The ethics of IVF over 40

The average age of women having their first child has been rising in recent decades [1]. Since fertility declines with age, it is not surprising that larger numbers of women over 40 are seeking IVF. Any change in reproductive norms tends to generate concern. Women's apparent postponement of motherhood has met with criticism directed variously at women themselves, and at society for its failure to support women to have children at the 'appropriate' time. The provision of IVF to women over 40 is one facet of this broader social trend towards later reproduction.In this paper I consider a number of ethical problems that might be connected with the provision of IVF to patients over 40. I look at risks to women and offspring, and also consider questions of efficacy and cost-effectiveness. I discuss the possibility that IVF for older women could raise increase the problems associated with egg procurement. Finally I address the concept of medicalisation and suggest that as long as IVF is regarded as a medical treatment, access to it should not be used as a means of social control. Nor should it be provided or withheld on the basis of moral judgements about patients' values or lifestyles.1