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That this is precisely what has happened is no surprise, given the powerful human urge to procreate. Some 100 women ages 50 and older have borne children in the U.S., and so have many more in other countries. In fact, the 60-year-old barrier has been broken several times. Last spring, a 63-year-old California woman named Arceli Keh gave birth (she had allegedly lied to the clinic about her age); so, in 1994, did an Italian woman who was 62.
"Nobody's tried it in 70- or 80-year-olds yet," says Dr. Richard Paulson, head of reproductive endocrinology and infertility at the University of Southern California, where Keh was a patient, "but at present there's no evidence of an upper age limit." Inevitably, the prospect of using their own eggs, frozen years before, rather than a donor's genetically foreign eggs, will only increase the number of older women who want to give birth.
Even at 50, though, pregnancy and childbirth can put a terrible strain on a woman's body, and the demands of child rearing can do the same to both body and spirit. Some observers believe it is not fair to the child. "When that child is of college age," observes John Paris, professor of bioethics at Boston College and a Jesuit priest, speaking of the 62-year-old Italian woman's offspring, "his mother will be 80." That is, if she is still alive. "We're designing orphans by choice, and we say this is O.K.," he says.
Older mothers disagree, of course. People live longer nowadays, they argue, and stay healthy and strong well into their 70s and 80s. Besides, when an elderly man fathers a child--Strom Thurmond or Tony Randall, to name just two recent examples--many applaud his virility. When an older woman bears a child, she is seen as some sort of freak. Yet sexist as it may seem, most experts agree that the mother is usually the more crucial parent.
For all these reasons, only a handful of the hundreds of fertility clinics in the U.S. will treat women 50 and older. The ethics committee of the American Society for Reproductive Medicine has issued guidelines stating that "infertility should remain the natural characteristic of menopause." But the guidelines are voluntary; no law prevents doctors from starting a pregnancy in any woman who wants one.
Assisted reproduction is among the least regulated medical specialties in the U.S. Unlike most of Europe, the U.S. does not require fertility clinics to be licensed. Moreover, many U.S. clinics are interested above all in turning a buck. Thus, says Gladys White, executive director of the National Advisory Board on Ethics in Reproduction, "the U.S. has some of the best and some of the worst infertility centers in the world."
The insurance industry doesn't help matters. In most of the world, IVF is covered by national health insurance. Private insurers in the U.S., by contrast, often refuse to pay for it. Since each attempt costs an average of nearly $8,000, patients often risk multiple births in order to avoid having to pay for a second visit. Eight states now mandate IVF coverage, but in most of the U.S., high-quality assisted reproduction is only for the well-to-do.