Fooling nature, and the fertility doctor

But there was little jubilation Monday for Dr. Vicken Sahakian as he acknowledged that one of his patients had become the world's oldest new mother.

"Congratulations? It was unintentionally successful," Sahakian said. "She lied to me. She falsified records, knowing my cutoff for single women is 55

Carmela Bousada, a 67-year-old retired Spanish department store clerk, gave birth to twin boys Dec. 29 in Barcelona. Over the weekend, the single mother admitted to European reporters that she had deceived Sahakian in order to become pregnant.

The birth of 3-pound, 7-ounce Pau and 3-pound, 5-ounce Christian -- who were premature -- roiled the world of fertility medicine Monday and raised a basic question: How old is too old?

Dr. Richard J. Paulson, director of the USC Fertility clinic, said the easier determination is the physiological one. Women over 50 face an increased risk of pregnancy complications, such as diabetes and high blood pressure.

"That reaches an almost prohibitive level at 55," Paulson said. "Most clinics won't treat women over 55. We're one of the few mainstream clinics that treat over 50

Paulson's clinic has required a photo identification before treating any patient since he unwittingly helped a woman in her 60s become pregnant. When she started infertility treatment, she said she was 53 -- two years younger than USC's cutoff. She underwent a barrage of screening tests and produced medical records attesting to her age.

But when she became pregnant, she fessed up. Her healthy baby daughter was born in 1996, when the woman was 63, making hers the oldest successful pregnancy on record at the time.

Paulson believes a cutoff of 55 is appropriate, but he resists the call for greater government regulation that might create a legal age limit.

"As soon as you get into an area of zero tolerance, it's easy to find a case when regulation becomes wrong or harmful," Paulson said in an interview Monday. "To go and try to interfere with someone's reproductive rights is a very touchy area."

No one foresees a run on obstetrical care for the 60-and-up set. Still, every time someone in her 60s delivers, there's a media frenzy. Even the AARP magazine has featured a long spread answering the question "What's it like to be changing diapers at 50?"