In Cheating time, the fourth episode in the A child against all odds series, Robert Winston turns his attention to older women seeking to become pregnant by IVF. The focus is on two couples from the UK, plus an interview with Adriana Iliescu who aged 66 was, at that time, the oldest mother in the world (A 67 year old Spanish woman gave birth to twins in December 2006).
Karen and her husband Alex already have one daughter as a result of regular IVF. Despite Karen being only 35, a dramatic decline in her fertility has left them seeking an embryo donated by a younger woman in order to increase their family. Their search takes them to Russia. A donor, paid the equivalent of a month’s wages for her services, provides a remarkable 21 eggs which are fertilised using Alex’s sperm. There are concerns because the lining of Karen’s uterus is not as thick and ready to receive an embryo as they had hoped. Despite this, the doctor’s transfer two embryos and Karen achieves a pregnancy. She later discusses on camera her struggle as she comes to terms with the fact that her unborn baby is not genetically hers (c. 51 mins), although the 12 week scan helps her in the bonding process. The episode finishes with her giving birth to a son.
Suzanne is a businesswoman in her early 40s. She has only married Alan relatively recently and they find themselves wanting to start a family. Unfortunately, as the commentary puts it, “Suzanne is ready to have children at exactly the age when the quantity and quality of her eggs is falling” (5:50 into episode). Initially they try an experimental new procedure called “assisted hatching”. Working on the premise that older women may have difficulty conceiving because the outer layer of their eggs has become tougher with time and hence less likely to implant when put back into the uterus, doctors soften the eggs by careful treatment with a laser. Sadly on neither this occasion, nor a later round of IVF, are they able to achieve a pregnancy.
In terms of teaching about the science and bioethics of fertility treatment, there are fewer stand-out clips in this episode than some of the other programmes in the series. The section starting about 5 minutes in where we are first introduced to Suzanne and Alan is perhaps the most self-contained section illustrating the sort of situations that lead women to be seeking IVF. Robert Winston’s reflections on the upper age limit for fertility treatment following his conversation with Adriana Iliescu are also interesting (43 mins in).
This programme was initially transmitted on BBC1 on December 5th 2006 (TRILT identifier = 005DCCC6). Clicking on this link will take you to the BBC website for this episode, which also includes a short video clip where Robert Winston discusses Adriana’s case with her fertility doctor. This is perhaps more illuminating concerning the key ethical issues than the programme itself. BioethicsBytes notes on the next episode in the series, Gift of life, can also be found via this link.