A German woman who after having 13 children has had IVF quadruplets at the age of 65. Experts at a top fertility conference are dismayed by the case.
The episode damages the reputation of in-vitro fertilization (IVF), which has enabled millions to know the joy of parenthood, they said.
"It's the kind of tale which makes headlines around the world and skews the image of our field," said Francoise Shenfield, a specialist in reproductive medicine and bioethics at University College London.
The controversy swirls around Annegret Raunigk, a Berlin teacher near retirement age who is the oldest woman to have given birth to quadruplets.
After going to Ukraine for IVF treatment from anonymous donors, Raunigk gave birth last month to three boys and a girl, delivered by Cesarean about 15 weeks early.
The babies weighed between 655 and 960 grams (1.4 to 2.1 pounds) at birth, have since gained between 30 and 50% in weight "and are developing well", Berlin's Charite Hospital said Wednesday.
One is on respiratory assistance and the others "require milder aids for breathing", it added, but medical confidentiality barred it from saying more.
One baby required surgery for an intestinal problem, doctors said last month.
Specialists interviewed at the annual conference of the European Society of Human Reproduction and Embryology (ESHRE), closing in Lisbon Wednesday, highlighted ethical concerns about the mother's age and risks for the babies.
There is no international regulation of fertility treatment and national guidelines are based on medical opinion.
A general age limit for IVF is about 50, close to the typical onset of menopause, the experts said.
- Single embryo
Women in Germany today live to around 85, "so you could argue that a 65-year-old's got 20 years and could see that child through to adult life," said Adam Balen, a professor of reproductive medicine and chairman of the British Fertility Society.
A much bigger concern, he said, was that the clinic had implanted numerous embryos to boost chances of a live birth.
"Multiple pregnancies are dangerous. They're dangerous for the mother, but they're more dangerous for the babies," said Balen.
Fertility clinics in advanced economies stopped routine transfers of multiple embryos about six years ago.
The evidence shows that babies born from such multiple transplants generally enter the world with lower birth weight and higher risk of ill health and cognitive difficulties.
Most Western watchdogs recommend single embryo transfers, which are now much more likely to succeed than a decade ago.
The German Society for Reproductive Medicine (DGRM) describes Raunigk's case as "extremely questionable."
"Egg donation and especially the transfer of more than one embryo should not have been allowed or performed in these circumstances, both on medical and ethical and moral grounds," it says.
Raunigk, who has seven grandchildren, had negotiated exclusive rights to her story with German TV channel RTL.
News of her multiple pregnancy emerged in April, when Raunigk dismissed criticism that she was acting irresponsibly.
But she is not the first woman to raise a storm about IVF ethics.
One prominent case was Carmen Bousada, a single Spanish woman who in 2006 had twin IVF boys at the age of 66, making her oldest woman at the time to become a mother.
She later admitted she had lied about her age to doctors, tell them she was 55.
After becoming a campaigner for the rights of older women to experience motherhood, Bousada died of cancer in 2009, leaving orphans aged two-and-a-half.
Another was Nadya Suleman, a 33-year-old Californian woman who was dubbed "octomum" after giving birth to octuplets. It later transpired she was a single mother of six other children under the age of eight.
Rogue clinics dangle offers of egg and sperm donation and cheap IVF rates, and pay commissions to intermediaries who bring in punters, the experts said.
"The outcome is this sort of thing, which is a disaster, and somebody, somewhere is making a lot of money," said Balen.
"Like all technology, assisted reproduction can be used rightly or wrongly," Shenfield observed.