In many countries in Europe, too few children are being born for the population to replace itself. In the future this can entail major problems when it comes to financing health care and pensions, for example. In Greece, Italy, and Spain roughly 1.3 children are born per woman, and in Sweden the figure is 1.88. At the same time, in Sweden, for instance, some 10 percent of all couples are unable to have children for various reasons, even though they wish to.
"Subsidized in vitro fertilization is not a total solution for aging populations, but it is part of a strategy. And it's important to have plan to make Sweden and other countries better able to deal with the future," says Anders Svensson, today a medical student, who is the lead author of the article and who was prompted by a suggestion from the American think tank Rand to look at state-subsidized IVF treatment.
The author of the article points out that there are great regional differences in Sweden today when it comes to how easy it is to get access to county-subsidized in vitro fertilization. Certain county councils will not pay if the couple already has children; some pay for two attempts only, and others for three attempts.
"Actually roughly half of all test-tube fertilizations are paid for out of pocket, which means that only those who can afford it can undergo IVF treatment."
In the longer term the state benefits from subsidizing the costs of test-tube children for couples that are involuntarily childless.
"This is a group that could potentially help boost population growth. Our calculations show that in a long-term perspective in vitro fertilization doesn't cost the state anything at all since the state actually sees a return on its investment in the form of the tax monies the individual will pay during his or her lifetime."
Anders Svensson uses a scenario where every test-tube baby is an average person in terms of longevity and income, for example. The study is based on a net present value calculation, which factors in inflation and other parameters. If the state invests in a test-tube baby today, that investment today is worth SEK 254,000, calculated only on what the individual will pay in income tax and value-added tax – other taxes have not been counted, which means that the state's profit per individual is likely underestimated.
"The effect on the Swedish population curve is comparable to raising state child allowances by 25 percent, but at a lower cost."
In other countries, IVF children are probably even more profitable, since Sweden has a relatively costly welfare system. In a similar calculation based on British conditions, two co-authors of the article in SJPH, Federico Callo, Rand, and Mark Connolly, Global Market Access Solutions, have found that every IVF child yields a profit of GBP 160,069.
"The difference can largely be explained by the fact that schooling, elderly care, and health care are relatively higher costs for the Swedish state than for the UK state. In other words, the Swedish welfare system is more expensive, which reduces the profits," says Anders Svensson.
One third of all inhabitants in Europe will be older than 65 years old in 2050, compared with every sixth person today.
"If we want to maintain our various welfare systems as they look today, we need to reverse the downward population trend, since in the future fewer and fewer working people will be supporting more and more old people."
Increased subsidization would moreover reduce some of the personal suffering that comes from wanting to have children, but not being able to.
"Test-tube fertilization differs from all other medical treatment. It creates life instead of extending life. This is unique," says Anders Svensson.
Source: Swedish Research Council
Wednesday, December 24, 2008
Tuesday, December 23, 2008
Reasons why Indians Can Never Be Terrorists
1. We are always late; we would have missed all 4 flights.
2. We would talk loudly and bring attention to ourselves.
3. With free food & drinks on the plane, we would forget why we're there.
4. We talk with our hands;therefore we would have to put our weapons down.
5. We would all want to fly the plane.
6. We would argue and start a fight in the plane.
7. We can't keep a secret; we would have told everyone a week before doing it.
8. We would have put our country's flag on the windshield.
9. We would have postponed the mission because a cricket match was going on that day
10. We would all have fallen over each other to be in the photograph being taken with one of the hostages.
Monday, December 22, 2008
'I wanted a child more than a man'
Financially independent but without long-term relationships, a growing number of young women are now turning to artificial insemination and embracing single motherhood.
Gwyneth, now 44, a nurse from the home counties, was 32 and single when she decided she could not wait any longer to conceive a child. "I've always known that having a child was more important to me than being in a relationship. I'd done what I wanted career-wise, I'd travelled and worked in Australia. A lot of my friends were settling down and having children. And as a nurse I was aware that after 35 it would be harder to conceive. I just thought it was the right thing to do."
