Abstract

Requests to proceed with assisted reproduction at advanced ages require careful consideration of risks balanced against ethical concerns. Key ethical issues include: (1) Patient autonomy to determine whether and when to become a parent, assuming that the patient is educated about all medically acceptable options, (2) health care provider/ART clinic autonomy to develop fact-based guidelines that limit a patient’s reproductive options regarding age, (3) physician duty to promote wellbeing (beneficence) and prevent harm (non-maleficence) to a patient, fetus or neonate, and (4) acknowledgment that assisted reproduction is a scarce resource to which few individuals have access and that pregnancy at an advanced age likely requires a higher level of care. To promote justice, reproductive health care professionals should work to ensure an equitable distribution of resources while being aware of how ageism may shape the plans they propose to patients.