Headlines last week about a Spanish mother who at age 69 died leaving behind two, two-year-old twins sparked controversy about the wisdom of providing IVF treatment to women of advanced maternal age. In the case of Maria del Carmen Bousada de Lara, she lied about her age (at the time she was 67) to be able to receive fertility treatments at the Pacific Fertility Center in California.

But what matters about this story now is not Maria’s decision to lie on her application or to get a fake ID or any of her other choices, but that now there are two children that will grow up without their biological mother or their biological father and will have a different understanding of family than most children do.

Is this bad? Of course not. The “traditional” notion of family as bound up by biological relationships comprised of a mother and father genetically-related to their child has been abandoned my most for some time.

But the deeper question is: do we want the Maria del Carmen Bousada de Lara cases to become more mainstream with the chance that mothers of advanced maternal age, even if they can give birth to healthy babies, may die before their children grow to adulthood?

For me, the only key requirement for candidacy in these circumstances is that the prospective IVF mothers have a plan in the event that the very worst world happen. Ideally, these mothers would be required to designate a set of “second-string” parents (if you will pardon the sports metaphor) who would be younger than the biological mother be more likely able to care for the child continuously throughout their childhood and adolescence until adulthood.

If there is an extended family, as would be the case in many cultures and situations that would also be caring in large part for the child, all the better–but the primary caregiver would be someone who would be younger than the original mother (but of course chosen by her) who would care for that child until adulthood.

Having more than one adult designated will ensure that in the event that one of these adults could not serve as the parent, the other could. The sole goal of such a system is to ensure that young children are not left without caregivers of the original IVF parent’s choosing and that advance planning is done, especially for mothers of advanced maternal age, given the greater likelihood that they may not live to see their child grow to adulthood.

Now, some may argue that all parents (young or old, reproducing naturally or artificially) should have such a plan as any parent could be struck with an unexpected injury or illness at any moment. While this may be true, it is the children born to single mothers, mothers of advanced maternal age, or mothers without extended families or social networks that suffer the most from such tragedy and for whom such advanced planning must be done. For nothing could be worse than having twins left without a mother and no plan for who will care for them.

Giving IVF to mothers of advanced maternal age isn’t the problem–giving it without making sure they have a plan in the event of unexpected illness or tragedy is.

Summer Johnson, PhD.