Treatment and preservation at the extremes of reproductive age: a case report outlining the ethical dilemmas

Abstract

Purpose The purpose of the study was to report a livebirth from a cryopreserved embryo created from autologous oocytes collected at 47 years and 9 months that outlines the ethical difficulties of decision-making at the extreme of reproductive age. Methods The method used was IVF and embryo cryopreservation within an assisted conception unit prior to adjuvant cancer treatment in a nulliparous patient diagnosed with breast carcinoma (47 years and 9 months at oocyte collection). Results A 47-year-old nulliparous woman was diagnosed with breast malignancy during work-up for fertility treatment. Ovarian stimulation yielded one embryo from four oocytes that was cryopreserved to allow completion of adjuvant treatment. Subsequent embryo transfer cycle led to a live birth of a healthy baby girl at term, weighing 3.37 kg. Conclusion This paper demonstrates the oldest reported age of autologous oocyte collection to have achieved a livebirth. In women where most would consider treatment futile, we highlight the difficulties in decision-making in this group of patients.

Live Birth Rates After Assisted Reproductive Techniques of Women Aged 42 and Over

“…The chance of the live birth (LB) with an ART treatment is at extremely lower rates, specifically age over 42 years old. On the other hand, there are reports of patients with extremely advanced age and successfully achieved LB after ART using autologous oocytes [15][16][17][18]. The decision to proceed or not to proceed to an ART treatment should be based on the patient's findings and their own decision after detailed information on the potential risks and success rates of ART treatment.…”