The waiting rooms of Cornell Weil, Columbia University and New York University fertility clinics have up to forty women waiting to see specialists on any given day. Many of these women, having delayed having a baby for years, now face a deeply troubling scenario: the impossibility of having a genetic child of their own. For most women over 40 whose ovaries are now producing few and poor quality eggs, fertility specialists offer little help. Ovarian reserve, or how many eggs you have in your ovaries, is measured by a number called FSH. They call FSH the cruelest number in infertility because a high FSH signifies an extremely low chance of conception.
Most women with diminished ovarian reserve use donor eggs to conceive. A number of the celebrities one often sees having babies in their mid to late forties have used donor eggs. However, this fact is never discussed in public, leaving many women with the false notion that age is not an important factor in fertility: “I know a 43 year old can have a baby. I just read about Celebrity X in People magazine who had twins and she is 45 years old!!”
Recently, some news coming out of Egypt may offer help for both celebrities and non-celebrities who suffer from diminished ovarian reserves. In the fall of 2010, Dr. Osama Azmy of the National Research Centre in Cairo announced that he had been able to kick start prematurely failed ovaries in rats by using embryonic stem cells. The rats’ ovaries had begun to create fresh new eggs, and FSH levels had returned within eight weeks to pre-ovarian failure levels. If Azmy can replicate the same results in humans as planned, women will be able to take their time finding a partner and building a career, and still be able to have their own genetic offspring. This scenario is not socially irresponsible: men already have these choices available to them.
The path to the treatment is controversial as are the complicated social implications afterwards. First, Azmy would need approval to use stem cells from aborted fetuses or discarded embryos from fertility procedures like IVF. Embryonic stem cell research and therapy is illegal in several countries, including many states in the US. If their use is allowed, will we see harvesting of embryos for the specific purpose of kickstarting the ovaries of infertile women? Recently, researchers have been able to return mature cells to their immature or stem cell status, which avoids using embryos altogether. This might be one solution to the biopolitical roadblocks in using stem cells.
Right now, Azmy is urging caution because these rats have only exhibited functioning ovaries, and will next produce offspring, which will be analyzed for disorders and also to check whether they are genetically related to the mother or to the donor who supplied the stem cells. He is also considering the treatment for women younger than 40 who suffer from premature ovarian failure.
But if the treatment works, and can be extended to older women, then even post-menopausal women in their 60s could have children. Should the state put a ceiling on how old a woman can be to have this treatment? While it made sense from an evolutionary perspective to reduce the fertility of older women when lifespan was less than 50 years, it doesn’t make sense now that the life expectancy of anyone born today in the developed world is 100 years. Not only are people living longer, but they are also healthier and earning well past the retirement age of 65. This means a woman who is 50 years old could easily nurture and provide for a baby until it reaches adulthood. Besides, there is no law stopping a man from having a child late in life; men can conceive well into their 50s and beyond. David Letterman, for example, had his son at 56 years.
We have already had much controversy over the “Octomom” who gave birth to eight babies at once using in-vitro fertilization (IVF). We can expect as much controversy over cases of ineligible mothers reversing menopause and having children very late in life. However, just as with IVF, stem cell therapy for ovaries can also give hope to many deserving women who are healthy, relatively young and fully capable of looking after a child.
Ayesha and Parag Khanna explore human-technology co-evolution and its implications for society, business and politics at The Hybrid Reality Institute.