<- Home <- Arhive <- Vol. 28, Issue 4, December 2020

Rom J Leg Med28(4)470-473(2020)
© Romanian Society of Legal Medicine


C. Gică, A. M. Panaitescu, A. E. Dumitru, A. Veduță, G. Peltecu, R. Botezatu, N. Gică,

Abstract: Nowadays the average age of the first pregnancy in women has risen all over the world. With this increase come the decreased chances of obtaining a spontaneous pregnancy. The recent advances in artificial reproductive techniques have made it more possible for older couples to conceive. Age is considered the most important factor in determining the success rates in IVF (in vitro fertilization). In addition, availability of assisted reproduction techniques to older women and option of fertility preservation produced a growing demand for fertility services. The objective of this narrative review is to determine the age-related ethical and medical aspects regarding IVF. We performed a systematic review searching relevant information in PubMed using MeSH Terms such as: pregnancy, IVF, post-menopause women, advanced maternal age, fertility, pregnancy outcome. The results were then screened and included if they met the criteria to be written in English and containing information regarding ethical and medical aspects. The ethical landscape identifies a few distinguishable items like: “the unnatural” way of conception and relationship with the pre-embryo, the financial difficulties involved with these procedures, the relationship with malignancy and infectious diseases and patient’s autonomy. Medical considerations discussed the use of younger donor oocytes to reduce the risks, as well as the higher risk for preeclampsia and gestational diabetes in women of advanced age, but with similar rates for miscarriage and multiple gestation. The results showed higher ethical and medical considerations in advanced maternal age, with possible involvement on the pregnancy and fetal outcome such as miscarriage, low birth weight or premature delivery. In conclusion, there is an overall positive attitude towards achieving pregnancy by IVF techniques in advanced maternal age with the possibility of donor oocytes. With respect to the medical complications that may arise, the consensus established that it involves higher risks for both mother and fetus, which can be mitigated by careful maternal screening and optimal maternal status.
Keywords: fertility, advanced maternal age, pregnancy, IVF (in vitro fertilization).

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