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4 Arguments That Stop Older Women Getting IVF – And Why They Are Deeply Flawed
Many women are unable to have children due to age restrictions on IVF. Dr. Dominic Wilkinson, Director of Medical Ethics at the Oxford Uehiro Centre for Practical Ethics, challenges the 4 most flawed arguments.
A 62-year-old Spanish woman recently gave birth to her third child by way of in vitro fertilization (IVF) despite the refusal of help and support from a series of gynecologists who all told her that a safe and successful pregnancy would be nearly impossible for her. Now, she and her baby are both healthy. And she’s not the oldest woman to defy such expectations: a 72-year-old Indian woman also gave birth to a healthy child earlier this year after IVF. In both cases, the pregnancies were without major complications.
Nevertheless, these maternal success stories have fueled heated debates about whether an age cap should be placed on the availability of IVF. In the context of these stories and discussions, professor and physician Dominic Wilkinson wrote in Oxford University’s popular philosophical blog Practical Ethics about four common arguments against permitting older women to have IVF and why they are flawed. The four he lists are:
1. Having an older mother is harmful.
2. Being pregnant while older is harmful.
3. IVF doesn’t work in older women.
4. IVF shouldn’t be publicly funded.
These objections are common, and they all turn out to be deeply flawed. Nevertheless, many countries make it difficult or impossible for women to undergo IVF after a certain age. In the UK, for example, where Professor Wilkinson works, women cannot receive IVF after age 42. With so many individuals and families being affected, these claims merit scrutiny.
The claim that having an older mother is harmful to the child is based on the expectation that the mother will die while the child is still young. This, in turn, is ostensibly very harmful to the child – so much so as to render the child’s life not worth living. Conceding that this potential for harm is real, Wilkinson notes that this objection fails to reckon with how long women typically live. According to the American Social Security Agency, a woman in the United States turning 65 years old today can expect to live to be 86.6 years old. In Spain, the average woman lives 85.5 years. Therefore, the youngest child of Lina Alvarez, the 62-year-old Spanish woman who gave birth after a controversial yet utterly successful IVF, can reasonably expect to live to see her mother for over the first 20 years of her life. As a result, it is difficult to justify why women of her age or in their mid-40s should be forbidden from trying to have a child on these grounds. As Professor Wilkinson puts it, “[T]his argument only works if we think that the lives of children born to older mothers are going to be so bad that it would be better that they had never been born.” While the loss of a parent is surely sad, it seems implausible that an otherwise good life in which someone grows up with his or her mother well into adulthood is not worth living. Furthermore, such critics seldom advocate to make natural conception of a child illegal for middle-aged to older women. If women over 42 can legally conceive children without IVF, then it is unfair to restrict others from doing so with IVF.
The second objection Professor Wilkinson addresses is that pregnancies are harmful to older women. The fact that older women have higher rates of medical complications during pregnancy is indeed borne out by empirical data. However, Wilkinson observes that objecting to providing older women with IVF on this basis fails to reckon with the more general fact that the vast majority (around 80%) of older women encounter no such problems. Thus, Wilkinson concludes:
There are good reasons for women to be aware of those risks of complications, and to take them into account when making decisions about whether or not to become pregnant. But for women without major health problems already, the risks of pregnancy are not so high that they can’t go ahead.
Given older women's general rates of success with pregnancies, demanding anything more than informed consent and a considered decision seems excessive. If a woman in her mid-40s or later gets pregnant, she will most likely be fine during and after the pregnancy.
The third criticism Wilkinson examines is that IVF does not work for older women. The aforementioned success stories notwithstanding, such critics believe that IVF generally fails to work for women beyond their early 40s. Wilkinson identifies some sloppy thinking here too. This line of argument tends to invoke reputable studies revealing low birth rates among an irrelevantly narrow set of subjects: women being fertilized with their own eggs. More realistically for modern IVF, older women receiving eggs from younger donors have virtually the same success rates as younger women. Besides, a low rate of success does not, in and of itself, merit a legal prohibition against a woman’s right to try anyway.
The fourth and final argument Wilkinson explores is based on the premise that IVF should not be publicly funded. Such critics note that resources would be more justly allocated toward more pressing ends such treatments for cancer. Wilkinson outlines a particular and a general flaw in this line of argumentation. First of all, someone committed to this line of criticism must hold that older women should not be able to get IVF as well as younger women. Yet, few critics advocate for such an outright banning of public support for IVF. More generally, Wilkinson notes that even if something should not be funded publicly, that does not mean it should be illegal. He writes: “[W]hether or not public IVF should be funded, these arguments shouldn’t stop someone paying for private fertility treatment, as Alvarez did.”
