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Reproductive ageing and conflicting clocks: King Midas’ touch

Published:September 25, 2013DOI:https://doi.org/10.1016/j.rbmo.2013.09.012

      Abstract

      The population attempting pregnancy and having babies is ageing. Gynaecological and obstetric complications worsen with age. Maternity services are struggling. Increasing rates of infertility and complications are not matched by the marvels in the laboratory. This paper argues that assisted reproduction treatment has had a damaging social impact. Despite its public acclaim, it helps few and fails many more. The assisted reproduction industry could take a new and revolutionary direction towards empowering men to experience pregnancy, producing babies from artificial gametes, with a final goal being the liberation of both women and men from the burdens and dangers of pregnancy through the development of artificial wombs.
      This paper seeks to give a brief explanation as to why women are having children older and discusses how reproduction technologies have contributed to this trend. It argues that reproduction technologies is not a panacea for this problem and has in fact contributed to it. We suggest that as a means of promoting reproduction equality between the sexes, science needs to extend the reproduction experience to men, as well as developing artificial gametes and wombs.
      VIDEO LINK: http://sms.cam.ac.uk/media/1401028

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      References

        • Alexander S.
        • Wildman K.
        • Zhang W.
        • Langer M.
        • Vutuc C.
        • Lindmark G.
        Maternal health outcomes in Europe.
        Eur J Obstet Gynecol Reprod Biol. 2003; 111: S78-87
        • Andersson G.
        • Rønsen M.
        • Knudsen L.B.
        • Lappegard T.
        • Neyer G.
        • Skrede K.
        • Teschner K.
        • Vikat A.
        Cohort fertility patterns in the Nordic countries.
        Demogr. Res. 2009; 20: 313-352
        • Arnett J.
        Conceptions of the transition to adulthood: perspectives from adolescence through midlife.
        J. Adult Dev. 2001; 8: 133-143
        • Asthana A.
        • Hill A.
        Late Motherhood: Time for a Vital Wake-up Call.
        Observer, London2009
      1. Braude, P., 2013. Are the ‘best’ embryos being selected and what prospects for improvement? Reprod. Biomed. Online 27, 644–653.

        • Becker G.
        The Elusive Embryo: How Women and Men Approach New Reproductive Technologies.
        University of California Press, Los Angeles2000
        • Benzies K.
        • Tough S.
        • Tofflemire K.
        • Frick C.
        • Faber A.
        • Newburn-Cook C.
        Factors influencing women’s decisions about timing of motherhood.
        AWHONN Lifelines. 2006; 35: 625-633
        • Berrington A.
        • Stone J.
        • Falkingham J.
        The changing living arrangements of young adults in the UK.
        Pop Trends. 2009; 138: 27-37
        • Bewley S.
        • Davies M.
        • Braude P.
        Which career first?.
        BMJ. 2005; 331: 588-589
      2. Bewley S. Ledger W. Nikolaou D. Reproductive Ageing. Royal College of Obstetricians and Gynaecologists, London2009
        • Billari F.C.
        • Kohler H.P.
        Patterns of low and lowest low fertility in Europe.
        Popul. Stud. 2004; 58: 161-176
        • Boivin J.
        • Bunting L.
        • Collins J.A.
        • Nygren K.G.
        International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care.
        Hum. Reprod. 2007; 22: 1506-1512
        • Bongaarts J.
        • Sobotka T.
        A demographic explanation for the recent rise in european fertility.
        Popul. Dev. Rev. 2012; 38: 83-120
        • Botting B.
        What has happened to reproduction in the 20th century?.
        in: Bewley S. Ledger W. Nikolaou D. Reproductive Ageing. Royal College of Obstetricians and Gynaecologists, London2009: 33-40
        • Bretherick K.L.
        • Fairbrother N.
        • Avila L.
        • Harbord S.H.A.
        • Robinson W.P.
        Fertility and aging: do reproductive-aged Canadian women know what they need to know?.
        Fertil. Steril. 2010; 93: 2162-2168
      3. CDC, 2009. Retrieved from: <http://www.cdc.gov/nchs/data/databriefs/db21.pdf>.

