IMR Press / CEOG / Volume 35 / Issue 2 / pii/1630638481793-137735905

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Editorial
A 59-year-old woman gives birth to twins – when should a fertility specialist refuse treatment?
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1 The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ (USA)
Clin. Exp. Obstet. Gynecol. 2008, 35(2), 93–97;
Published: 10 June 2008
Abstract

Objective: To review cases of infertility where despite extremely low odds of success and potential risks to the woman if she became pregnant or to the fetus, the couples elected to take a chance to fulfill their dreams of having a baby. Materials and Methods: Six cases are described: case 1, a 59-year-old woman with hyperstimulation and intramuscular fibroids compressing the uterine cavity who wanted to be a donor egg recipient; case 2, a 59-year-old woman desiring a second transfer of sibling frozen embryos who had previously conceived with donor eggs at age 57; case 3, a 33-year-old woman with a subseptated uterus and cervical abnormality from intrauterine diethilstibesterol exposure plus hemoaphilia trait, and only 25% of her liver remaining from a previous partial liver resection; case 4, a woman with an unicornuate uterus refusing reduction of her twins to a singleton; case 5, a 39-yearold woman willing to try again to have her first live born child with a history of a large macroprolactinoma that was resected but markedly enlarged in her previous pregnancy despite bromocryptine therapy; and, case 6, a woman willing to try a unique experimental therapy with extremely high thyroid stimulating immunoglobulins to inhibit severe intrauterine growth retardation and potential premature synostosis for her condition of Hashimoto’s disease. Results: Cases 2-5 all had successful outcomes. Case 1 was never given the chance for donor oocytes since she was rejected by a majority vote of our physicians because of the fear of a malpractice suit. Discussion: If a couple understands the potential risks and the low odds of success, they should be given the opportunity to fulfill their dreams of having a baby. However, treating physicians are under no obligation to take malpractice risks.
Keywords
Advanced maternal age
Premature ovarian failure
Uterine anomalies
Intrauterine growth retardation
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