Earlier this month, 61-year-old Cecile Eledge made headlines for acting as a gestational surrogate for her own grandchild. Her son, Matthew Eledge, and his husband, Elliot Dougherty, were interested in having a child, and that’s when Cecile Eledge offered to carry their child. The baby was conceived by her son’s sperm and an egg from Dougherty’s sister.
But her age has many people wondering how it was possible.
According to the American Society for Reproductive Medicine (ASRM), “Pregnancy may be possible in virtually any woman with a normal uterus, regardless of age and even in the absence of ovaries and ovarian function.”
In their position paper, ASRM raised concerns about gestational carriers of advanced ages, but said that many women from 45 to 54 are healthy and well prepared for parenting, and therefore are reasonable candidates to receive donated oocytes and embryos.
In the case of Cecile Eledge, who gave birth to her granddaughter, she won’t be raising the child. The child will be raised by her son and his husband.
The baby was born at nearly six pounds at the Nebraska Medical Center in Omaha, Nebraska. There were no complications.
Women can carry a pregnancy after menopause with the assistance of hormones, said Dr. Lisa Campo-Engelstein, PhD, an associate professor in the department of obstetrics and gynecology and the Alden March Bioethics Institute at Albany Medical College.
Menopause means their ovaries stop producing hormones, but their uterus remains functional.
A potential grandma gestational carrier would need approval from a medical provider or reproductive endocrinologist, as there are a wide range of medical considerations, said Dr. Erika Fuchs, PhD, an assistant professor in the department of obstetrics and gynecology at the University of Texas Medical Branch in Galveston.
The woman carrying the child would face the same risks of pregnancy along with minor risks posed by medications taken with an embryo transfer.
Little is known about the risks of carrying a child with advanced age, but the risks tend to increase with age, she said.
Dr. Paul Lin, MD, president-elect of the Society for Assisted Reproductive Technology, told Healthline that physicians can give post-menopausal women estrogen and progesterone to trick the uterus into thinking it can get pregnant.
“Just because she can get pregnant doesn’t mean she should,” Lin noted. “There is very documented experience that women in the very advanced maternal age (vAMA), have increased maternal risk of preterm delivery, gestational diabetes, high blood pressure, preeclampsia, and preterm labor.”
Epidemiologic studies on the health impacts of advanced age pregnancies can’t be done due to the low number of cases and health concerns.
“We must be cautious in embracing this form of family building as mainstream,” Lin warned.
On the flip side, many premenopausal women may have high risks associated with pregnancy, and they may not be discouraged from getting pregnant, Campo-Engelstein said.
“While women of advanced maternal age are at increased risks during pregnancy, these risks can typically be managed so that it is safe for them,” she added. “These risks are not usually serious enough to discourage healthy postmenopausal women from carrying a pregnancy.”
“Gestational carrier” is the preferred term for a woman who carries a pregnancy for someone else and isn’t produced using her oocyte, Fuchs said.
Though there’s not a lot of data about how many parents are using gestational carriers they know, Fuchs said she doesn’t expect grandparents carrying their grandchild to be a common event.
There shouldn’t be different costs or legal procedures when a family member or close friend serves as a gestational carrier, she added. “All of the costs for the medical care of the woman will still exist, the woman may still be compensated for her time and discomfort, and both parties should still each have their own separate legal representation.”
The laws and procedures vary by state, so it’s important to have separate legal representation for each party involved from the beginning, prior to pregnancy. The gestational carrier needs to have an experienced attorney looking out for her best interests while the intended parent or parents should have their own attorney, Fuchs said.
In general, women who are gestational carriers should have good physical and mental health, should have had previous uncomplicated pregnancies and deliveries, and should be raising their own children in a stable, healthy home environment, Fuchs said.
Aside from the legal and health concerns, Lin said the social stress and implications of using a known gestational carrier are significant. What a family may gain in saving money could be more expensive emotionally due to the potential strain that it can put on family members. Coercion is already an issue with anonymous gestational carriers, and is “exponentially a bigger issue with known family or friend relationships.”
“Pregnancy is not necessarily risk free, and it is definitely not risk free in a woman 61 years old,” Lin said.
“While there may be numerous positive emotions associated with caring one’s own grandchild, there may also be some negative emotions,” Campo-Engelstein added.