Sexist or rational?

clairefontaine

A friend of mine lost her two year old in a drowning accident. Obviously she was beyond consoling. Due to the nature of the tragedy and the accident, and strain on the marriage, her husband left her. Their grief was incompatible.

She is 44 years old. She wants another child but the country she is in wont let her get in vitro at her age. They tell her she is too old. She puts it down to the sexist culture she is in. Many countries would let her, like the UK and the USA but this one wont.

Not G.R

Is it the opinions of medical professionals in the country or are the laws in the country preventing her?

miamee

I'm very sorry for your friend, what a tragic and horrific thing to happen.

Every country will have their own regulations. Perhaps it is related to the life expectancy of that country? Or on how safe it is for the average woman in that country at that age?

I can't see how it might be sexist, it is the one area in which men and women are incomparable - the strain on a woman's body to go through such treatment and a possible pregnancy or pregnancies (should one or more miscarry) does not have a male physical equivalent.

wallycharlo

I don't see this as being sexist.

When you say 'won't let her' do you mean that the laws of that particular country forbid it outright, or that she would not get any financial support towards the costs from the social system in that country, and hence make the whole process a non-starter for her?

I know that plently of European countries at least have different flavours of laws when it comes to what exactly can be done from an IVF/ICSI type perspective, which does lead to people going abroad for treatment.

There is of course also the sad reality that at this age the woman may be quite unlikely to become pregnant and carry the baby to term in any case.

I think that the morale onus would be on the physician to advise as to whether the chance of success could outweigh the potential psychological stress of successive failed IVF/ICSI attempts, which can in any case be a major issue for couples who have not also had the added misfortune such as in the case of this poor lady.

eviltwin

What an awful thing to happen. I can totally empathise with her wanting another baby after going through that.

I don't think its sexist though. There are rules with IVF and age limits are one of those and with good reason. I wonder, in her fragile condition, would it be wise for her to proceed seeing as how the odds are against it working? Would that not be worse if she pins her hopes on IVF and it doesn't work?

zl1whqvjs75cdy

I am terribly sorry for your friend. But sexist? I think not. My understanding is sexism involves treating someone differently based on their sex. So if a man went in looking for IVF treatment at 44 it would be given to him based on your friend's logic. But the procedure obviously can't be preformed on a man. I think this is a case where sexism is next to impossible since IVF only applies to one sex anyway. God I explained that badly.

Sexist? I don't think so.

Ageist? Possibly.

Sensible? Perhaps.

"Wont let her" is very vague. Is it a medical professional's choice (i.e. doctors on a personal level saying "I don't think it would be wise to offer you treatment due to your age and situation"), or law (i.e. there's a cut off age where it's illegal) or is it a particular practice's policy (i.e. we wont do it for you because of the cost incurred if it fails repeatedly)?

Either way, sexism would be if only men her age, but not women, were allowed to get it. Which obviously isn't the case.

starling

Your friends story is very sad, I feel bad for her. But like other posters have said "won't let her" is quite vague, what's the rationale behind it? Are they refusing to do the ivf/fertility treatment or refusing to fund it?
My understanding is that IVF etc is a very psychologically trying process and if you are already in a fragile mental state (no offence meant to your friend) it is not always wise to go ahead with it, because of the toll it can take if it doesn't work the first time. Plus her own physical health might be a factor outside of her age I mean.

I don't think it's sexist. It may be ageist if your friends age is the main reason why doctors are advising against ivf, but have they actually said that? Just because you can do a medical procedure doesn't mean you should, it has to be the best choice for the individual patient according to her own circumstances and health. And unfortunately decisions do have to be made about the cost / benefit of any procedure.

I know it's not the same but would your friend consider fostering or adoption? When she has come to terms with her grief I mean. She's lost her child and her husband, two huge blows; she needs to give herself time to deal with that before trying to have another child. To be perfectly frank, (I am not a medical professional) I'm not sure it would be ethical for doctors to do ivf for someone who is in those very sad circumstances.

