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Infertility & Reproduction Health Center

Octuplets' Birth Sparks Fertility Debate

Fertility Experts Question Medical Ethics of Transferring Embryos to California Mom
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Nadya Suleman's View

Suleman, who is unmarried, unemployed, and living with her parents, told NBC's Ann Curry that she knew there was a risk of multiple births if she had all six of her remaining frozen embryos transferred at one time.

But she said she did not believe it would happen because she had so many fertility problems, including severe endometriosis and scarred fallopian tubes.

All six embryos did implant, however, and two apparently split, resulting in eight babies.

"The most I would have ever anticipated would have been twins," she told Curry. "It wasn't. It was twins times four."

She said with her medical history, she considered it "very appropriate" for her doctor to transfer so many embryos.

"He did nothing wrong," she said.

But Atlanta infertility doctor Mark Perloe, MD, of Georgia Reproductive Specialists, strongly disagrees.

He points out that her chances for a successful pregnancy were actually very good, considering her young age and the fact that she had -- by her own account -- four previous successful single-birth pregnancies and one twin pregnancy resulting from IVF.

Guidelines for Embryo Transfers

Fertility treatment guidelines call for women under 35 who have favorable chances for a successful pregnancy to have no more than two fresh embryos transferred. Suleman's embryos had been frozen, but there was still no justification for transferring more than two or at most three, Perloe says.

"There was a breach of ethical propriety here that was absolutely staggering," he tells WebMD.

Perloe even questions the ethics of treating Suleman at all. "I would not agree to treat a single mom on disability with six small children at home already."

SART and the American Society for Reproductive Medicine (ASRM) developed embryo transfer guidelines several years ago in an effort to reduce the number of high-order pregnancies, defined as triplets or more.

The guidelines make it clear that high-order pregnancies are an undesirable consequence of infertility treatment because of the extreme risk to the mother and her babies.

As a result of efforts to restrict the number of embryos transferred during IVF, the rate of high-order multiple births has been declining in the U.S.

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