Assisted Reproductive Technologies

Mamas on Bedrest: Delaying Childbearing and the Cost to Society

January 25th, 2013

I just finished reading a very thought provoking article which is pondering the question, “Cost implications to society of delaying childbirth.”

I am somewhat befuddled that this question is even being considered as I have always felt that when and how a woman or couple decide to have a baby is their decision and their decision alone. I know that in other countries, China in particular, there is huge governmental pressure to have only one child and if at all possible, to have a boy. China is currently dealing with a crisis in that they have a generation of males without enough females with whom to make and continue the culture. But that is a discussion for another day and I am going to try to stay on topic with the question of assisted reproductive technologies and women of increased maternal age.

This is a topic that is very near and dear to my heart as I had my first child at age 37 and gave birth to my second child at age 40. I never intended to have children that late in life. In all honesty, I was stressed beyond all recognition when I turned 30 and wasn’t dating and there was no prospect on the horizon. If I had had the option then to freeze embryos, I have to say that in all likelihood, I would have seized the opportunity. It would have alleviated years of stress, anxiety and relieved some of the decisions I have made over the years regarding my career and desire to have a family. I think that this is an aspect of the discussion not addressed. For many women, we don’t choose to delay childbearing, we delay because (not being self pollinating) we can’t conceive children on our own and are waiting for a partner to appear. Now, I also considered purchasing donor sperm and being inseminated when I was in my early 30’s. Again, due to my personal beliefs, I didn’t feel that this was a suitable solution and so I did not journey upon this route to a family. But this conundrum-the desire to have a family vs. not finding a suitable partner with which to raise a family was completely overlooked in this article. I think the underlying tone that women are somehow callous and career seeking is far too simplistic and biased and the assumption that women utilizing assisted reproductive technologies are somehow creating a financial burden on society is also misleading and biased.

Before I offer any more of my own opinions on this topic, I want to share with you all the highlights of the article so that we are all talking about the same things. The article begins by asking the question, Should women without any sort of medical reason (i.e. cancer or autoimmune disorder) be offered the option of freezing either their ovarian tissue, oocytes (eggs) or embryos so that they can delay childbearing? The article is evaluating whether or not the costs of egg or ovarian tissue preservation outweighs the benefit of having a child. One thing that I think this article did well is ask the question, “What is the actual value of having a family?” Who can really answer that question? I think that the answers will vary from person to person, culture to culture and It’s really hard to put a monetary value on bearing a child or having a family. Additionally, the article attempts to assess a cost to these assisted reproductive procedures and quite frankly, there is no uniformity, so it’s hard to say whether or not the costs outweigh the benefit. One thing that is discussed is the fact that currently, women who opt to freeze either ovarian tissue, eggs or embryos most often do so by paying for the procedures themselves. So with that in mind, is it any of society’s business what a woman chooses to spend her money upon? Does society have the right to say that, “The potential cost of having a baby via assisted reproductive technologies is so great that we don’t want women spending their money doing this.” I could see if this is a cost that is being foisted upon society at large, but as previously stated, most women who engage in these cryo-preservation procedures do so at their own expense, so raising this question is, to me, an invasion of privacy.

One question that I do believe we have to ask is, “Are we giving women a false sense of hope for future childbearing?” Many of the cryo-preservation procedures have limited success, and success really varies depending on the health of women, their personal “ovarian age” and many factors that one really can’t quantify. Thus, it’s really hard to say which women will have success with the procedures and which won’t. Now these are questions that, I believe, for which we must get more specific answers.  Technology has again preceded ethics and at this point in time, we really don’t know if we should be offering these technologies to any woman who asks for them and is able to pay for them.

I appreciate the author’s attempt to ponder the question, “Should women, given what we know about cryopreservation procedures, be offered cryopreservation of their ovarian tissue, eggs or embryos so that they can delay childbearing?” But I think that the question should be posed as such, from the position of health, safety, efficacy and benefit to the women, not whether or not it presents an unnecessary burden on society. Again, most women who do cryopreservation pay for it out of pocket. Many women are not trying to set childbearing aside in favor of career building. They are trying to give themselves every opportunity to find a suitable mate with whom to raise a family, and are hoping against all hope that once they do find a suitable mate, they will have viable eggs with which they can have the children that they so desire.

Finally, I agree with the article in that we as a society and culture do need to offer more counsel and support to young women (and men because we are not a self polinating species and it is the responsibility of BOTH partners to care for the children they produce!!) as they are coming through their 20’s, the decade deemed “optimal” for child bearing, to make them aware of their potentially waning fertility (women and men!!), and to assist those who do have career aspirations to pursue career and have a family. (i.e. advancing paid family leave legislation, providing better childcare options, etc..)