Swedish Government Advisory Body Recommends Removing Age Limits for IVF Treatments

The Swedish National Council on Medical Ethics (Smer) has released a comprehensive report proposing the removal of regional age restrictions for in vitro fertilization (IVF) treatments. The council argues that current age limits set by Swedish regions are overly restrictive and do not adequately account for individual circumstances or advancements in medical technology.

Currently, public clinics in Sweden adhere to strict recommendations set by the Swedish Association of Local Authorities and Regions (SKR), which stipulate that fertilization must occur before a woman's 40th birthday and a male partner must not be older than 56 years. Any remaining frozen embryos must be used before the woman turns 45, after which unused embryos are destroyed. While some private clinics offer more flexible age limits, individuals must personally fund the transfer of embryos to these clinics.

The Smer report emphasizes that there is no national legislation explicitly defining age limits for starting fertility treatments. Instead, the existing practice relies on regional guidelines, which often do not consider the unique medical conditions or life expectancies of individual patients. The council suggests that decisions regarding eligibility for IVF should be based on thorough individual medical assessments rather than fixed age thresholds. According to Smer, the main criterion should be whether a parent is likely to be able to provide care for the child until adulthood, considering rising average life expectancies in Sweden.

Advocates for the removal of current age restrictions highlight that biological suitability for pregnancy varies significantly among individuals, and advances in fertility medicine continue to expand the possibilities for successful outcomes at older ages. The council notes that applying a blanket age limit particularly affects those whose infertility is age-related, thereby treating them differently from individuals with other causes of infertility.

The report also addresses the legal framework around embryo storage, noting that the current law allows embryos to be frozen for up to 10 years, regardless of the woman's age, with possible extensions granted by the National Board of Health and Welfare under special circumstances.

In addition to age, Smer's report covers broader topics related to assisted reproduction, including issues around donation and surrogacy, reflecting two years of work examining the ethical, legal, and societal implications of reproductive technologies in Sweden.

While cost savings and risk management have been cited as reasons for maintaining age limits, Smer argues that modern fertility care should prioritize individualized assessments. The council points out that societal trends indicate a continued rise in the age at which individuals choose to start families, and medical advances are making such choices increasingly viable.

The report concludes that Sweden's fertility care should move towards a more personalized model, where treatment eligibility is determined by comprehensive medical evaluations rather than arbitrary age cutoffs. This approach, the council contends, would better align with both medical ethics and contemporary societal developments.