      4. CEMACH, 2004. Why Mothers Die 2000–2002. Available from: <http://www.hqip.org.uk/assets/NCAPOP-Library/CMACE-Reports/33.-2004-Why-Mothers-Die-2000–2002-The-Sixth-Report-of-the-Confidential-Enquiries-into-Maternal-Deaths-in-the-UK.pdf>.

      5. CEMACH, 2006. Perinatal Mortality Surveillance, 2004: England, Wales and Northern Ireland. London: CEMACH; 2006. Available from: <http://www.hqip.org.uk/assets/NCAPOP-Library/CMACE-Reports/43.-March-2006-Perinatal-Mortality-Surveillance-Report-2004.pdf>.

        • Collins J.A.
        An international survey of the health economics of IVF and ICSI.
        Hum. Reprod. Update. 2002; 8: 265-277
        • Cooke A.
        • Mills T.A.
        • Lavender T.
        ‘Informed and uninformed decision making—Women’s reasoning, experiences and perceptions with regard to advanced maternal age and delayed childbearing: a meta-synthesis.
        Int. J. Nurs. Stud. 2010; 47: 1317-1329
      6. Cracknell, R., 2010. The Ageing Population. Key Issues for the New Parliament 2010; Retrieved from: <http://www.parliament.uk/documents/commons/lib/research/key_issues/Key% 20Issues%20The%20ageing%20population2007.pdf> (accessed 12.1.13).

        • Daly I.
        Explaining the trend towards older first time mothers – A life course perspective.
        in: Ebtehaj F. Herring J. Johnson M.H. Richards M. Birth Rites and Rights. Hart, Oxford2011: 255-270
        • Daly I.
        MISCONCEPTIONS: women’s knowledge of age-related fertility decline in the context of a trend towards older motherhood, PhD.
        University of Cambridge, Cambridge, 2012
        • Daniluk J.C.
        • Koert E.
        The other side of the fertility coin: a comparison of childless men’s and women’s knowledge of fertility and assisted reproductive technology.
        Fertil. Steril. 2013; 99: 839-846
        • Daniluk J.C.
        • Koert E.
        • Cheung A.
        Childless women’s knowledge of fertility and assisted human reproduction: identifying the gaps.
        Fertil. Steril. 2012; 97: 420-426
        • Dey I.
        • Wasoff F.
        Another child? Fertility ideals, resources and opportunites.
        Popul. Res. Policy. 2010; 29: 921-940
        • Dixon H.
        Cassandra’s prophecy: a response from a sex education perspective.
        Reprod. Biomed. Online. 2013; 27: 15-17
        • Elder G.H.
        The life course paradigm: social change and individual development.
        in: Moen P. Elder Jr., G.H. Luscher K. Examining Lives in Context: Perspectives on the Ecology of Human Development. American Psychological Association, Washington1996: 101-140
        • Elder G.H.
        • O’Rand A.
        Adult lives in a changing society.
        in: Cook K.S. Fine G.A. House J.S. Sociological Perspectives on Social Psychology. Allyn and Bacon, Boston1995: 452-475
      7. Equal Opportunities Commission, 2005. Greater expectations: summary final report EOC’s investigation into pregnancy discrimination. Retrieved from: <http://www.equalityhumanrights.com/uploaded_files/eoc_pregnancygfi_summary_report.pdf>.

        • Eriksson C.
        • Larsson M.
        • Skoog Svanberg A.
        • Tyden T.
        Reflections on fertility and postponed parenthood-interviews with highly educated women and men without children in Sweden.
        Ups. J. Med. Sci. 2013; 118: 122-129
        • ESHRE Capri Workshop Group
        Europe the continent with the lowest fertility.
        Hum. Reprod. Update. 2010; 16: 590-602
        • Everywoman J.
        Cassandra’s prophecy: why we need to tell the women of the future about age-related fertility decline and ‘delayed’ childbearing.
        Reprod. Biomed. Online. 2013; 27: 4-10
        • Faddy M.J.
        • Gosden R.G.
        • Gougeon A.
        • Richardson S.J.
        • Nelson J.F.
        Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause.
        Hum. Reprod. 1992; 7: 1342-1346
        • Firestone S.
        The Dialectic of Sex: The Case for Feminist Revolution.
        Morrow, New York1972
        • Franklin S.
        Conception through a looking glass: the paradox of IVF.
        Reprod. Biomed. Online. 2013; 27: 722-732
        • Franklin S.
        • McNeil M.
        Reproductive futures: recent literature and current feminist debates on reproductive technologies.
        Feminist Stud. 1988; 14: 545-560
        • Frejka T.
        • Sobotka T.
        • Hoem J.M.
        • Toulemon L.
        Summary and general conclusions: childbearing trends and policies in Europe.
        Demogr. Res. 2008; 19: 5-14
      8. Galston, W.A., 2004. The changing 20s. Retrieved from: <http://www.brookings.edu/speeches/2007/1004useconomics_galston.aspx>.

