What if the biological clock ran forever?

On the heels of rampant debate over the tension between work and parenthood, fertility researchers in Italy are adding a new dimension to this balancing act. Thanks to a promising fertility-preservation procedure now eight years in the making, women may soon be able to postpone menopause — indefinitely — by freezing their ovarian tissue and transplanting it later in life.

This experimental technique has, so far, mostly been used on young cancer patients undergoing high-dose chemotherapy that could lead to infertility. Substantiating a track record of more than 20 successful births thanks to ovarian tissue freezing, Italian researcher Dr. Gianluca Gennarelli presented the most recent indication of the technique's promise at the European Society of Human Reproduction and Embryology's annual meeting: A 21-year-old cancer patient who underwent the procedure in 2003 before undergoing chemotherapy became pregnant 15 months after her ovarian tissue was transplanted in 2011. Infertile just two years before, she gave birth to a healthy baby in March 2012.

Such encouraging outcomes have led Gennarelli to advocate that the experimental procedure be "recognized as a routine clinical practice to be offered in appropriate cases." As the website Jezebel notes, women could ostensibly transplant portions of frozen tissue incrementally as they age, essentially rendering the infertility of menopause a choice rather than an inevitability (that is, of course, if you can afford the procedure).

Plus, ovarian tissue transplant has marked advantages over the increasingly popular methods of egg and embryo freezing. Not only do these more typical techniques require hormone treatments and retrieval procedures that take precious time not afforded to cancer patients, but the hormones themselves can exacerbate certain types of cancer.

So … hooray? Should we rejoice, now that our feverishly ticking biological clocks might be able to slow down to island time? For those among us who dread the moment of reproductive reckoning, when pregnancy becomes a "now or never" predicament, having such flexibility seems nothing short of miraculous. But is it that simple?

Is it fair to limit a kid's chance to be parented by able-bodied caretakers before they themselves must care for their geriatric parents? Should a 20-year-old college student be saddled with the complexities and costs of mom's assisted-living arrangements? The option to evade menopause also begs the question of how we decide when availing ourselves of this technology is appropriate, and who does the deciding. Will this procedure be for anyone who wants it, or will women have to show a certain physical and mental ability to bear and raise children if they are over a certain age? Given how hard women continue to fight for control over our own bodies, opening the floodgates to external determinations of "maternal fitness" seems like a dangerous and disempowering prospect.

Women are already delaying motherhood, and that's not necessarily a bad thing. But if the ovarian tissue transplant becomes routine, the delay could extend beyond the now typical 35 to 55 and beyond. Such a shift would affect society dramatically, altering not only when people have children, but also when they marry, how they pursue career advancement, how they spend and save, and when and how they retire. Still, it is hard to deny that the mere possibility of extending the fertility window inspires a slight sigh of relief for young women like me, with our eyes on two prizes — the short-term freedom of childlessness, and the long-term fantasy of a family. Bypass the church. Get me to the freezer on time.

© 2012 Slate

What if the biological clock ran forever? 07/21/12 [Last modified: Saturday, July 21, 2012 5:30am]

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