The Israeli doctor who helped a woman have a baby at age 60
‘Metro’ interviews the doctor who helped make it happen.
By MIRIAM KRESHDr. Ilya Barr: ‘This is the message I’d like to convey: Have your first child before age 35.’(photo credit: Courtesy)
Last month, a 60-year-old woman gave birth at the Kaplan Medical Center, Rehovot. It wasn’t her first pregnancy, but it was a first birth. The news has attracted plenty of media attention, but the mother understandably refuses to give interviews or even allow her name to be known.Dr. Ilya Barr, Israeli fertility expert with clinics around the country, is the doctor who helped her conceive and stay pregnant until full term. He talked to Metro without giving away details of the mother’s private life.The doctor is genial, with a slight Romanian accent.“She’s a woman like any other,” he says. “Healthy in every way, except that she wasn’t able to get pregnant. She came to us [referring to the medical team that works with him] at age 53, after years of futile treatments somewhere else. We helped her to get pregnant, twice, but unfortunately those pregnancies ended in early miscarriages.”Those miscarriages resulted from a growth in the woman’s womb that caused the placentas to separate from the uterine wall. Barr and the surgeons involved in the case debated removing the growth surgically.There was danger of damaging the womb. Some leaned toward removing the womb altogether, “which would have been normal, in most circumstances,” Barr remarks, “but we removed the growth without damage, and the uterus remained viable.”All of the woman’s pregnancies were results of in vitro fertilizations. “IVF was the only possible way, considering the woman’s age,” Barr affirms.Girl babies are born with all the eggs they will ever have. By a certain age they deteriorate past viability or simply don’t exist anymore. The woman involved was well past the age that women retain healthy eggs. She received eggs donated by an anonymous European woman. As in most cases of IVF, the relationship between the donor and the recipient legally ended once the donor’s eggs were extracted.
“What with the treatments, miscarriages, decisions to consider and then to execute, it took a good number of years until we succeeded,” says Barr. “Normally we don’t encourage women older than 43 to attempt pregnancy. That is the recommendation of the Israel Fertility Association. However, this woman was already in the system, undergoing treatment, and unusually for such cases, she had been pregnant several times, which was a factor in her favor. We examined the state of her health at every level, down to genetic mapping, and weighed her every treatment.“Genetic mapping is a sort of physiological ID card; it reveals what risks a person has of coming down with the ailments of senior years, such as high blood pressure, heart disease, cancers of different types. So we can advise the patient, or couple, what to expect in their futures, and they can base their decision to try for a late-life birth on that information.“Which brings me to the issue everyone raises,” continues Barr. “Is it right to help a woman bear a child at this age? To which I say, it’s fine. Today’s 60 is yesterday’s 40. Our life span has increased by six hours per every 48 that pass. Today’s Israeli woman can expect to live to age 84, whereas 60 years ago her life expectancy was only 48 years. And it’s not only that we live longer lives now; we also live healthier lives.“The ailments of old age that were almost inevitable once are becoming less common. Most of us understand about maintaining good health through correct nutrition and physical activity, plus we enjoy excellent medical care when issues arise. We can detect health problems in their early stages. We can even prevent the ailments that we formerly expected to have by the time we reach age 50 or 60,” Barr maintains.“Since the news about the birth became public, journalists have assaulted me over this issue, over and over: ‘What, when the little girl will be 10, her mother will be 70! Like her grandmother! Is this right?’”Answering a question with a question, Barr responds, “Do couples in their 20s, with career worries and the day-to-day issues of making their way in the world, make better parents than couples with all that already behind them? Consider who actually raises the children of young couples. Most often, it’s the babysitter or nursery, then the kindergarten teacher, and then the school. We know that infants’ greatest influences come from the environment. Who provides the better environment: paid babysitters or the older mother with time to raise the child herself? The answer is clear. Today, children raised by older parents enjoy a better formative environment than those born to younger couples.“So if you ask me, is it right for a 40-year-old woman to bear a child for the first time, I say yes. Professionals should accept this. But scientists and doctors change attitudes slowly. It’s always been that way, back to the times when people were put to death for daring to claim that the world is round. There’s been a radical change in biology since the human gene was discovered, but in spite the incredible advances in the field, many professionals stick to conservative views, and refuse to approve of older women having children.”What about the new mother herself; what kind of person is she? All Barr allowed himself to say is that she’s married and that her husband has an adult child from a previous marriage. She proved suitable for parenthood by all the examinations for physical and mental health and emotional stability. She also has a supportive social and family network, another favorable factor. The only statement she gave to the press was to express gratitude to the team at Kaplan Medical Center in Rehovot for their professional excellence and support as she was prepared for the birth.The birth was through cesarean section. Although the mother is in good health generally, and worked at her job until almost full term, there were concerns about her safety when she developed high blood pressure in late pregnancy. Barr’s team was vigilant for signs of preeclampsia, a condition characterized by high blood pressure and swellings, which must be treated before the convulsions and coma of eclampsia itself develop. Given that older women run a high risk of preeclampsia, and with this woman’s womb weakened by previous surgery, the team had already decided that the safest was for the birth to take place via cesarean section.“She showed signs of preeclampsia in the last few weeks before the scheduled surgery, so we simply brought it forward. We would do this for any older firsttime mother, even one 20 years younger,” says Barr. The new mother and baby left the hospital after a normal post-operation length of time, and both are feeling fine.Metro asked Barr how he feels after this happy culmination.“It was a long, hard road with this mother, but all our efforts – hers, my team’s, and that of the surgeons and midwives – were worthwhile. Just to witness her boundless joy made the work worth everything. Both men and women have the biological urge to disperse their genes, but a woman’s joy in motherhood has no limits.”Does Barr think more older women seeking first births will come forward, after all the publicity this one has had? Apparently not. “As I said, we don’t encourage late first-time pregnancies. I don’t expect more than one or two in the coming year or even longer. This is the message I’d like to convey: have your first child before age 35. That’s the reality of biology. Even if it’s not convenient in terms of finances and careers, start while you’re young. We’re living longer lives, even approaching biblical ages, but fertility diminishes with age. Why delay starting a family until you’ll need these complicated procedures?” Metro asked who the women are who seek first births at an older age. In Barr’s 30 years of experience, they’re mostly women in their early and mid-40s.“We see many career women who left having children until late, single women who feel that they’re not going to build a nuclear family and are anxious to have a child before their biological clock winds down. We’ve also helped older couples who have lost a child through an accident or other traumatic event to conceive again.”Most of Barr’s patients are Jewish. Israeli Arabs usually have their children relatively early in marriage, says Barr, and additionally, use of donated eggs or sperm is forbidden by Islam.“We have had secular Arab couples seeking treatment, but very few. I treated one Arab couple where the wife was born without eggs. She got pregnant after one treatment and had a child. They left frozen sperm, eggs, and embryos in the laboratory. I asked them if, having all the materials at hand, they wouldn’t like start another pregnancy. The couple said they decided not to, for religious reasons, since they already have one.”Barr says that not many couples come to Israel for fertility treatment anymore, and those are mostly Russians.These treatments are widely available in many countries these days, and have the same success rate as here. Israelis have the economic advantage of having their expenses covered by the government-supported medical funds.How many babies have Barr and his team brought into the world? “About 10 years ago we figured on 7,000 births, then we stopped counting. Now we’re probably around 10,000,” says Barr.And last month, happily, one more.