        • Gooldin S.
        Cultural competence and ethical incompetence: notes from a study of the new reproductive technologies in Israel.
        Divers. Health Care. 2011; 8: 45-55
        • Gosden R.
        Designer Babies: The Brave New World of Reproductive Technology.
        Victor Gollancz, London1999
      9. Gosden, R., 2013. Programmes and prospects for ovotechnology. Reprod. Biomed. Online 27, 702–709.

      10. Grant, J., Hoorens, S., Gallo, F., Cave, J., 2006. Should ART be Part of a Population Policy Mix? A Preliminary Assessment of the Demographic and Economic Impact of Assisted Reproductive Technologies. Paper Presented at the 22nd Annual Meeting of the European Society of Human Reproduction and Embryology, Prague.

        • Hayashi K.
        • Ogushi S.
        • Kurimoto K.
        • Shimamoto S.
        • Ohta H.
        • Saitou M.
        Offspring from oocytes derived from in vitro primordial germ cell-like cells in mice.
        Science. 2012; 338: 971-975
      11. HFEA, 2011. Fertility Treatment in 2011. Trend and Figures. Retrieved from: <http://www.hfea.gov.uk/docs/HFEA_Fertility_Trends_and_Figures_2011_-_Annual_Register_Report.pdf>.

      12. HFEA, 2013. In vitro Derived Gametes. Retrieved from: <http://www.hfea.gov.uk/in-vitro-derived-gametes.html>.

      13. HFEA, 2013. Freezing and Storing Eggs. Retrieved from: <http://www.hfea.gov.uk/46.html#1>.

        • Hoem J.M.
        Overview chapter 8: the impact of public policies on European fertility.
        Demogr. Res. 2008; 19: 249-260
        • Hodgekiss A.
        Egg freezing should be every father’s graduation present to his daughter, claims leading fertility expert.
        The Daily Mail, London2012
        • Hoorens S.
        Trends in fertility: what does the 20th century tell us about the 21st?.
        in: Bewley S. Ledger W. Nikolaou D. Reproductive Ageing. Royal College of Obstetricians and Gynaecologists, London2009: 41-58
        • Hubner K.
        • Fuhrmann G.
        • Christenson L.K.
        • Kehler J.
        • De Reinbold R.
        • La Fuente R.
        • Wood J.
        • Strauss 3rd, J.F.
        • Boiani M.
        • Scholer H.R.
        Derivation of oocytes from mouse embryonic stem cells.
        Science. 2003; 300: 1251-1256
        • Jackson E.
        Degendering reproduction?.
        Med. Law Rev. 2008; 16: 346-368
        • Johnson M.H.
        • Franklin S.
        A patient perspective.
        Reprod. Biomed. Online. 2013; 27: 1-3
        • Jørgensen N.
        • Asklund C.
        • Carlsen E.
        • Skakkebaek N.E.
        Coordinated European investigations of semen quality: results from studies of Scandinavian young men is a matter of concern.
        Int. J. Androl. 2006; 29: 54-61
        • Joshi H.
        Production, reproduction, and education: women, children, and work in a British perspective.
        Popul. Dev. Rev. 2002; 28: 445-474
        • Kemkes-Grottenthaler A.
        Postponing or rejecting parenthood? Results of a survey among female academic professionals.
        J. Biosoc. Sci. 2003; 35: 213-226
        • Knight J.
        Artificial Wombs: An Out of Body Experience.
        Nature. 2002; 419: 106-107
      14. Lampi, E., 2006. The Personal and General Risks of Age-related Female Infertility: Is There an Optimistic Bias or Not? Working Papers in Economics (online), vol. 231. Retrieved from: <http://www.frisch.uio.no/firstnordic/Lampi-paper.pdf>.