She did not know anyone who had done this but had read about the London Women's Clinic, which has treated single women since the late 1980s. She signed up for private treatment: donor insemination at £170 for each attempt, plus her travel costs. "It was costing me about £200 a month - and it took nine tries over 15 months. In those days they were just doing cervical insemination [when the sperm is inserted into the cervix] - now they tend to do IUI [sperm is inserted into the uterus] - and the success rates were much lower." However, at the age of 33, she conceived her daughter, Helen, now 10, and became one of the UK's first - and, then, youngest - "choice mothers".
Ten years on and this group of women is growing. So-called "single motherhood by choice" has always existed: around 250 of the 1,100-strong membership of the UK's Donor Conception Network (DCN) are single mothers. Usually this is a decision women come to in their late 30s or early 40s. Not any more. Olivia Montuschi, a spokeswoman for the DCN, reports that the organisation has been approached recently by a several women in their early 30s already considering donor insemination: "It's increasingly an option. They're more likely to conceive [at this age], of course. But the idea that women are giving up on finding a man at 33 or 34 does seem a bit sad." The DCN has relaunched a Single Women section on its website and released a leaflet entitled: Dear Would-Be Single Mum.
A survey of attitudes towards contraception out this week appears to confirm this as a trend. Both men and women said they had serious concerns about whether they would meet the right partner in time to conceive naturally; and 56% of the women asked said they would consider asking a male friend to father their child if they failed to find a partner by a certain age. And it was younger women - those aged between 28 and 31 - who were the most likely to go it alone if the right man did not turn up in time.
Seeking artificial insemination in your 20s or 30s is not unusual among lesbians (who have no reason to delay), but heterosexual women typically wait to see if they can find a partner first. Using a sperm donor has always been a last resort. Now the process is becoming a first resort. Say that you are in your early 30s and you are convinced your life will not be complete without a child. Why wait? Many women have financial independence earlier in life than in the past and few see being a single mother as a situation that carries a stigma. Many single mothers by choice argue that they see couples struggling with the difficult issues that shared parenting raises. Women in this category who know that they definitely want a baby are less concerned about raising a child alone than they are about waiting for the "right man" for so long that they miss their fertility window.
On the Single Women forum at the website Fertility Friends - an invaluable resource for anyone seeking any kind of fertility treatment - there are dozens of posts from single, heterosexual women under 35 seeking donor insemination. One, now 36, tells of how she first saw her GP in April 2006 at the age of 34 and went on an NHS waiting list for donor sperm later that year. Another woman writes, "I am a 31-year-old single woman considering donor insemination to start a family as Mr Right still hasn't appeared."
Their forum sign-offs all include their ages, fertility history and often their reasons for doing it. Some of the stories are heartbreaking: "36-year-old single girl. Currently flummoxed by Inhibin B test results [a test that can diagnose problems with ovulation]. Wondering whether to co-parent with lovely gay friend." Another writes: "Eeeek! 35 now! Not sure what's next. Watch this space!" There is a post from a 34-year-old woman who has been trying to get pregnant for the past two years using donor sperm from the UK and the US - but who has just discovered that she has polycystic ovaries, which can reduce fertility. Several women have been through IUI with donor sperm five or six times with no success and are now considering IVF. Many mention how difficult it is to go through these treatments on your own, without a partner, and how heavily they rely on the support of friends and family.
In many ways it is an extraordinary decision to use donor sperm in your early 30s because you are fed up waiting for a partner. Some campaigners argue that choice mothers are wrongfully depriving their children of a father. But many women in this position think long and hard about this aspect of their decision and often line up a host of male role models in advance. Gwyneth says of 10-year-old Helen: "I think there are some children who grow up perfectly well without male role models - and she has got my father, my brother and my nephew."
But there are also long-term implications for the woman's future relationship status. As any single parent knows, it's more difficult to meet someone once you're in that situation. "Quite honestly, I've never had a serious relationship," admits Gwyneth. "It's just never been a priority for me. And since my daughter was born, finding the time for a relationship is just impossible." She could do with someone to help out: "It is difficult when you have to work full-time and raise a child. You don't get the after-school time with them because they're in an after-school club. But it's definitely worth it." But she does not romanticise the lives of two-parent families: "Our children don't have to go through the pain of seeing their parents separate," says Gwyneth.
