The 66-year-old Romanian who on Sunday became the oldest woman to give birth insists her family has a history of longevity. Even though the average Romanian woman’s lifespan is 73, she says time is on her side.

Thanks to in vitro fertilization from a donor egg, time has not been an issue.

The birth of her daughter, however, has reignited an ethical debate over the boundaries of man’s power to use science – in this case a donor egg and sperm – to extend the childbearing age beyond the time when women are naturally fertile. In some ways, doctors say, it is the contentious issue of reproductive rights turned on its head.

The birth comes on the heels of a 56-year-old Manhattan mother, Aleta St. James, who gave birth to twins last November. She became the oldest woman to give birth to twins, three days before her 57th birthday.

“Reproductive rights or reproductive autonomy has a pretty strong precedent in this country,” the director of the University of Southern California’s fertility clinic, Richard Paulson, told The New York Sun. “You don’t have to be pregnant if you don’t want to. Conversely, if you cannot be pregnant, we will help you.”

But, Dr. Paulson says, lines must be drawn. Many clinics will not help women over 50 get pregnant.

“We routinely refuse to transfer embryos in woman over the age of 55,” Dr. Paulson said.

Ms. Iliescu, who turns 67 in May, began receiving hormone replacement therapy when she was 58. The therapy is similar to the kind used for menopausal woman, though with markedly different goals.

Romanian doctors have said Ms. Iliescu and her baby, who was delivered by cesarean section at 33 weeks, are doing well. Eliza-Maria is in intensive care and weighs 3.19 pounds – half the weight of an average newborn carried to term – and is eating glucose. Doctors performed the surgery after the smaller of Iliescu’s twins died in the womb, the Associated Press reported.

The previous record was held by Arceli Keh, who was 63 in 1996, when she gave birth to a baby with the help of doctors at the fertility clinic headed by Dr. Paulson at the University of Southern California.

Dr. Paulson was markedly relieved when told that Romania held the new honor – and onus – of helping the world’s oldest woman give birth.

In November 2002, Dr. Paulson published research he conducted over a decade in the Journal of the American Medical Association entitled “Pregnancy in the Sixth Decade of Life,” in which he showed that 55 of 77 women between the ages of 55 to 63, including Ms. Keh, were able to become pregnant using a donated egg. The results removed doubts over the feasibility of older women giving birth. But with every new milestone comes added ethical considerations.

Does age preclude a woman from undergoing pregnancy? This, experts say, must be judged on an individual basis.

Ms. St. James’s doctor, Jane Miller, said the process to ready Ms. St. James, who was in particularly good health for her age, took three years and included surgeries to remove large fibroids from her uterus. Of the Romanian mother, Dr. Miller says the cesarean section – and the death of the twin – proves that the uterus was not a healthy environment for the child.

“That is more common for someone who is older,” Dr. Miller, who has a clinic in Englewood Cliffs, N.J., said. “Who knows how normal this child will be. I wouldn’t have taken this on.”

Whether a fetus can survive, on the other hand, is another question often determined by age. Many clinics won’t serve woman over 50, though no law exists in America restricting a woman’s freedom to reproduce.

To many on the outside – who are neither the mother nor the doctor – the question seems obvious: How can a woman entering the sunset of her life care for a newborn just beginning hers?

The chairman of the ethics commit tee at the American Society for Reproductive Medicine and a University of Texas law professor, John Robertson, points out an inconsistency in the argument that would limit a woman’s ability to reproduce just because the end of their life may be imminent. Death, he says, can strike at any time.

“Someone who is facing cancer, they can have a child and they face a shortened lifespan” he said. “We don’t apply that in the case with older men or people with cancer. It’s hard to argue ethically that [in vitro fertilization] should not be done.”

Meanwhile, Ms. Iliescu says she feels fine and is happy with her decision.

With a book about her ordeal due out by the end of the year, it is obvious carrying her twins did not slow her down.