        • Lampic C.
        • Svanberg A.S.
        • Karlström P.
        • Tydén T.
        Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics.
        Hum. Reprod. 2006; 21: 558-564
        • Leridon H.
        Can assisted reproduction technology compensate for the natural decline in fertility with age? A model assessment.
        Hum. Reprod. 2004; 19: 1548-1553
        • Maheshwari A.
        • Porter M.
        • Shetty A.
        • Bhattacharya S.
        Women’s awareness and perceptions of delay in childbearing.
        Fertil. Steril. 2008; 90: 1036-1042
        • Martin L.J.
        Anticipating infertility: egg freezing, genetic preservation, and risk.
        Gender Soc. 2010; 24: 526-545
        • Martin F.
        • Preston J.
        Ageing: what is it and why does it happen?.
        in: Bewley S. Ledger W. Nikolaou D. Reproductive Ageing. Royal College of Obstetricians and Gynaecologists, London2009: 3-14
        • McDonald P.
        Sustaining fertility through public policy: the range of options.
        Population. 2002; 57: 417-446
        • Menken J.
        • Trussell J.
        • Larsen U.
        Age and fertility.
        Science. 1986; 233: 1389-1394
        • Mishtal J.
        Irrational non-reproduction? The ‘dying nation’ and the postsocialist logics of declining motherhood in Poland.
        Anthro Med. 2012; 19: 153-169
        • Mortimer J.T.
        • Zimmer-Gembeck M.J.
        • Holmes M.
        The process of occupational decision making: patterns during the transition to adulthood.
        J. Vocat. Behav. 2002; 61: 439-465
        • Neugarten B.L.
        Time, age, and the life cycle.
        Am. J. Psychcol. 1979; 136: 887-894
        • Neugarten B.L.
        • Datan N.
        Sociological perspectives on the life cycle.
        in: Baltes P.B. Schaie K.W. Life Span Developmental Psychology: Personality and Socialisation. Academic Press, New York1973: 53-69
        • Neugarten B.L.
        • Moore J.
        • Lowe J.C.
        Age norms, age constraints, and adult socialization.
        Am. J. Sociol. 1965; 70: 710-717
      15. NHS, 2011. Improving Maternity Care in London. A Framework for Developing Services, March 2011. Retrieved from: <http://www.londonhp.nhs.uk/wp-content/uploads/2011/03/Improving-maternity-care-in-London_A-framework-for-developing-services.pdf>.

      16. NICE, 2013. Clinical Guideline 156. Fertility: Assessment and Treatment for People with Fertility Problems. Available from: <http://www.nice.org.uk/cg156>.

        • Nybo Anderson A.-M.
        • Wohlfahrt J.
        • Christens P.
        • Olsen J.
        • Melbye M.
        Maternal age and fetal loss: population based register linkage.
        BMJ. 2000; 320: 1708-1712
      17. OECD, 2011. Doing Better for Families. Retrieved from: <http://www.oecd.org/social/soc/doingbetterforfamilies.htm>.

        • O’Leary L.
        • Natamba E.
        • Jeffries J.
        • Wilson B.
        Fertility and partnership status in the last two decades.
        Popul. Trends. 2010; 140: 5-35
        • Settersten R.A.
        Age structuring and the rhythm of the life course.
        in: Mortimer J.T. Shanahan M.J. Handbook of the Life Course. Springer, New York2006: 81-102
        • Office for National Statistics
        Social Trends 40: How UK Life has Changed Since the 1970s.
        Office of National Statistics, Newport2010
      18. Office for National Statistics, 2011. Births, Deaths in England and Wales, 2010. Newport: The Office of National Statistics. Retrieved from: <http://www.statistics.gov.uk/>.

      19. Office for National Statistics, 2012. Births in England and Wales by Parent’s Country of Birth, 2010. Newport: The Office for National Statistics. Retrieved from: <http://www.ons.gov.uk/ons/dcp171778_230307.pdf>.

