¿Es la gestación a edad materna muy avanzada éticamente aceptable?

Abstract

In recent years, there has been an increase in the age at which women conceive and have children, especially in developed countries.

This study aims to elucidate whether pregnancy at a very advanced maternal age is ethically acceptable or if it is better to promote pregnancy at a younger age. The specific objectives include evaluating the medical risks associated with pregnancy at a very advanced maternal age and analyzing the ethical and social implications of pregnancies at advanced maternal ages.

A systematic review was conducted using PubMed and Web of Science with the keywords pregnancy outcome, 45 years, 50 years, very advanced maternal age, menopause, ethics, bioethics. Studies published in the last 10 years in Spanish or English were included. Reviews, meta-analyses, clinical cases, letters to the editor, comments, and opinion articles were excluded.

The systematic review revealed that pregnancy at age 45 or older is associated with more adverse maternal-fetal outcomes compared to younger ages. Thus, patients of very advanced maternal age should receive appropriate prenatal counseling and close prenatal monitoring. Women of very advanced age wishing to conceive with their own oocytes should be informed about the low probabilities of success and high risk of embryonic aneuploidies. Preimplantation genetic diagnosis is recommended for women over 43 years with good ovarian reserve, and in vitro fertilization cycles should be limited to three for patients aged 44-45 years. Patients aged 45-46 years should be informed about the minimal probability of success with autologous oocytes.

As a conclusion, pregnancy at a very advanced maternal age is increasingly common and is considered ethically acceptable by both patients and specialists in reproductive medicine and obstetrics and gynecology.