There may be some sound reasons why women might consider avoiding getting IVF as they get older. However, Professor Wilkinson offers a thorough and lucid account of why none of these reasons could justify a legal prohibition against women’s access to IVF based on age.
Perhaps in the words of Bill Nye, we should stop telling women what to do with their bodies:
Join Pulitzer Prize-winning reporter and best-selling author Charles Duhigg as he interviews Victoria Montgomery Brown, co-founder and CEO of Big Think, live at 1pm EDT tomorrow.
Richard Feynman once asked a silly question. Two MIT students just answered it.
Here's a fun experiment to try. Go to your pantry and see if you have a box of spaghetti. If you do, take out a noodle. Grab both ends of it and bend it until it breaks in half. How many pieces did it break into? If you got two large pieces and at least one small piece you're not alone.
But science loves a good challenge<p>The mystery remained unsolved until 2005, when French scientists <a href="http://www.lmm.jussieu.fr/~audoly/" target="_blank">Basile Audoly</a> and <a href="http://www.lmm.jussieu.fr/~neukirch/" target="_blank">Sebastien Neukirch </a>won an <a href="https://www.improbable.com/ig/" target="_blank">Ig Nobel Prize</a>, an award given to scientists for real work which is of a less serious nature than the discoveries that win Nobel prizes, for finally determining why this happens. <a href="http://www.lmm.jussieu.fr/spaghetti/audoly_neukirch_fragmentation.pdf" target="_blank">Their paper describing the effect is wonderfully funny to read</a>, as it takes such a banal issue so seriously. </p><p>They demonstrated that when a rod is bent past a certain point, such as when spaghetti is snapped in half by bending it at the ends, a "snapback effect" is created. This causes energy to reverberate from the initial break to other parts of the rod, often leading to a second break elsewhere.</p><p>While this settled the issue of <em>why </em>spaghetti noodles break into three or more pieces, it didn't establish if they always had to break this way. The question of if the snapback could be regulated remained unsettled.</p>
Physicists, being themselves, immediately wanted to try and break pasta into two pieces using this info<p><a href="https://roheiss.wordpress.com/fun/" target="_blank">Ronald Heisser</a> and <a href="https://math.mit.edu/directory/profile.php?pid=1787" target="_blank">Vishal Patil</a>, two graduate students currently at Cornell and MIT respectively, read about Feynman's night of noodle snapping in class and were inspired to try and find what could be done to make sure the pasta always broke in two.</p><p><a href="http://news.mit.edu/2018/mit-mathematicians-solve-age-old-spaghetti-mystery-0813" target="_blank">By placing the noodles in a special machine</a> built for the task and recording the bending with a high-powered camera, the young scientists were able to observe in extreme detail exactly what each change in their snapping method did to the pasta. After breaking more than 500 noodles, they found the solution.</p>
The apparatus the MIT researchers built specifically for the task of snapping hundreds of spaghetti sticks.
(Courtesy of the researchers)
What possible application could this have?<p>The snapback effect is not limited to uncooked pasta noodles and can be applied to rods of all sorts. The discovery of how to cleanly break them in two could be applied to future engineering projects.</p><p>Likewise, knowing how things fragment and fail is always handy to know when you're trying to build things. Carbon Nanotubes, <a href="https://bigthink.com/ideafeed/carbon-nanotube-space-elevator" target="_self">super strong cylinders often hailed as the building material of the future</a>, are also rods which can be better understood thanks to this odd experiment.</p><p>Sometimes big discoveries can be inspired by silly questions. If it hadn't been for Richard Feynman bending noodles seventy years ago, we wouldn't know what we know now about how energy is dispersed through rods and how to control their fracturing. While not all silly questions will lead to such a significant discovery, they can all help us learn.</p>
A study looks at the performance benefits delivered by asthma drugs when they're taken by athletes who don't have asthma.
- One on hand, the most common health condition among Olympic athletes is asthma. On the other, asthmatic athletes regularly outperform their non-asthmatic counterparts.
- A new study assesses the performance-enhancement effects of asthma medication for non-asthmatics.
- The analysis looks at the effects of both allowed and banned asthma medications.
