What is the issue?

• A 74-year-old woman from Andhra Pradesh was recently recorded as the oldest in the world to give birth to twins through in-vitro fertilisation (IVF).
• While babies and mother are stable, the medical community has expressed ethical and medical concerns over conception at such an advanced age.

What are the recent notable IVF births?

• Under IVF, the male’s sperm is fertilised with a donor’s eggs and placed in the woman’s uterus (mother).
• Erramatti Mangayamma, 74, visited Ahalya Nursing Home in 2018 after 57 years of marriage and multiple failed attempts to conceive.
• With an IVF expert at that clinic, she conceived with in-vitro fertilisation technique.
• She recently delivered twin babies through a caesarean procedure.
• In 2016, Dajinder Kaur, 70, had delivered a boy through IVF in Haryana.
• At the same Haryana clinic, a 66-year-old woman had delivered triplets in 2010.

Why is this a concern?

• Internationally this pregnancy is being condemned as things could have gone wrong and it sets a wrong precedent.
• Several experts have demanded punitive action, saying the Indian Council of Medical Research (ICMR) should deregister the doctor’s Andhra Pradesh centre.
• ICMR is considering issuing a notice to the clinic for indulging in an unethical practice.
• Concerns - The average life expectancy of an Indian woman is 70 and of a man, 69.
• So, the medical community has expressed concerns over future of children born to such an elderly couple.
• [Notably, the very day after the delivery, the twins’ father, 80, suffered a stroke.]
• Medical technology has reached a stage in which even a 90-year-old can conceive a baby.
• But, there are complications that can risk human life in this.
• The womb of an older woman has to be prepared by injecting hormones for the foetus to grow for nine months.
• Also, a woman of that age cannot breastfeed.
• Pregnancy in old age also poses multiple risks such as hypertension, diabetes, convulsions, bleeding, and cardiac complications.

What is the current practice?

• The Assisted Reproductive Technologies (Regulation) Bill, 2010 proposes the upper age limit at 45 for women and 50 for men to undergo the IVF procedure; the bill is pending.
• Since the Bill on ART has not been passed yet, legal action against the clinics is impossible.
• With no law in place, the assisted reproductive technology (ART) industry continues to operate in a grey zone.
• As of now, several centres rely on ICMR’s 2017 guidelines that recommend the same age limits.
• Even for adoption, the total age of the couple must not exceed 110 years.
• With increasing life expectancy, doctors are in talks with the government to increase the IVF age limit to 50-52 years for women.
• Now, several experts self-regulate, some counsel senior citizens to drop the idea, and others refuse them IVF treatment.
• Other countries - Most countries that have a law, range the upper limit for IVF between 40 and 50 years.
• In the US, the upper limit for IVF is 50, and for ovum donation, 45.
• In Australia, guidelines prohibit IVF beyond menopause (52 years).

What necessitates old age pregnancy?

• Globally, an estimated 15% of couples are infertile.
• Societal pressure to have children, the fear of living without support in old age, and the loss of an only child often encourage couples to go for advanced treatments even at old age.
• The Assisted Reproductive Technologies (Regulation) Bill, 2010 too states that in the Indian social context, children are “old-age insurance”.
• Some doctors argue that childbirth is a personal decision and each individual has the right to make that choice after counseling.