Another single mother by choice, Lucy (not her real name), 47, a marketing executive from Northern Ireland, argues that by definition this situation makes you a responsible parent. "The thing is, you are making a proactive decision. It's very different to those single parents who through no choice of their own have ended up with two or more children." She has not had a relationship for over seven years: "I suspect I actually wanted a child much more than a partner. I would be concerned about the impact on my son if I got into a relationship. It seems pointless actively pursuing any love interest if it could impact negatively on him."
For Amy (not her real name), 32, from the south of England, mother of an 18-month-old daughter, it was about abandoning the need for a man and getting on with her own life. "I didn't have a great childhood, which has made relationships quite difficult for me," she says, "I thought about the possibility of a one-night stand [to get pregnant] but I wouldn't go and sleep with someone just to get a baby. I feel a lot better saying she was the product of sperm donation. She's planned and she's loved. OK, she doesn't know who her dad is but at least she's not the result of a quick fumble."
Amy sought treatment at the age of 30. "I just thought: I want a baby and I need to do something about it. I could have waited but I didn't think time was on my side. I thought it would take years and I was just lucky it worked for me first time." She ordered sperm from an agency listed on the internet at a cost of around £400. "I was sent a list of (anonymous) donors in my area and I chose one of them. I had to wait until one of my ovulation tests was positive and then contact them. They sent me the sperm by courier that evening. It arrived in a little pot inside a Pizza Hut-type padded bag. There was a note with instructions and a syringe. I expected it to be much more complicated, but it wasn't."
Amy was shocked that it was so easy - and that she got pregnant immediately. She acknowledges that the whole thing happened a bit too fast. She now feels uncomfortable that her daughter will never be able to trace her father: "fresh" sperm falls outside the law and so donors are not required to register with the authorities. The Donor Conception Network unequivocally advises against using these services: "There is so much that can go wrong," says Montuschi, "There is very little information on the donors and you are not covered by any legal structure." Clinics should be registered with the Human Fertilisation and Embryology Authority.
"I do feel sad about it," says Amy, "but I will tell my daughter that she is really loved and that I wanted her so badly that this is the way I went about it and that I chose the best person I could out of the choice that I had." She was told the age, height, colour of hair and of eyes of the donor. "Part of me asks if I did the right thing for her. It does sound crazy. But I don't regret it because I have a beautiful daughter who has got everything I can ever give her." Amy is on long-term sick leave from work, takes in ironing to make ends meet and lives with a female flatmate who also helps out.
She intends to repeat the process once she has finished breastfeeding her daughter. She has been back in touch with the same agency.
"I want to try for a brother or a sister with the same donor. They have said he would do it again. I want her to have somebody growing up with her. If I give her a full brother or sister she will have someone else who is completely genetically hers and I will know that she will always have this person." (That is, of course, if the agency she is using is telling the truth about the unregistered, anonymous donor.)
Although some choice mothers would not approve of using unregulated sperm donations, there seems to be a consensus that Amy was right to start early. Mikki Morrissette, "choice mom" from Minnesota and author of Choosing Single Motherhood: The Thinking Woman's Guide, says that in the US "there are more women today who don't particularly care if they are in a lifetime commitment but do care to have children, and figure they might as well get started."
She has noticed more women in their 20s joining her online discussion group. "I don't know their stories well enough to know the deeper reasons for this but I suspect it might have to do with some bad examples in fathering or dating - which is too bad if that's the case, since there are good men out there. But I'm also seeing a lot of women who are trying to decide whether to stay with a partner who doesn't want children."
Morrissette herself married after becoming a choice mother: she met her husband when she already had one donor-conceived child, a three-year-old girl, and was pregnant with a second, a boy. Both live in separate houses and, despite being married, operate as single parents.
The early 30s are not too young to start planning a path to single parenthood, she says: "It's a shame not to have a partner when you have to deal with infertility challenges, but the earlier you seek out your fertility information, the more time you have to prepare for the next plan, whether it be IVF, adoption, foster care or childlessness." Older choice mothers often warn younger ones not to wait, she adds: "Many women had trouble conceiving siblings for their first child, which tends to be a regret."