WADA uncertainty<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzNzU0OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxMDc4NjUwN30.fFTvRR0yJDLtFhaYiixh5Fa7NK1t1T4CzUM0Yh6KYiA/img.jpg?width=980" id="01b1b" class="rm-shortcode" data-rm-shortcode-id="2fd91a47d91e4d5083449b258a2fd63f" data-rm-shortcode-name="rebelmouse-image" alt="urine sample for drug test" />
Image source: joel bubble ben/Shutterstock<p>When inhaled β-agonists first came out just before the 1972 Olympics, they were immediately banned altogether by the WADA as possible doping substances. Over the years, the WADA has reexamined their use and refined the organization's stance, evidence of the thorniness of finding an equitable position regarding their use. As of January 2020, only three β-agonists are allowed — salbutamol, formoterol, and salmeterol —and only in inhaled form. Oral consumption appears to have a greater effect on performance.</p>
The study<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzNzU0Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1MTIzMDQyMX0.Gk4v-7PCA7NohvJjw12L15p7SumPCY0tLdsSlMrLlGs/img.jpg?width=980" id="d3141" class="rm-shortcode" data-rm-shortcode-id="ebe7b30a315aeffcb4fe739095cf0767" data-rm-shortcode-name="rebelmouse-image" alt="runner at starting position on track" />
Image source: MinDof/Shutterstock<p>Of primary interest to the authors of the study is confirming and measuring the performance improvement to be gained from β-agonists when they're ingested by athletes who don't have asthma.</p><p>The researchers performed a meta-analysis of 34 existing studies documenting 44 randomized trials reporting on 472 participants. The pool of individuals included was broad, encompassing both untrained and elite athletes. In addition, lab tests, as opposed to actual competitions, tracked performance. The authors of the study therefore recommend taking its conclusions with just a grain of salt.</p><p>The effects of both WADA-banned and approved β-agonists were assessed.</p>
Approved β-agonists and non-asthmatic athletes<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzNzU1MC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxMzkxODk0M30.3RssFwk_tWkHRkEl_tIee02rdq2tLuAePifnngqcIr8/img.jpg?width=980" id="39a99" class="rm-shortcode" data-rm-shortcode-id="b1fe4a580c6d4f8a0fd021d7d6570e2a" data-rm-shortcode-name="rebelmouse-image" alt="vaulter clearing pole" />
Image source: Andrey Yurlov/Shutterstock<p>What the meta-analysis showed is that the currently approved β-agonists didn't significantly improve athletic performance among those without asthma — what very slight benefit they <em>may</em> produce is just enough to prompt the study's authors to write that "it is still uncertain whether approved doses improve anaerobic performance." They note that the tiny effect did increase slightly over multiple weeks of β-agonist intake.</p>
Banned β-agonist and non-asthmatic athletes<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzNzU1Mi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjI3ODU5Mn0.vyoxSE5EYjPGc2ZEbBN8d5F79nSEIiC6TUzTt0ycVqc/img.jpg?width=980" id="de095" class="rm-shortcode" data-rm-shortcode-id="02fdd42dfda8e3665a7b547bb88007ef" data-rm-shortcode-name="rebelmouse-image" alt="swimmer mid stroke" />
Image source: Nejron Photo/Shutterstock<p>The study found that for athletes without asthma, however, the use of currently banned β-agonists did indeed result in enhanced performance. The authors write, "Our meta-analysis shows that β2-agonists improve anaerobic performance by 5%, an improvement that would change the outcome of most athletic competitions."</p><p>That 5 percent is an average: 70-meter sprint performance was improved by 3 percent, while strength performance, MVC (maximal voluntary contraction), was improved by 6 percent.</p><p>The analysis also revealed that different results were produced by different methods of ingestion. The percentages cited above were seen when a β-agonist was ingested orally. The effect was less pronounced when the banned substances were inhaled.</p><p>Given the difference between the results for allowed and banned β-agonists, the study's conclusions suggest that the WADA has it about right, at least in terms of selection of allowable β-agonists, as well as the allowable dosage method.</p>
Takeaway<p>The study, say its authors, "should be of interest to WADA and anyone who is interested in equal opportunities in competitive sports." Its results clearly support vigilance, with the report concluding: "The use of β2-agonists in athletes should be regulated and limited to those with an asthma diagnosis documented with objective tests."</p>
Certain water beetles can escape from frogs after being consumed.
- A Japanese scientist shows that some beetles can wiggle out of frog's butts after being eaten whole.
- The research suggests the beetle can get out in as little as 7 minutes.
- Most of the beetles swallowed in the experiment survived with no complications after being excreted.