Postmenopausal pregnancy is medically OK, study finds

Tuesday, November 12th 2002, 12:00 am

By: News On 6

CHICAGO (AP) _ Though old enough to be grandmas, there's no medical reason healthy women in their 50s should be prevented from having babies with donated eggs, according to the largest study of motherhood after menopause.

While healthy postmenopausal women are likely to have Caesarean births and face high rates of pregnancy-induced diabetes and high blood pressure, the conditions are temporary and not reason enough to exclude them from attempting pregnancy, the researchers found in a study to be published Wednesday.

Rates of pregnancy, childbirth and multiple births were similar to those in women a decade or more younger who get pregnant with donor eggs.

The researchers studied outcomes for 77 postmenopausal women who participated in the assisted reproduction program at the University of Southern California between 1991 and last year. Forty-two of the women had babies.

``We're having our own grandkids _ we just skipped having kids,'' said study participant Marilyn Nolen, 58, who had twin boys at age 55 using eggs from a woman in her 20s.

Nolen, women's volleyball coach at St. Louis University, experienced blood pressure abnormalities while pregnant and had a C-section.

She has no regrets. She and her husband tried for 10 years to have children, turning to egg donation after she hit menopause. It worked on the first try.

``For us it's just a dream come true,'' Nolen said.

Some say it's unethical to allow women to become pregnant who might not live to see their children grow up. The American Society for Reproductive Medicine's ethics committee says using egg donation in postmenopausal women should be discouraged.

But Dr. Richard Paulson, the lead researcher and director of USC's program, said denying them the chance would be ageism.

``Not only do I not have a problem in allowing them to become pregnant, I would have an ethical problem in denying them,'' he said.

The study is one of several in this week's Journal of the American Medical Association that focuses on aging-related research.

One study found that human growth hormone, touted as an anti-aging remedy, increased lean body mass and decreased potbellies in adults aged 65 and older, as has been shown in younger people. But it also raised the risk of diabetes and other side effects, and the authors concluded that the hormone should only be used in research.

Another study found that weekly training for five weeks in tasks such as memory and problem-solving helped improve older adults' mental function. And other researchers found that walking for at least four hours weekly reduced the risk of hip fracture by 41 percent in postmenopausal women.

The older mothers' study highlights a phenomenon that has been increasing, though specialists say the number of postmenopausal women seeking to become pregnant through egg donation is small.

In 2000, there were 255 births nationwide to women aged 50 to 54, up from 174 in 1999, according to the most recent data available from the Centers for Disease Control and Prevention. The CDC does not keep statistics on births to women over age 54.

Because of the JAMA study, ``We probably will see more of these procedures done because, unfortunately, medicine ... is treated less and less as a public good and increasingly as if it were little more than another commodity,'' said bioethicist Roberta Springer Loewy of the University of California at Davis.

``Simply because we find we can and want to do something doesn't mean we ought to do it,'' Loewy said.

Rates of pregnancy in the study _ 45 percent _ and multiple births _ 30 percent _ were similar to those in younger women who become pregnant with donor eggs. So was the birth rate _ about 37 percent.

There were no infant or mother deaths.

Preeclampsia, a potentially serious condition involving high blood pressure, occurred in 35 percent of the women and gestational diabetes occurred in about 20 percent. Those rates are at least double the rate of younger women.

About 78 percent of the women had Caesarean births.

Paulson said all those factors can be medically managed and are not reason to avoid pregnancy.

Egg donation is an accepted practice used to help infertile women become pregnant. Embryos are created through in vitro fertilization and recipients take hormones to prepare the uterus for pregnancy. Many programs won't accept patients who are over 50.

At Advanced Fertility Center of Chicago, the cutoff is 45. At Chicago's Northwestern Memorial Hospital, it's 50.

``We have to have a cutoff just for practical reasons,'' said Dr. Ralph Kazer, who heads the hospital's IVF program. ``If somebody's very old, it's not realistic.''

Biologically, it's normal to be unable to become pregnant after menopause, which occurs on average around age 51, and many doctors believe that since IVF costs thousands of dollars, it should be ``reserved for people who have something wrong with them,'' Kazer said.