this as an acceptable cut-off age, but I do think an age limit on having children via IVF should be put in place by the government. I think that 50-years-old would be a medically sensible yet emotionally sensitive limit. Anything later could be bad for mother and child, not just during pregnancy and delivery but throughout their lives. I worry the babies will be orphaned in childhood, and the aged couple will be too tired to be the active parents their daughters deserve. As I consumed the story, my mind raced back to my early years of motherhood, when sleep eluded me and I became a lackluster, frazzled version of myself. The exhaustion of servitude to these tiny, crying, demanding dictators was all consuming, and I was in my mid-30s. As any mother knows it is difficult to cope with sleepless nights, the emotional ups and downs and the hard physical labour of parenting babies at any age… but at 74?
Reading the news reports, I didn’t know whether to feel sorrier for her, or her twin girls. But then I imagined her daughters, alone in the world as teenagers, and I couldn’t help think this medical miracle is no more than a selfish act of wish fulfilment.
As a woman who struggled for two years to get pregnant, I want to be on the new mother’s side. Yes, I was much younger than Mangayamma when I desperately wanted to conceive but understand the visceral, burning misery many women feel when they have yet to hold their own child in their arms. During this darkest period of my life I felt a despair I wouldn’t wish on my worst enemy. I had to stop going to baby showers for fear of collapsing in tears, and my relationship with my husband became tense – every time he picked up or cooed over another woman’s baby, I felt like he’d stabbed me in the heart. I couldn’t work out why he wasn’t in a hyper state of baby anxiety at all times alongside me.
I was a day away from my first IVF appointment when I finally saw the blue plus sign on a pregnancy test stick, and the relief and wonder I felt was immeasurable. My life would continue on the path I’d always imagined it would; we could be a family. If I had never conceived, my husband and I would have navigated our way around the pain, longing and heartbreak – the social exclusion – I like to think, but something inside us would be broken forever.
I felt for Mangayamma when she told of the desperation and grief, she felt not being able to conceive during her 57-year marriage. “People looked at me with accusing eyes, as if I had committed a sin,” she told a newspaper of her childless years. “Neighbours would call me ‘godralu’ [an insult for an infertile woman].” Last year, when she heard a 55-year-old local woman had successfully conceived through IVF, I can comprehend why she wanted to have one last chance of making her dream of motherhood a reality. “We are the happiest couple on earth today,” her husband said when the twins had been safely delivered via C-section. “We have our own children.”
This is something I can relate to. What I don’t understand , is the ethics of the doctors who impregnated a 74-year-old woman, especially when India’s average life expectancy is 70 years. At best, one could argue, they were driven by the desires of a desperate woman, putting her emotional needs above concern for the future welfare of the children they were helping to bring into the world.
Manngayamma’s doctor has told the media she went through a series of physical and psychological examinations, which she passed. As confident as he could be that all would be well, the first-time mother was implanted with an egg from a donor (she had gone through menopause nearly 25 years earlier), fertilised with her husband’s sperm.
She became pregnant after a single cycle of IVF – “a medical miracle” her doctor said. And according to a 2015 report by the Society for Assisted Reproductive Technology, 44-plus women using their own eggs only have on average of 0.6 percent chance of bringing a healthy baby to full term, so it is easy to understand his excitement.
But at worst, her doctor was using a woman’s vulnerability to break a new world record, shamefully taking advantage of her willingness to be their fertility guinea pig. And she was a willing experiment, ignoring reason to look towards the blissful moment she would rest her child on her chest and the years of longing would be over – not contemplating the years of longing her daughters would have for their years without their mother.
Some Indian gynecologists and IVF specialists are already demanding a new law is put in place so this doesn’t happen again, and I agree with them. How that rule is navigated will take multiple studies and tests, a deep analysis of mental, physical and sociological factors that create a healthy mother and a healthy child. Life is a lottery and we can never truly predict the outcome, but starting out with parents who probably won’t make it to your 10th birthday is not a good start.