This is the case for Lucy from Northern Ireland: her donor-conceived son is six years old and she is sorry he will most likely not have a sibling. "The chances of conceiving are so much higher when you're younger. I've been contacted by women of 40-plus who haven't been able to get pregnant via this route." As a younger woman she wrote off donor conception. "I was more concerned with finding a partner and looked on having children as something I would do if I found the right person. Also, because of all the negative publicity at the time about single parents, I assumed it was an extremely tough job - which I accept that it is. So I decided single parenthood would be too tough a challenge for me."
When she had a relationship in her late 30s with a male single parent she saw that it was not an insurmountable challenge. "It made me realise how much I wanted a child and I reassessed everything. While I would have loved to have that relationship with a life partner, having a child was now more of a priority. That was the turning point. After that relationship finished, I read an article where some choice mothers were interviewed and they were so positive and candid that I thought - yes, maybe this is possible." Her treatment at King's College Hospital in London worked on the first attempt.
Now she wishes that she had started in her 30s. "I'll always wish I could have provided my son with a sibling. It's not out of the question, with adoption. But it is the one factor that I never really considered." And she occasionally feels uncomfortable about him being an only child. "You bond with other mothers who are having their first child. Then two years down the line they have another and you think, 'Well, that isn't an option for me'," she adds.
Lucy also wishes that more women had the chance to think about this earlier, adding that as choice mothers tend to be older, if they do have two donor-conceived children, they tend to have them very close together: "It's financially difficult to pay the childcare costs for two young children. If you have a gap, then it is easier." Although waiting has its compensations too. "By leaving it until I was 40, friends could see that there had been a number of failed relationships and felt that I deserved some personal happiness. It wasn't that I hadn't sought a life partner. I had just been unlucky," she says.
First-resort donor conception is not for the fainthearted. But it is, Gwyneth argues, a sensible decision for women who are certain that having a child is the single most important consideration in their life. If you are that sure, why put it off? "I always knew that I wanted children. You can have a relationship later in life. But your child-bearing years are limited.", she says.
By Viv Groskop
Gwyneth, now 44, a nurse from the home counties, was 32 and single when she decided she could not wait any longer to conceive a child. "I've always known that having a child was more important to me than being in a relationship. I'd done what I wanted career-wise, I'd travelled and worked in Australia. A lot of my friends were settling down and having children. And as a nurse I was aware that after 35 it would be harder to conceive. I just thought it was the right thing to do."
She did not know anyone who had done this but had read about the London Women's Clinic, which has treated single women since the late 1980s. She signed up for private treatment: donor insemination at £170 for each attempt, plus her travel costs. "It was costing me about £200 a month - and it took nine tries over 15 months. In those days they were just doing cervical insemination [when the sperm is inserted into the cervix] - now they tend to do IUI [sperm is inserted into the uterus] - and the success rates were much lower." However, at the age of 33, she conceived her daughter, Helen, now 10, and became one of the UK's first - and, then, youngest - "choice mothers".
Ten years on and this group of women is growing. So-called "single motherhood by choice" has always existed: around 250 of the 1,100-strong membership of the UK's Donor Conception Network (DCN) are single mothers. Usually this is a decision women come to in their late 30s or early 40s. Not any more. Olivia Montuschi, a spokeswoman for the DCN, reports that the organisation has been approached recently by a several women in their early 30s already considering donor insemination: "It's increasingly an option. They're more likely to conceive [at this age], of course. But the idea that women are giving up on finding a man at 33 or 34 does seem a bit sad." The DCN has relaunched a Single Women section on its website and released a leaflet entitled: Dear Would-Be Single Mum.
A survey of attitudes towards contraception out this week appears to confirm this as a trend. Both men and women said they had serious concerns about whether they would meet the right partner in time to conceive naturally; and 56% of the women asked said they would consider asking a male friend to father their child if they failed to find a partner by a certain age. And it was younger women - those aged between 28 and 31 - who were the most likely to go it alone if the right man did not turn up in time.
Seeking artificial insemination in your 20s or 30s is not unusual among lesbians (who have no reason to delay), but heterosexual women typically wait to see if they can find a partner first. Using a sperm donor has always been a last resort. Now the process is becoming a first resort. Say that you are in your early 30s and you are convinced your life will not be complete without a child. Why wait? Many women have financial independence earlier in life than in the past and few see being a single mother as a situation that carries a stigma. Many single mothers by choice argue that they see couples struggling with the difficult issues that shared parenting raises. Women in this category who know that they definitely want a baby are less concerned about raising a child alone than they are about waiting for the "right man" for so long that they miss their fertility window.
