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Older Mothers/Fathers


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“Sex is for recreation; leave reproduction to the professionals.”

September 24, 2008

In Intelligent Life magazine, Helen Joyce discusses “social egg-banking” and the IVF revolution to come

I believe the true IVF revolution is still to come. Soon, IVF may be better than natural conception for many, perhaps most, couples, not just those who can't make babies the usual way and the fewer still who know they carry genetic diseases.

The first steps to this reproductive nirvana are already being taken by a few brave, or foolhardy, souls. They are freezing (or, strictly speaking, “vitrifying”) their eggs in order to keep them fresh till the right man comes along. Men have been able to freeze and bank their sperm for decades, for example when facing cancer treatment that risks leaving them infertile, and couples can store surplus embryos produced during IVF. But eggs are a tougher challenge. Sperm are small, and of the tens of millions in a single ejaculation plenty will survive freezing and thawing; a couple of days after fertilisation, an embryo will consist of several cells, and even if a few don't survive the trauma, the embryo itself often will. Eggs, though, are single cells—so they have no built-in redundancy—and big (many times larger than the average human cell), so they are full of water that can form ice crystals and destroy the delicate structures inside them.

 

ART in the News

An Artist's Journey, Sperm Donor Roots, Aussie Clones, and More

September 23, 2008

Newsweek Tackles What Women Want

September 17, 2008

Newsweek’s latest issue asks what women want. No surprise, there are a few articles on ART developments.

The first looks at the challenges facing infertile women in developing countries

In some developing countries, the consequences of infertility—which can include ostracism, physical abuse and even suicide—are heartbreaking. “If you are infertile in some cultures, you are less than a dog,” says Willem Ombelet of the Genk Institute for Fertility Technology in Belgium. Women are often uneducated, so their only identity comes from being moms. “It [infertility] is an issue of profound human suffering, particularly for women,” says Marcia Inhorn, professor of anthropology and international affairs at Yale University. “It’s a human-rights issue.”

The second examines the rise of the “advanced maternal age” mom:

The reasons women become first-time moms or add to the brood later in life are as varied as the women themselves. There are career goals to meet. And bank accounts to grow. Some women waited for marriage. Some never married at all. There are second marriages. And even surprise births.

For those who wait, getting pregnant is a roll of the dice even with the help of science. “Not every egg over age 40 is created the same,” says Dr. Karen Ashby, assistant professor of reproductive biology at University Hospitals Case Medical Center. “Some healthy women will get pregnant without a problem, other women simply won’t.”

 

ART in the News

Affordable IVF, Older Dads, and The World's Oldest Mother

July 9, 2008

ART in the News

Solo "daddies," too posh to adopt?, and more

June 23, 2008

Questions for Jodi Panayotov, “In Vitro Fertility Goddess”

Part Two: Having It All, Happy Endings, and the Infertile Community
June 1, 2008

Part Two of my interview with Jodi Panayotov. For Part One, click here.

You talk about the “having-it-all” myth, the idea that women can combine a successful career with a family. Do you wish you had done things differently and pursued your career less determinedly? Do you think women should be encouraged to have children earlier?

JP:
You know, I have had a teeny bit of regret there. After Nina was born, I had a miscarriage on her first birthday then three failed rounds of IVF and I’ve since had a full hysterectomy so there is no chance of giving her a sibling. But I am so thrilled and blessed to have Nina that I don’t look back and say “What if?” or anything as I realize how lucky I am.

Of course I do think women should be encouraged to have children earlier but I don’t think it’s that simple. There are plenty of women who do try earlier and still have problems and there are so many reasons for others postponing children. For instance, not being able to find a partner who doesn’t dribble and who has evolved beyond Cro Magnon man, or a career structure that requires you to spend your fertile years climbing the corporate ladder if you are ever to reach the heights.

And don’t get me started on the women I know who were in long-term partnerships and the male kept saying, “in a couple of years” to the baby question till all of a sudden the women were in their late thirties with still no commitment. So I think men should be encouraged to start earlier too if that’s the case.

Start looking to K-Fed rather than Rupert Murdoch or Paul McCartney as role models. Well, maybe not K-Fed but more of a functional high-profile male who started early in having a family.

So many books about infertility are written by those who have gone through treatments or adoption and emerged out the other side with a child. Do you think the book would have been published if you weren't successful ?


JP: My agent was adamant that you can’t have a humorous book with a sad ending. But I do know of some Repro Lit with not-so-happy endings. I think both are important as both represent the two sides of the reality of infertility.

How has infertility changed your thinking about motherhood?


JP: As a mother I’m probably more anxious than I’d otherwise have been. I spent so long worrying when I was trying to conceive then I had a troubled pregnancy and I haven’t stop worrying since. It’s become normal to me to worry. If I don’t wake up worried it worries me and I have to find something to be anxious about.

Has infertility changed your views on abortion and stem cell research? I've talked to many infertility patients who were once strongly pro-choice and pro-stem cell research, but now feel much more ambivalent about these issues. Have you seen a similar change in your views?

JP: Definitely. Once you’ve viewed an embryo or blastocyst at close range you have a different perspective on where life begins. Although I still believe in abortion because I think a child should be entitled to the best possible upbringing and clearly there are situations where there would be no chance of this.

Do you still consider yourself part of the infertile community?

JP: Whatever that means, as there are a lot of different groups that make up the “infertile community.” Some may question whether I am as I now have a child, albeit through assisted reproductive techniques. But without a uterus and ovaries I’d say I qualify.

I definitely think the same as I did before I had Nina—I still get infuriated when I hear someone moaning about their pregnancy or how they didn’t want to fall pregnant right away or whatever. Recently I had a go at a shop assistant who was carrying on about her “poor” sister who found she was pregnant for the fourth time.

