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Octuplets' Birth Sparks Fertility Debate

Fertility Experts Question Medical Ethics of Transferring Embryos to California Mom
By
WebMD Health News
Reviewed by Louise Chang, MD

babies_on_board_the_real_risks_of_multiple_

Feb. 10, 2009 - As the mother and grandmother of the two-week-old California octuplets squared off on competing morning talk shows this week, infertility specialists continue to voice their dismay over the fertility treatment that led to the birth of the eight babies.

In an interview that aired on NBC's Today show, Nadya Suleman, 33, said her fertility doctor did nothing wrong by transferring six embryos into her womb when she had already given birth to six babies through in vitro fertilization (IVF).

Suleman's mother, Angela Suleman, says she disagrees with her daughter's decision to undergo the treatment that led to the birth of the octuplets. She called her daughter's actions "really unconscionable" in an interview that aired on ABC's Good Morning America.

Infertility specialists have their own views. Many have been deeply critical of the fertility doctor who treated Suleman.

On Feb. 6, the Medical Board of California announced plans to investigate the fertility doctor who treated Suleman. The board did not identify the doctor, but the Today show identified the clinic as the West Coast IVF Clinic in Beverly Hills, Calif.

"I am deeply disappointed that any fertility clinic in the United States, or anywhere, would do this," says Colorado reproductive endocrinologist Eric Surrey, MD, who is a past president of the Society for Assisted Reproductive Technology (SART).

"There may be a medical justification, but I can't think of one, and I've been doing this for 20 years," he tells WebMD.

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.

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