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The American Fertility Association Blog

Oh Bitch Please!

July 16, 2009 - Thursday
Posted by admin

By:  Dr. Daniel Shapiro

Today, Maria del Carmen Bousada, the Spaniard who three years ago became the oldest woman on record to conceive through IVF, died of cancer.  She left behind twins and no known biological father to care for them. On seeing the news of her passing on CNN, my 16 year old daughter reflexively yelled out ‘Oh Bitch Please!!” at the TV. Being a conscientious father (and an IVF doctor) I castigated my scion to be respectful of the dead. I further cautioned her against use of the ‘B” word in describing women.

My eldest, who suffers fools lightly, explained that she was not in any way criticizing poor Maria, but making a general comment about the absurdity of the situation. She went on to say that ‘Oh Bitch Please!” means the same as ‘Tcha, as if!?’ which she was sure I would understand since I am old and from the 80’s.

In fact, I do understand exactly what she means.

To date, there are fewer than 20 reported pregnancies ever in women over 60. ALL of the recent cases occurred as a result of IVF and donor eggs. These pregnancies occurred solely by choice and with great effort on the part of many players. The press has gleefully shown every sexagenarian pregnancy that they can and in every case the debate about whether we should do this or not rages back and forth both in print and between wonkish talking heads on the tube.

The American Society for Reproductive Medicine says plainly that we should not do this. The ASRM guidelines suggest that egg donation services be limited to women at the natural age of menopause (51+) or less.

Proponents of individual rights correctly point out that men are under no such limitation and that it is inherently sexist to apply age limits to women who wish to be parents.

So what’s a society or an IVF clinic to do?

The debate really boils down to competition between the rights of the individual and the best interests of society as a whole. Though I do not pretend to know the right answer to this one, I think I can make a logical argument as to why the rights of the individual here should be secondary to societal norms.

The desire to parent is essentially an accepted form of narcissism. Though childbearing serves a social need by bringing joy to family units and creating a new generation of workers, consumers and thinkers we are all deluding ourselves into thinking that we are individually capable of parenting well. Of course no one person has the right to criticize the parenting style of any other person as long as we stay within legal boundaries and keep our children housed, fed, clothed, schooled and reasonably safe. At the same time we do have the right as members of a larger social group to limit parenting arrangements that put a child or a parent at risk.

In cases such as these the benefit to the individual is narrow and particular and does not serve the greater good. We now see in painful strokes of pointillist realism why this is so. Who now will care for Maria’s twins? Aside from the inherent benefit to the children by being born, who else benefited from this arrangement beside the doctor and those who write about this for the tabloids?

Though Maria’s death is tragic at many levels, the real tragedy is that this happened at all.  Saying this usually elicits an uncomfortable ‘utz’ in the stomachs of reasonable people: criticizing the birth of any child after that child is born goes against our natural wiring. Yet this story represents failure at many levels.

Let’s start with Maria herself. Ms. Del Carmen Bousada just wanted to have a baby. Fair enough. But at age 66, she should have asked herself how being 83 teaching her twins to drive would work. Or maybe she should have asked who would manage the house if she broke her hip at 77. Maria sadly was only thinking of herself and succumbed to narcissistic rationalization.

Now let’s consider her doctor. The clinic’s cut-off was age 55. This is outside ASRM guidelines and opens the clinic up to criticism and scrutiny. The doctor here was a ‘co-dependant enabler’ of our tragically narcissistic lead player. A simple 2-letter word, ‘NO’ would have prevented this.

Our clinic cut-off used to be 55. I personally have helped a 54 year-old conceive. We now adhere to ASRM guidelines precisely because of what we are seeing happen here.

Maria lied to her doctor about her age. The doctor is on record as saying that she falsified records from Spain. He went on to say that he should not be in the business of checking passports. Passports are not as easy to fake and frankly he SHOULD have asked to see it. She was a beautiful woman and did look younger than her real age. But 50 something is still iffy and it should be clinic policy to verify by best possible means a patient’s true age where the reality will make a difference in management. A reproductive tourist like Maria would have had her passport handy. A minimally curious doctor should also have wondered why a Spaniard would need to travel to Los Angeles when Europe’s busiest egg donor program is in Valencia, Spain!

Society as a whole is to blame for this too. Our belief that we are entitled to anything we can conjure and the unquenchable thirst we have for sensational stories create the tableau on which such a picture is painted.

Let me be clear that I do think age limits are sexist, but I also believe that the power of true feminism is not in mimicking male patterns of behavior but in giving women the power to choose wisely for themselves. Maria and her doctor chose unwisely.

Oh Bitch Please!

Categories
Donor Egg • Egg Donation • Family Building • Fertility • Infertility • IVF



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