Octuplets' Birth Sparks Fertility Debate
Fertility Experts Question Medical Ethics of Transferring Embryos to California Mom
WebMD News Archive
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
All six embryos did implant, however, and two apparently split, resulting in
"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
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.