Social Pressure, Affordable Access Prompt Older Women In India To Seek IVF Services

Intense social pressure to bear children and access to relatively affordable reproductive technology has spawned hundreds of infertility clinics across India, where a significant number of clients are women older than age 50, the Washington Post reports. In India, "giving birth to many children defines a woman's worth" in society and is "considered parents' best chance for financial security," according to the Post. Little is being done to curb the nation's rapidly growing population of 1.2 billion, and planning advocates argue that the unchecked expansion is stalling India's economic growth and straining its infrastructure.

As in the U.S., the majority of Indian IVF clients are upper-middle class couples in their 30s and early 40s who have delayed childbearing to focus on careers. However, about 20% of India's clients are older women looking to "shed the stigma of being unable to conceive," the Post reports. For example, the private National Fertility Center in the northern state of Haryana has helped 100 women older than age 50 conceive in the past 18 months, including a 66-year-old woman who gave birth to triplets. About 60 of the women were able to carry their pregnancies to term.

A single IVF attempt in India costs about $2,500, compared with up to $15,000 in the U.S., and many patients take out loans or borrow money from relatives to pay for the procedure. Some of the women used eggs donated by younger relatives that were fertilized with their husbands' sperm.

Fertility experts who oppose the use of IVF in older women note that it carries several risks for the mother, including stress on the heart, high blood pressure and uterine rupture. In addition, older women's infants are more likely to be born prematurely and face health problems. Although the U.S. has no age limit on IVF, doctors discourage it after age 45 and can refuse to provide it in situations they consider too risky.

The Indian government does not regulate IVF clinics. Hrishikesh Pai, a leading IVF expert in India and president of the 900-member Indian Society of Assisted Reproductive Technology, said there are more than 550 in-vitro fertilization centers in India, with an average of one new clinic opening every 15 days. Pai said that some health experts expect as many as 600,000 IVF cycles to be performed in India in the next three years, exceeding the number of IVF cycles performed in the U.S. -- 150,000 -- and China -- 80,000 -- in 2009. Doctors in India will often attempt up to four rounds of IVF on a patient (Wax, Washington Post, 8/13).


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