TY - JOUR

T1 - Age-discriminated IVF Access and Evidence-based Ageism

T2 - Is There a Better Way?

AU - Cavaliere, G.

AU - Fletcher, J.R.

N1 - The final, definitive version of this article has been published in the Journal, Science, Technology, & Human Values, 47 (5), 2022, © SAGE Publications Ltd, 2021 by SAGE Publications Ltd at the Science, Technology, & Human Values page: https://journals.sagepub.com/home/SPP on SAGE Journals Online: http://journals.sagepub.com/

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Access to state-funded fertility treatments is age-restricted in many countries based on epidemiological evidence showing age-associated fertility decline and aimed at administering scarce resources. In this article, we consider whether age-related restrictions can be considered ageist and what this entails for a normative appraisal of access criteria. We use the UK as a case study due to the state-funded and centrally regulated nature of in vitro fertilization (IVF) provision. We begin by reviewing concepts of ageism and age discrimination in gerontological scholarship and contend that it is analytically useful to differentiate between them when considering age-restricted health services. We then argue that criteria to access IVF could be considered indirectly ageist so far as they rely on an age-related evidence base that manifests ageist categorizations of persons. Lastly, we examine whether there could be more normatively desirable alternatives to devise criteria to access fertility treatment, considering “lifestyle” as a potential candidate. We conclude, however, that lifestyle-based discrimination is problematic because, unlike age-based discrimination, it risks exacerbating existing socioeconomic and ethnic inequalities. © The Author(s) 2021.

AB - Access to state-funded fertility treatments is age-restricted in many countries based on epidemiological evidence showing age-associated fertility decline and aimed at administering scarce resources. In this article, we consider whether age-related restrictions can be considered ageist and what this entails for a normative appraisal of access criteria. We use the UK as a case study due to the state-funded and centrally regulated nature of in vitro fertilization (IVF) provision. We begin by reviewing concepts of ageism and age discrimination in gerontological scholarship and contend that it is analytically useful to differentiate between them when considering age-restricted health services. We then argue that criteria to access IVF could be considered indirectly ageist so far as they rely on an age-related evidence base that manifests ageist categorizations of persons. Lastly, we examine whether there could be more normatively desirable alternatives to devise criteria to access fertility treatment, considering “lifestyle” as a potential candidate. We conclude, however, that lifestyle-based discrimination is problematic because, unlike age-based discrimination, it risks exacerbating existing socioeconomic and ethnic inequalities. © The Author(s) 2021.

KW - ageing

KW - assisted conception

KW - epidemiology

KW - fertility

KW - gerontology

KW - reproduction

U2 - 10.1177/01622439211021914

DO - 10.1177/01622439211021914

M3 - Journal article

VL - 47

SP - 986

EP - 1010

JO - Science, Technology, and Human Values

JF - Science, Technology, and Human Values

SN - 0162-2439

IS - 5

ER -