Sleepwalking Into Infertility: The Need for a Public Health Approach Toward Advanced Maternal Age

Am J Bioeth. 2015;15(11):37-48. doi: 10.1080/15265161.2015.1088973.

Abstract

In Western countries today, a growing number of women delay motherhood until their late 30s and even 40s, as they invest time in pursuing education and career goals before starting a family. This social trend results from greater gender equality and expanded opportunities for women and is influenced by the availability of contraception and assisted reproductive technologies (ART). However, advanced maternal age is associated with increased health risks, including infertility. While individual medical solutions such as ART and elective egg freezing can promote reproductive autonomy, they entail significant risks and limitations. We thus argue that women should be better informed regarding the risks of advanced maternal age and ART, and that these individual solutions need to be supplemented by a public health approach, including policy measures that provide women with the opportunity to start a family earlier in life without sacrificing personal career goals.

Keywords: advanced maternal age; assisted reproductive technologies; egg freezing; empowerment; reproductive autonomy.

MeSH terms

  • Adult
  • Educational Status
  • Employment*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Income
  • Infertility* / therapy
  • Maternal Age*
  • Middle Aged
  • Organizational Culture*
  • Personal Autonomy
  • Power, Psychological
  • Public Health / ethics*
  • Quebec
  • Reproductive Rights* / ethics
  • Reproductive Rights* / trends
  • Reproductive Techniques, Assisted* / economics
  • Reproductive Techniques, Assisted* / ethics
  • Risk
  • Social Problems
  • Social Values*
  • United States
  • Western World