An interesting counterpoint to the octuplet story. The main criticism here is similar - the mother went 'home' to India for in-vitro fertilization, and came back to Canada to have her twins. They were not only delivered by emergency Caesarean, but she had a hysterectomy as well. The costs of this decision come out of the Canadian taxpayer's wallet as well.

She has been in Canada 5 years, and speaks no English. How will she deal with her kids being in English speaking schools? She will not be able to teach them to speak ahead of time.

Maybe no big deal there - they'll have friends - but I wish she had stayed in India for the birth and follow up NICU and hysterectomy, and come back to Canada later.

JMO

http://www.cbc.ca/canada/calgary/sto...ld-mother.html

60-year-old Calgary mother welcomes twins
Last Updated: Thursday, February 5, 2009 | 1:19 PM MT

CBC News

Ranjit Hayer delivered her twin boys at Calgary's Foothills Hospital on Tuesday morning. (CBC)

Ranjit Hayer tried for decades to have a child, enduring multiple miscarriages, surgery, even the trauma of being robbed by a fertility doctor. Finally, after a successful IVF treatment, the Calgary woman gave birth to twins — at age 60.

She is believed to be among the oldest Canadian women to give birth.

Hayer's boys were delivered seven weeks prematurely by C-section at Calgary's Foothills Hospital on Tuesday morning, CBC Radio's The Current reported Thursday. The mother is recovering in intensive care, while the twins are in the neo-natal intensive care unit.

'I always said there should be a baby. I had my heart set on it. I wanted a baby.'— Ranjit Hayer, new mother

One of the babies is breathing with the help of special equipment, while the other boy is in the special care unit. Doctors say both are doing well. The twins will be kept in hospital until they reach a specified weight and can breathe on their own.

"My mind was always uneasy. I always said there should be a baby. I had my heart set on it. I wanted a baby," Hayer said from her hospital bed through a Punjabi translator.

"I used to say to my husband, 'Go ahead, marry someone else. You have earned so much.'

"He used to say to me, 'There's nothing wrong with you. If God wants to give us kids, he will.'"

Case raises ethical questions

Hayer's case — especially her age — has raised many ethical questions about how far to push the frontiers of medical science, even from the Calgary specialist who helped her.

"We can do so much but the question is, should we do it just because we can do it?" said obstetrician Colin Birch, who was excited by the challenge but says he has yet to reconcile the social implications.

"It all sounds very fine when this age group — isn't it fantastic what medical technology can do, how we're stretching the boundaries and everything else — but there's so much more involved in this. It's not just having the babies and being born," he told CBC.

"There's not just one generation gap here, there's two generation gaps. They're really what would be like the age of grandparents."

Hayer, who is originally from India, tried for years to get pregnant with her husband, but she miscarried three times.

After Hayer became a permanent resident in Canada, an obstetrician gynecologist diagnosed a problem with Hayer's womb and recommended surgery. She had the operation in Calgary but she still couldn't conceive.
Woman got pregnant through fertility treatment in India

About 10 years ago, the couple paid a doctor in India for in vitro fertilization, but he took off with their money.

The couple spent years working and saving up their money in Canada. After being turned down for IVF in this country because of her age, Hayer returned to India for the treatment using donor eggs last year — and got pregnant with triplets.

'I couldn't imagine if I was 65 having two five-year-olds running around crazily. The energy to do that is incredible.' — Dr. Colin Birch

"I thought it was a joke because the referral said 60-year-old patient with triplets, and I thought one of my colleagues or somebody's just playing jokes with me or up to mischief, and then actually the patient turned up in my office," Birch recalled.

One of Hayer's embryos had to be terminated for medical reasons and the pregnancy with twins left her with high blood pressure and diabetes.

She also had a condition called placenta previa — where the placenta is attached to the bottom of the uterus and covers part or all of the cervix and can cause severe bleeding. Hayer spent the last four weeks in hospital so doctors could deliver the babies at a moment's notice if necessary.

Hayer began to hemorrhage this week so Birch performed an emergency C-section to deliver the twins. The bleeding was so severe he had to take out the woman's uterus. Hayer was admitted to the intensive care unit, where she required blood transfusions to stabilize her condition.

Debate in medical community

The cutoff age in Canada for IVF is between 45 and 50 years old.

Glenys Godlovitch, who chairs the health research ethics board at the University of Calgary, said there are many situations where patients return to Canada for care, after choosing to pay for treatment elsewhere.

"We need to think of this as the broader context, not just the individual circumstances here, as to what obligation is there in the Canadian health-care system or on the Canadian taxpayer to support the after-care for people who've received an initial intervention, at cost, somewhere outside of Canada," she said Thursday.

There are also the social implications of raising children when the parents may not live long enough to see them grow up.

"I couldn't imagine if I was 65 having two five-year-olds running around crazily. The energy to do that is incredible," said Birch.
With files from Dr. Brian Goldman