Restraining myself from saying her sister was clearly stupid if she already had three kids and didn’t know how they got there, I said, “Isn’t it funny how for every woman who doesn’t want to be pregnant there’s another out there who’s trying desperately and can’t fall pregnant?”

She went all red and didn’t know what to say but hopefully I made her think.

What misconceptions do people have about infertility?

JP: Well, one that comes to mind is it’s always the woman who has the problem when almost half of couples can’t conceive due to a problem the male has. Another is that a woman is to blame for her infertility and the most infuriating one for me: If we just learned to relax we wouldn’t be infertile!

What do you think is the most important thing a person can do to help a friend or family member currently undergoing fertility treatment?

JP: Plenty. You can refer to my site and check the article “Tips for Friends and Relatives who Wish to Remain Friends and Relatives.”

ART in the News

Is sex necessary? Soldiers going to Iraq bank their sperm. And more...

June 1, 2008

The "Advanced Maternal Age" Mom

May 20, 2008

Confirming that the recent "older mothers" craze is not going away, there's now a magazine devoted to the "advanced maternal age" mom, Plum:

Plum magazine coverThe first-ever magazine dedicated to the 35+ childbearing woman, Plum is a unique blend of an informative health journal and an insightful lifestyle magazine.

With topics ranging from birthing plans, prenatal testing, pregnancy myths, and mothering to entertaining, travel, fashion, and culture, Plum gives the 35+ soon-to-be or new mom the know-how and support she needs before, during, and after pregnancy. She will be informed, entertained, and moved as she learns about the best health-care practices, the hottest trends, and the most poignant personal stories. 

(via Laura at 11D)

My Two Cents on Baby Mama

Beware: Spoilers galore!
April 27, 2008

  

I didn't write too much about the movie Baby Mama in my recent WSJ article as I didn't want to step on their film critic's toes. Now with no such worries, I thought I'd give my two cents on the film. If you haven't seen it yet, beware as there are spoilers galore below.

One thing I found interesting while researching the WSJ piece was that no one in the industry or the infertility and bioethics communities was excited about the movie. Surrogates worried it would perpetuate negative stereotypes of surrogates as "ignorant white trash" just in it for the money. Attorney Theresa Erickson, who handles surrogacy and egg donation cases, feared the movie with its surrogacy-scam subplot would make surrogacy seem unsafe even though the majority of cases pass without incident. Anne Adams of the American Fertility Association agreed: Most surrogate situations are "utterly uninteresting and banal.... Is this what happens most of the time? No. But you obviously wouldn’t make a movie about what happens most of the time."

On the other side, Jennifer Lahl, director of the Center for Bioethics and Culture, was concerned that Baby Mama made surrogacy look too appealing, and left its dark underside unexplored: "In reality, it's not a light-hearted situation.... Americans will watch this movie, and go, 'How sweet!' But wait a minute, let's have a reality check here." Slate critic Dana Stevens had a similar take: The movie, she wrote,

could have been the springboard to investigating (or wickedly satirizing) some of the issues surrounding surrogacy, which, as this excellent Newsweek piece reported, can be a minefield for class, race, and gender tensions. But the conflict between Kate and Angie rarely rises above Odd Couple level: Organic pea soup or Tastykakes? Touchy-feely birthing videos or American Idol karaoke?

Like Stevens, I found the movie rather tame in its approach to the politics of modern parenthood. Naturally, the "mommy wars" make an appearance with laid-back mom Caroline (Maura Tierney) explaining to her sister Kate (Tina Fey), a driven career woman, that motherhood is "not like opening one of your stores. It's not an executive decision." Later, Kate recalls an old flame who wanted to marry her, but she was too focused on her career. "Other women got pregnant. I got promotions," she says ruefully.

Yet the entire career vs. family debate is rendered moot by Kate's diagnosis: a "sucky" T-shaped uterus. Kate's "advanced maternal age" notwithstanding, her eggs are fine, and it's her mother's exposure to DES — not Kate's decision to put family on the backburner — that causes her fertility woes.

To judge from the script, the writers didn't think too hard about this incongruity. Kate's diagnosis is mostly a means of explaining her need for a surrogate (and a source of mostly lame jokes about her mother's liver spot medication). The career vs. family debate is there because...well, that's what movies about career women and infertility are about.

This wouldn't have been hard to work around — Kate could have used an egg donor as well as a sperm donor, for instance — but it's clear the writers wanted Kate to have her own biological child. The press materials for the movie talk of "two kinds of family: the one you're born to and the one you make," yet Baby Mama is very timid when it comes to alternative families.

The movie's conservatism reminded me of two other infertility-related films I recently watched: the truly awful sperm-donor comedy And Then Came Love and Hannah and Her Sisters (which features a DI subplot). In all three movies, the importance of blood ties is reaffirmed. Love might be an important ingredient, but it's biology that really makes a family in these films. In And Then Came Love, Vanessa Williams leaves her successful, long-time boyfriend for her son's donor dad. In Hannah and Her Sisters, Woody Allen finds himself unable to bond with his wife Hannah or their children who are the product of donor insemination. They divorce, but he soon finds romantic bliss with his wife's sister, who despite his extremely low sperm count, becomes miraculously pregnant.

Baby Mama has a similar twist to Hannah and Her Sisters. After a series of plot turns in which Angie may be faking her pregnancy, Kate gets pregnant the old-fashioned way as does her surrogate Angie. Like Woody Allen's character, Kate's pregnancy only comes about after she finds her true love: Greg Kinnear, who plays a sweet single dad. There's an element of wish-fulfillment here, of course, as with all romantic comedies — which makes a strange ending for a movie that seemed to promise an edgy, provocative take on surrogacy and family.