Early Education is De Rigueur in Planning Late-life Pregnancies

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					     HUMAN REPRODUCTION AND GENETIC ETHICS




     Early Education is De Rigueur in Planning
     Late-life Pregnancies
     SHIRIN KARSAN
     117 East Laurier Place, Bryn Mawr, Master of Bioethics Program, University of Pennsylvania PA
     19010, USA
     Karsan2@mail.med.upenn.edu




     Introduction:
     The concept of “Time” seems to play out differently at various phases of our lives: In our
     teens and twenties, we experience the luxury of youth; we may feel invincible or even
     indomitable. Generally, we feel our whole lives are ahead of us, and we “take” time to
     enjoy, explore and experience our world. Concurrently, our physiology also goes through
     the phases of childhood, adolescence, puberty and into adulthood, or the “reproductive
     years”; and ultimately (for women) through menopause and “ageing”, or, the “non-
     reproductive years”.
         In this paper I will submit, on what I believe, is the obligation of the health care
     community to disseminate information early to their patients. This might ensure that
     the choices that people make in specific phases of their lives are educated and informed
     choices. Early education would be invaluable if backed up by the benefit of research
     that already exists, some of it presented in this paper. If this research was to be made
     available, say, on a patient’s first visit to a gynaecologist, (presumably in their late teens,
     early twenties), to start the education process, I believe many patients could benefit from
     it.
     Social trends and their implications:
     A study done more than 20 years ago indicated that there was definitely a trend for
     couples to postpone childbearing or their first birth to well into their late 30s or 40s
     (1). In addition, while successful late life pregnancies have occurred in many cases, and
     continue to occur, evidence also shows that there is certainly a decline of fertility and
     fecundity with age.
         Recent studies show that this trend (of later-life pregnancies) has generated further
     research about infertility, due to the resulting concerns of delaying pregnancy into the late
     30s and beyond. An article on “Perimenopausal Conception” states: “Fertility, defined
     as the ability to achieve a pregnancy, declines gradually over the woman’s lifespan. (2)
     Although this decline seems to begin from the age of 30 years, it is more obvious between
     35 and 40 and increases dramatically thereafter. The age of 41 is considered to be the
     point when fertility stops and sterility starts. The actual menopause occurs approximately
     10 years after the substantial loss of conception potential.” Dunson, Baird and Colombo
     reported the following statistics in their article: “Increased infertility with age in men and
     women”. (3) A recent study took 782 couples from seven European centres for natural
     family planning. All women aged 18-40 years were eligible. Daily intercourse records
     were used to adjust for their timing and freque
				
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