Is Dr. Melissa Walker Too Old To Have A Baby?

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Having gone to medical school for four years following her graduation from college, Dr. Melissa Walker postponed her life, always too busy for starting a family or even for finding the right person to share her life. She followed medical school with four years of surgery residency, and spent two years after that specializing in surgery on the hand. Yes, it was a long, arduous journey for Dr. Walker, but she finally made it! She had become a top-level orthopedic surgeon, fighting all the odds of a very specialized field, mostly closed for women doctors. It took a lot of hard work and self-sacrifice.

Dr. Walker had been a partner in a very reputable Sports Medicine Clinic for the past ten years. Then, the surprise of her life happened. While on a vacation in Santa Fe, she met the love of her life. His name was Michael Langford, and he worked at a publishing company as chief editor. They had a quick courtship and were married within almost six months of having met. Melissa's life was finally complete-a supportive partner whom she adored and who adored her. The man respected her profession and was willing to move to where she was currently in practice. It was the ideal situation.

However, a few years passed, and Michael felt that he wanted to have children in his life. Neither Melissa nor Michael had been married previously and had no offspring. The problem was her age! By now, Melissa was at the height of her career and was

53 years old! She was earning enough money to be more than comfortable in life. Although she had not passed through menopause yet, she knew the problems associated with maternal age and incidence of genetic mutations such as Down syndrome. She was physically healthy and had no chronic problems. She watched her weight and exercised on a regular basis. She was in top physical condition.

What We Need to Know

  1. What is menopause? Can women normally have babies after this period?
  2. Since Dr. Walker had not passed through menopause, would you say that she probably was still fertile? How would you know for sure if you were her gynecologist?
  3. Why are women more susceptible to producing babies with genetic disorders as they get older?
  4. Are men's sperm just as likely to carry mutations in advanced age as eggs? Why or why not?

Since money was no object for the couple, they decided to participate in the newer technologies in infertility which had been available for a few years. Also, Melissa had all the right medical connections to make their wish for having a child possible. The couple needed to ask themselves several serious questions, however, before embarking on a journey destined to alter their lives drastically.

What We Need to Know

  1. At what maternal age, in your opinion, is it NOT okay to give birth to a baby? At what paternal age is it NOT okay to become a new father?
  2. What are the concerns of the couple at this point in their lives?
  3. Should medical doctors deny certain people the right to use reproductive technology? When should they?

The new technology that is available for older couples these days includes using donor eggs from a younger female, mixed with the father's sperm and implanted into the mother's uterus. It is possible to give a post menopausal female hormones to ready the uterus for implantation. One problem with the implantation technique is that women who undergo the procedure are having multiple births. This is due to the fact that more than one egg is fertilized and implanted so that the chances of producing a baby are increased.

What We Need to Know

  1. What hormones are responsible for maintaining a healthy uterine lining? What is the condition of a uterine lining that is ready for implantation?
  2. Since many eggs are fertilized, some of the embryos implanted will not live. Would this be the same thing as abortion? Why or why not?
  3. What is the problem with multiple births on the infants? What can be the problems for the mother?

Assignment

Research other techniques such as cloning, cytoplasmic transfer, nuclear transfer, cryogenic techniques for preserving eggs, sperm, and embryos. Write a reaction paper to the technologies. Include your scientific way of thinking, then comment about the ethical considerations.

Find out about the costs of the techniques listed above. Write a brief statement defending whether these procedures should be covered by insurance companies. Should only the rich be able to produce babies using new technology?

Pretend that you are Dr. Walker's best friend. Give her advice to help her decide whether to go ahead with the procedure or not.

RESOURCES

Newman, Judith. 2000. How old is too old to have a baby? Discover Magazine. April, pp.60-67.

http://www.cdc.gov/nccdphp/drh/index.htm

http://www.asrm.org