Just my €0.02, probably haven't said anything that hasn't already been said. I hope your friend will be okay. I don't know how you would ever really recover from losing a child.:(

Neyite

clairefontaine wrote: »

A friend of mine lost her two year old in a drowning accident. Obviously she was beyond consoling. Due to the nature of the tragedy and the accident, and strain on the marriage, her husband left her. Their grief was incompatible.

She is 44 years old. She wants another child but the country she is in wont let her get in vitro at her age. They tell her she is too old. She puts it down to the sexist culture she is in. Many countries would let her, like the UK and the USA but this one wont.

If the country she is in wont let her, why does she not travel to another country that will? In India, Spain and Italy there have been fertility cases with advanced maternal age (into their 50's) Irish couples already have to travel for many fertility procedures that are not done here (donor eggs, genetic screening) so there is no reason why she cant travel.

Unless of course she is getting her treatment funded by insurance or a national health service. In which case they are paying, so they get to call the shots.

meeeeh

Somebody else posted this article in another thread. After 40 IVF becomes money grabbing exercise.

wrote:

Younger women’s ovaries respond better to the drugs used to extract the eggs, and younger women’s eggs are more likely to be chromosomally normal. As a result, younger women’s IVF success rates are indeed much higher—about 42 percent of those younger than 35 will give birth to a live baby after one IVF cycle, versus 27 percent for those ages 35 to 40, and just 12 percent for those ages 41 to 42. Many studies have examined how IVF success declines with age, and these statistics are cited in many research articles and online forums.

http://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-a-baby/309374/

Moncrieff had an interview with a woman who was trying to get pregnant after 40 and she quoted similar data.

--Kaiser--

meeeeh wrote: »

Somebody else posted this article in another thread. After 40 IVF becomes money grabbing exercise.



http://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-a-baby/309374/

Moncrieff had an interview with a woman who was trying to get pregnant after 40 and she quoted similar data.

Success rate drops to 2% for a woman aged 44. Blaming it on a 'sexist culture' is just nutty. That's aside from the fact that women giving birth at this age are more likely to suffer complications less likely to give birth to a healthy baby

http://www.advancedfertility.com/fertility-after-age-40-ivf.htm

starling

--Kaiser-- wrote: »

Success rate drops to 2% for a woman aged 44. Blaming it on a 'sexist culture' is just nutty. That's aside from the fact that women giving birth at this age are more likely to suffer complications less likely to give birth to a healthy baby

http://www.advancedfertility.com/fertility-after-age-40-ivf.htm

The issue is the age of the eggs rather than the age of the woman, in theory she could use donor eggs.
The article meeeeh linked to does a good job of explaining how many of these statistics can be misleading and that it is still quite possible for women to have healthy pregnacies after 40, despite popular opinion, particularly if they've had a successful pregnancy before. The decline in fertility after 35 and the increased risk of foetal abnormality are widely overstated. Early detection of foetal abnormality is also much easier nowadays, where historically it was not possible to detect in utero.
OP's friend presumably had her child when she was 42 so she has a decent chance of being able to conceive and carry to term a healthy baby. I think it's worth noting that OP didn't mention whether the friend wanted medical intervention because of known fertility issues or because she is now effectively single.

eviltwin

starling wrote: »

The issue is the age of the eggs rather than the age of the woman, in theory she could use donor eggs.
The article meeeeh linked to does a good job of explaining how many of these statistics can be misleading and that it is still quite possible for women to have healthy pregnacies after 40, despite popular opinion, particularly if they've had a successful pregnancy before. The decline in fertility after 35 and the increased risk of foetal abnormality are widely overstated. Early detection of foetal abnormality is also much easier nowadays, where historically it was not possible to detect in utero.
OP's friend presumably had her child when she was 42 so she has a decent chance of being able to conceive and carry to term a healthy baby. I think it's worth noting that OP didn't mention whether the friend wanted medical intervention because of known fertility issues or because she is now effectively single.

No matter what age you are IVF has a very low success rate. More people end up without a child than with one. Its physically and emotionally draining and seeing as the woman seems to want IVF as a result of losing her child - going by the OP that's what I took - maybe it would cause more harm than good for her to proceed.

