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Women After 50 Can Have Safe Pregnancy

But They Have More C-sections, Diabetes, High Blood Pressure
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Nov. 12, 2002 (Washington) -- As the years pass and technology improves, the barrier to pregnancy gets pushed farther and farther back. It used to be thought that women shouldn't get pregnant over the age of 40. Today, 50-something women and their doctors wonder if it is safe to push that barrier even farther.

"There is no medical reason" not to, said Richard J. Paulson, MD, in a news conference today. Chief of the division of reproductive endocrinology and fertility at the University of Southern California Keck School of Medicine, he is also the lead investigator on a study that appears in the Nov. 13 issue of The Journal of the American Medical Association.

The study of women aged 50 to 63, all of whom were postmenopausal, revealed an increased number of complications, but nothing that cannot be handled by close monitoring and quality healthcare.

After menopause, a woman no longer produces eggs and thus cannot become pregnant naturally. But although eggs succumb to this biological clock, pregnancy is still possible using a donor egg. Therefore, all of the women in the study had an egg from a younger woman implanted into her uterus.

"There are really two biological clocks: One for the ovary, which seems to run out, and one for the rest of the reproductive system, which seems to go on," said Paulson. All that's needed is a little priming with the hormones estrogen and progesterone, followed by a donated, fertilized egg.

Out of 121 attempts, there were 45 births -- a pretty good percentage and one that improved over the course of the study with improvements to the procedure, according to Paulson. There were complications, however.

An unusually high percentage of women (78%) who gave birth had cesarean sections. In addition, 20% developed diabetes of pregnancy -- called gestational diabetes -- compared to a more typical rate of 5%. More worrisome was a 35% rate of pregnancy-induced high blood pressure. Most of the cases were mild, but typical pregnancies carry only a 3-5% risk of this condition.

Still, the side effects were tolerable enough that a 50-something woman shouldn't completely discount the possibility of pregnancy. "We believe the data are reassuring," Paulson said.

Marcos J. Pupkin, MD, agrees that there are no real medical reasons to not get pregnant. "If someone wants to be a mother at age 50, that's a different issue. That's something that society will have to decide. Do they have time to take care of children? It may be that they're going to do better than a mother who is 18," Pupkin, chair of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore, tells WebMD.

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