On the Single Women forum at the website Fertility Friends - an invaluable resource for anyone seeking any kind of fertility treatment - there are dozens of posts from single, heterosexual women under 35 seeking donor insemination. One, now 36, tells of how she first saw her GP in April 2006 at the age of 34 and went on an NHS waiting list for donor sperm later that year. Another woman writes, "I am a 31-year-old single woman considering donor insemination to start a family as Mr Right still hasn't appeared."
Their forum sign-offs all include their ages, fertility history and often their reasons for doing it. Some of the stories are heartbreaking: "36-year-old single girl. Currently flummoxed by Inhibin B test results [a test that can diagnose problems with ovulation]. Wondering whether to co-parent with lovely gay friend." Another writes: "Eeeek! 35 now! Not sure what's next. Watch this space!" There is a post from a 34-year-old woman who has been trying to get pregnant for the past two years using donor sperm from the UK and the US - but who has just discovered that she has polycystic ovaries, which can reduce fertility. Several women have been through IUI with donor sperm five or six times with no success and are now considering IVF. Many mention how difficult it is to go through these treatments on your own, without a partner, and how heavily they rely on the support of friends and family.
In many ways it is an extraordinary decision to use donor sperm in your early 30s because you are fed up waiting for a partner. Some campaigners argue that choice mothers are wrongfully depriving their children of a father. But many women in this position think long and hard about this aspect of their decision and often line up a host of male role models in advance. Gwyneth says of 10-year-old Helen: "I think there are some children who grow up perfectly well without male role models - and she has got my father, my brother and my nephew."
But there are also long-term implications for the woman's future relationship status. As any single parent knows, it's more difficult to meet someone once you're in that situation. "Quite honestly, I've never had a serious relationship," admits Gwyneth. "It's just never been a priority for me. And since my daughter was born, finding the time for a relationship is just impossible." She could do with someone to help out: "It is difficult when you have to work full-time and raise a child. You don't get the after-school time with them because they're in an after-school club. But it's definitely worth it." But she does not romanticise the lives of two-parent families: "Our children don't have to go through the pain of seeing their parents separate," says Gwyneth.
Another single mother by choice, Lucy (not her real name), 47, a marketing executive from Northern Ireland, argues that by definition this situation makes you a responsible parent. "The thing is, you are making a proactive decision. It's very different to those single parents who through no choice of their own have ended up with two or more children." She has not had a relationship for over seven years: "I suspect I actually wanted a child much more than a partner. I would be concerned about the impact on my son if I got into a relationship. It seems pointless actively pursuing any love interest if it could impact negatively on him."
For Amy (not her real name), 32, from the south of England, mother of an 18-month-old daughter, it was about abandoning the need for a man and getting on with her own life. "I didn't have a great childhood, which has made relationships quite difficult for me," she says, "I thought about the possibility of a one-night stand [to get pregnant] but I wouldn't go and sleep with someone just to get a baby. I feel a lot better saying she was the product of sperm donation. She's planned and she's loved. OK, she doesn't know who her dad is but at least she's not the result of a quick fumble."
Amy sought treatment at the age of 30. "I just thought: I want a baby and I need to do something about it. I could have waited but I didn't think time was on my side. I thought it would take years and I was just lucky it worked for me first time." She ordered sperm from an agency listed on the internet at a cost of around £400. "I was sent a list of (anonymous) donors in my area and I chose one of them. I had to wait until one of my ovulation tests was positive and then contact them. They sent me the sperm by courier that evening. It arrived in a little pot inside a Pizza Hut-type padded bag. There was a note with instructions and a syringe. I expected it to be much more complicated, but it wasn't."
Amy was shocked that it was so easy - and that she got pregnant immediately. She acknowledges that the whole thing happened a bit too fast. She now feels uncomfortable that her daughter will never be able to trace her father: "fresh" sperm falls outside the law and so donors are not required to register with the authorities. The Donor Conception Network unequivocally advises against using these services: "There is so much that can go wrong," says Montuschi, "There is very little information on the donors and you are not covered by any legal structure." Clinics should be registered with the Human Fertilisation and Embryology Authority.