Even if she was passed for it on the grounds of age I wonder if it got to the counselling session would she be cleared.

meeeeh

starling wrote: »

The issue is the age of the eggs rather than the age of the woman, in theory she could use donor eggs.
The article meeeeh linked to does a good job of explaining how many of these statistics can be misleading and that it is still quite possible for women to have healthy pregnacies after 40, despite popular opinion, particularly if they've had a successful pregnancy before. The decline in fertility after 35 and the increased risk of foetal abnormality are widely overstated. Early detection of foetal abnormality is also much easier nowadays, where historically it was not possible to detect in utero.
OP's friend presumably had her child when she was 42 so she has a decent chance of being able to conceive and carry to term a healthy baby. I think it's worth noting that OP didn't mention whether the friend wanted medical intervention because of known fertility issues or because she is now effectively single.

I don't overly care what OP's friend's circumstances were. It's incredibly heart breaking but there has to be a cut off point. While stats can be misleading there is a lot less of a chance of successful IVF in 40ies. There is also bigger chance of something going wrong and public health system picking up the tab for it.

People wanting to have children are incredibly vulnerable and it's a lot easier to persuade them into something that has very little chance of success. IVF is a business and as such it has to be regulated. Public funding has to stop at point where success rates are low and even private funding should be curtailed so people are not taken advantage of.

starling

eviltwin wrote: »

No matter what age you are IVF has a very low success rate. More people end up without a child than with one.

Yeah by definition the people who go for ivf are less fertile than the average, and we shouldn't think of ivf as guaranteed because it is still not a effective as we might imagine; but what I'm getting at is there is a misconception (no pun intended) of how fertility in the average woman declines after say 35 - it's not necessarily as steep a decline as people think.

Like the article gives an example of one of the studies that contributes to the general notion of declining fertility, it was published in a medical journal in the early 00's but it turns out the research was based on childbirth rates among French women in the early 17th C :eek: so many different factors would have contributed that wouldn't apply today.

It also explains how difficult it is to actually conduct research into the issue in modern women.

eviltwin wrote: »

Its physically and emotionally draining and seeing as the woman seems to want IVF as a result of losing her child - going by the OP that's what I took - maybe it would cause more harm than good for her to proceed.

Even if she was passed for it on the grounds of age I wonder if it got to the counselling session would she be cleared.

Yeah I was saying basically the same thing earlier, obviously we don't know all the factors in this case but it doesn't sound like it would really be a wise decision for OP's friend based on her own mental state atm as opposed to just being all about her being "too old". She is acting in a state of severe grief and not necessarily making the best decisions

clairefontaine

My understanding is that it is a law preventing her.

She wasn't going for I've because of trouble conceiving. She was going because her husband left her, was short on time obviously, and nothing makes you more aware of time than bereavement, and wanted a donor so she could have a child.

It's not going to happen.

I know a 55 year of woman who had a child through IVF. Bought the sperm, bought the egg. Sure, not sexist, had all her reproductive rights, but seriously, IMO, this goes too far.

starling

clairefontaine wrote: »

My understanding is that it is a law preventing her.

She wasn't going for I've because of trouble conceiving. She was going because her husband left her, was short on time obviously, and nothing makes you more aware of time than bereavement, and wanted a donor so she could have a child.

It's not going to happen.

I know a 55 year of woman who had a child through IVF. Bought the sperm, bought the egg. Sure, not sexist, had all her reproductive rights, but seriously, IMO, this goes too far.

I understand if you can't tell us but what country does your friend live in?

wallycharlo

meeeeh wrote: »

...After 40 IVF becomes money grabbing exercise...

To be fair, any reputable clinic will be upfront about this, and will not allow someone to throw their money away in that regard.

Lola92

I don't really see this as being sexist. Your friend has been through a terrible time in her life, which must be very hard to have dealt with. As women we have a limited window in which reproduction is possible, it is well know and documented about the risks associated with advanced maternal age during pregnancy and the health implications for both the child and mother can be considerable. Even with IVF, there comes a point when you need to weigh up the potential risks against your personal desire to have a child. It is unfortunate but it is just the way it is.

I am surprised however that it is a law in the country rather than just a policy of the clinic.