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Against age limits for men in reproductive care

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Abstract

Almost all countries and fertility clinics impose age limits on women who want to become pregnant through Assisted Reproductive Technologies (ART). Age limits for aspiring fathers, however, are much less common and remain a topic of debate. This article departs from the principle of reproductive autonomy and a conditional positive right to receive ART, and asks whether there are convincing arguments to also impose age limits on aspiring fathers. After considering three consequentialist approaches to justifying age limits for aspiring fathers, we take in a concrete normative stance by concluding that those are not strong enough to justify such cut-offs. We reinforce our position by drawing a comparison between the case of a 39-year-old woman who wants to become a single mother via a sperm donor on the one hand, and on the other hand the same woman who wants to have a child with a 64-year-old man who she loves and who is willing to care for the child as long as he is able to. We conclude that, as long as appropriate precautions are taken to protect the welfare of the future child, couples who want to receive fertility treatment should never be limited on the basis of the age of the (male) partner. An absence of age limits for men would respect the reproductive autonomy of both the man and the woman.

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Notes

  1. The connection between success rate and risks for the offspring assumes that the advanced age women try to become pregnant with their own ‘fresh’ eggs. This connection no longer exists if they would use their own frozen eggs or younger donor eggs. If a couple or individual use a surrogate, the matter of obstetric risks of course also disappears.

  2. The average life expectancy for 60-year-old men and women over 26 European countries is 81 and 85 respectively (Weber and Loichinger 2022).

  3. This ambiguity of course pertains to parents of both genders. Therefore, APA is often used to abbreviate ‘Advanced Parental Age’. However, since our article particularly focusses on age cut-offs for aspiring fathers, we will use APA to refer to ‘Advanced Paternal Age’.

  4. Although this article focusses on heterosexual couples of which the aspiring father is significantly older than the aspiring mother, our argument is just as well applicable to other reproductive scenarios such as same-sex couples and persons using a surrogate. In such cases, “aspiring father” may simply be understood as “the eldest reproductive partner”. The fundamental criterion remains that at least one parent must live long enough in good health to be able to care for the child until it reaches maturity.

  5. Importantly, the arguments presented in (section “Impact of APA on the psychosocial welfare of the child”) and (section “Impact of APA on the (fair) distribution of tasks and responsibilities”) are also relevant with respect to other family forms where the second aspiring parent is not a man – e.g. lesbian couples. This is important to notice, since there are countries which pose parental age limit for both aspiring parents regardless of their gender. For example, French law imposes age limits also for ‘the member of the couple who will not carry the child’ (French Government 2021; art. 1).

  6. We are aware that concerns about paternalism exist with regards to arguments pertaining to harm to the mother. However, it is not self-evident that autonomy should always take priority over other considerations, especially not if the chance of a successful outcome is very poor or futile (e.g., because of the woman’s age). For example, the Ethics Committee of the ASRM has argued that in such cases, clinicians have a quasi-duty to not grant access to fertility treatment (2019).

  7. This systematic review analyzed the general population, and did not distinguish between women who achieved pregnancy through natural reproduction, medically assisted reproduction with own eggs, or donated eggs. The use of donated eggs from younger women or younger frozen own eggs may lead to different results.

  8. For these reasons, the American Society for Reproductive Medicine discourages treatment with donor or preserved eggs if a woman is over 55 years of age (Daar et al. 2016).

  9. Mutations like these are gathered under the aforementioned umbrella term “Paternal Age Effect” (PAE).

  10. It should be remarked that other studies have reached different conclusions and that the numbers referred to by us thus merely serve indicative purposes. Yet, the main observation of the absolute risks remaining low on the individual level is recurrent throughout the majority of studies like these.

  11. E.g., Assisted reproduction contributed to 2% of all babies born in the US in 2018 (Sunderam et al. 2022; p. 1).

  12. Of men with CF, 97% is infertile (Kazmerski et al., 2022).

  13. In which the father is the breadwinner while the mother stays at home to raise the children and take care of the household on her own.

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Funding

This work was supported by SNSF-FWO Lead Agency under Grant 10001AL_197415/1 and FWO (Research Foundation – Flanders) under Grant FWO.OPR.2021.0001.01.

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Authors and Affiliations

  1. Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, Ghent, 9000, Belgium

    Steven R. Piek & Guido Pennings

  2. Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland

    Andrea Martani

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  1. Steven R. Piek
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Correspondence to Steven R. Piek.

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Piek, S.R., Martani, A. & Pennings, G. Against age limits for men in reproductive care. Med Health Care and Philos (2024). https://doi.org/10.1007/s11019-024-10203-0

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