"I do feel sad about it," says Amy, "but I will tell my daughter that she is really loved and that I wanted her so badly that this is the way I went about it and that I chose the best person I could out of the choice that I had." She was told the age, height, colour of hair and of eyes of the donor. "Part of me asks if I did the right thing for her. It does sound crazy. But I don't regret it because I have a beautiful daughter who has got everything I can ever give her." Amy is on long-term sick leave from work, takes in ironing to make ends meet and lives with a female flatmate who also helps out.
She intends to repeat the process once she has finished breastfeeding her daughter. She has been back in touch with the same agency.
"I want to try for a brother or a sister with the same donor. They have said he would do it again. I want her to have somebody growing up with her. If I give her a full brother or sister she will have someone else who is completely genetically hers and I will know that she will always have this person." (That is, of course, if the agency she is using is telling the truth about the unregistered, anonymous donor.)
Although some choice mothers would not approve of using unregulated sperm donations, there seems to be a consensus that Amy was right to start early. Mikki Morrissette, "choice mom" from Minnesota and author of Choosing Single Motherhood: The Thinking Woman's Guide, says that in the US "there are more women today who don't particularly care if they are in a lifetime commitment but do care to have children, and figure they might as well get started."
She has noticed more women in their 20s joining her online discussion group. "I don't know their stories well enough to know the deeper reasons for this but I suspect it might have to do with some bad examples in fathering or dating - which is too bad if that's the case, since there are good men out there. But I'm also seeing a lot of women who are trying to decide whether to stay with a partner who doesn't want children."
Morrissette herself married after becoming a choice mother: she met her husband when she already had one donor-conceived child, a three-year-old girl, and was pregnant with a second, a boy. Both live in separate houses and, despite being married, operate as single parents.
The early 30s are not too young to start planning a path to single parenthood, she says: "It's a shame not to have a partner when you have to deal with infertility challenges, but the earlier you seek out your fertility information, the more time you have to prepare for the next plan, whether it be IVF, adoption, foster care or childlessness." Older choice mothers often warn younger ones not to wait, she adds: "Many women had trouble conceiving siblings for their first child, which tends to be a regret."
This is the case for Lucy from Northern Ireland: her donor-conceived son is six years old and she is sorry he will most likely not have a sibling. "The chances of conceiving are so much higher when you're younger. I've been contacted by women of 40-plus who haven't been able to get pregnant via this route." As a younger woman she wrote off donor conception. "I was more concerned with finding a partner and looked on having children as something I would do if I found the right person. Also, because of all the negative publicity at the time about single parents, I assumed it was an extremely tough job - which I accept that it is. So I decided single parenthood would be too tough a challenge for me."
When she had a relationship in her late 30s with a male single parent she saw that it was not an insurmountable challenge. "It made me realise how much I wanted a child and I reassessed everything. While I would have loved to have that relationship with a life partner, having a child was now more of a priority. That was the turning point. After that relationship finished, I read an article where some choice mothers were interviewed and they were so positive and candid that I thought - yes, maybe this is possible." Her treatment at King's College Hospital in London worked on the first attempt.
Now she wishes that she had started in her 30s. "I'll always wish I could have provided my son with a sibling. It's not out of the question, with adoption. But it is the one factor that I never really considered." And she occasionally feels uncomfortable about him being an only child. "You bond with other mothers who are having their first child. Then two years down the line they have another and you think, 'Well, that isn't an option for me'," she adds.
Lucy also wishes that more women had the chance to think about this earlier, adding that as choice mothers tend to be older, if they do have two donor-conceived children, they tend to have them very close together: "It's financially difficult to pay the childcare costs for two young children. If you have a gap, then it is easier." Although waiting has its compensations too. "By leaving it until I was 40, friends could see that there had been a number of failed relationships and felt that I deserved some personal happiness. It wasn't that I hadn't sought a life partner. I had just been unlucky," she says.
First-resort donor conception is not for the fainthearted. But it is, Gwyneth argues, a sensible decision for women who are certain that having a child is the single most important consideration in their life. If you are that sure, why put it off? "I always knew that I wanted children. You can have a relationship later in life. But your child-bearing years are limited.", she says.
By Viv Groskop
Sunday, December 21, 2008
Saturday, December 20, 2008
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