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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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