A 60 year-old woman has sparked controversy in Canada by travelling to India to receive fertility treatment after years of failed attempts to conceive naturally. Ranjit Hayer, originally from India, has become the oldest woman in Canada to give birth after receiving IVF at Dr Anoop Gupta's Delhi fertility clinic; her twin boys were delivered seven weeks prematurely by Caesarean section at the Foothills hospital in Calgary last week. 

Canadians are not usually eligible for fertility treatment above the age of 50, so Hayer travelled to what has been dubbed by one Canadian newspaper the 'salvation destination' amongst the global community of infertile; India, where 'unregulated reproductive technology makes anything possible'. Hayer is not the oldest woman to have given birth; a growing number of post-menopausal women have turned to fertility treatment in India where regulations have been minimal. In November 2008, a woman in the northern Indian state of Haryana gave birth to her first child at the alleged age of 70 years old. In 2006, Carmela Bousada of Spain was hailed as the oldest new mother after giving birth to twin boys at 66 years of age.

The case in Canada has not only raised ethical questions about older mothers and their ability to parent, but also about who pays for the treatment of patients who undergo medical procedures abroad. 'I very much object to the resources this woman has used in the health system. We have spent a lot of money on her' said Dr Cal Greene, medical director of a Calgary-based fertility clinic. Physicians in the state expressed concern that the cost of care for Hayer's twins could reach $6,000 a day, as resources are limited. Dr Greene would 'rather see those resources used in the normal age group'. However, Juliet Guichon, a bioethicist at the University of Calgary said it would be unethical for the medical system to turn away any patient in need.

Dr Gupta's clinic is one of an estimated 150 clinics in India offering an extensive range fertility treatments to patients such as Mrs Hayer who are either unable to access treatment in their home country, or cannot afford to. The lack of regulation has caused concern even within India: 'Total madness is prevailing', said Imrana Qadeer, a professor of public health at Jawaharlal Nehru University, a campaigner for regulated assisted reproduction. 'It is a totally unregulated thing... the doctors get away with a lot of things because people trust them and also there is a lot of ignorance about technologies... Women are vulnerable, they can be pressured'. Surrogacy in India is a big attraction for foreign patients, where the total cost is about $10,000 compared to $50-70,000 in the US. Yet surrogates tend to be poor, uneducated women often unable to read the contracts they sign. Egg donation is also widely desired by foreign patients, and according to Dr Gupta, has been on the increase since the economic downturn.

Reproduced from BioNews with permission, a web- and email-based source of news, information and comment on assisted reproduction and human genetics, published by Progress Educational Trust.