        • Peterson B.D.
        • Pirritano M.
        • Tucker L.
        • Lampic C.
        Fertility awareness and parenting attitudes among American male and female undergraduate university students.
        Hum. Reprod. 2012; 27: 1375-1382
        • Sample I.
        Have Your Eggs Frozen While You’re Still Young, Scientists Advise Women.
        The Guardian, London2011
        • Schmidt L.
        Should men and women be encouraged to start childbearing at a younger age?.
        Expert Rev. Obstet. and Gynaecol. 2010; 5: 145-147
        • Sigle-Rushton W.
        England and Wales: stable fertility and pronounced social status differences.
        Demogr. Res. 2008; 19: 455-502
        • Skakkebaek N.E.
        The contribution of assisted reproduction to completed fertility: an analysis of Danish data.
        Popul. Dev. Rev. 2008; 34: 79-101
        • Skoog Svanberg A.
        • Lampic C.
        • Karlstrom P.O.
        • Tyden T.
        Attitudes toward parenthood and awareness of fertility among postgraduate students in Sweden.
        Gend. Med. 2006; 3: 187-195
        • Soares S.R.
        • Troncoso C.
        • Bosch E.
        • Serra V.
        • Simon C.
        • Remohi J.
        • Pelliver A.
        Age and uterine receptiveness: predicting the outcome of oocyte donation cycles.
        J. Clin. Endocrinol. Metab. 2005; 90: 4399-4404
        • Sobotka T.
        Is lowest-low fertility in Europe explained by the postponement of childbearing?.
        Popul. Dev. Rev. 2004; 30: 195-220
        • Sobotka T.
        • Hansen M.A.
        • Jensen T.K.
        • Pedersen A.T.
        • Lutz W.
        • Skakkebaek N.E.
        The contribution of assisted reproduction to completed fertility: an analysis of Danish data.
        Popul. Dev. Rev. 2008; 34: 79-101
        • Sparrow R.
        Is it every mans right to have babies if he wants them? Male pregnancy and the limits of reproductive liberty.
        Kennedy Inst. Ethics J. 2008; 18: 275-299
        • Sperling D.
        Commanding the ‘be fruitful and multiply’ directive: reproductive ethics, law and policy in Israel.
        Camb. Q. Healthc. Ethics. 2010; 19: 363-371
        • te Velde E.
        • Habbema D.
        • Leridon H.
        • Eijkemans M.
        The effect of postponement of first motherhood on permanent involuntary childlessness and total fertility rate in six European countries since the 1970s.
        Hum. Reprod. 2012; 27: 1178-1183
        • Theodosiou A.
        Cassandra’s prophecy: medic or mother? Exploring the relevance of age-related fertility decline to women in medicine.
        Reprod. Biomed. Online. 2013; 27: 25-28
        • Tibbetts G.
        Sex education must include infertility lessons.
        Telegraph, London2008
        • Tong R.
        Feminist thought-a more comprehensive introduction.
        3rd ed. Westview, Oxford2008
        • Toulemon L.
        • Pailhe A.
        • Rossier C.
        France: high and stable fertility.
        Demogr. Res. 2008; 19: 503-556
        • Vasireddy A.
        • Bewley S.
        IVF is safe over 50 if it is not fatal.
        Am. J. Perinatol. 2013; 00: 1-2
        • Welles-Nystrom B.
        The meaning of postponed motherhood for women in the United States and Sweden: Aspects of feminism and radical timing strategies.
        Health Care Women Int. 1997; 18: 279-299
        • Woodroffe J.
        Not having it all: how motherhood reduces women’s pay and employment prospects.
        The Fawcett Society, London2009
      20. Worldbank, 2013. Retrieved from: <http://data.worldbank.org/indicator/SP.DYN.TFRT.IN>.

        • Wrosch C.
        • Heckhausen J.
        Being on-time or off-time: developmental deadlines for regulating one’s own development.
        in: Perrot-Clermont A.N. Thinking Time: A Multidisciplinary Perspective on Time. Hogrefe and Huber Publishers, Cambridge, MA2005: 110-123