Wednesday, February 04, 2009

Birth of Octuplets Raises Questions about In Vitro Fertilization

Birth of Octuplets Raises Questions about In Vitro Fertilization
Wednesday, February 04, 2009
By Edwin Mora

( – Medical experts, ethicists and pro-life activists are united in raising questions about why doctors implanted multiple embryos into a Southern California woman through in vitro fertilization [IVF] – a process which led the woman, who already had six children, to conceive and give birth to octuplets.

Dr. Robert Stillman, the medical director at Shady Grove Fertility Center in Rockville, Md., the largest fertility clinic by volume in the country, said he is disturbed by the fact that multiple embryos were implanted in 33-year-old Nadya Suleman.

He questioned the judgment of the doctors who treated the woman.

“I think the transfer of so many embryos, even if the patient wants them, is a breach of our professional society’s guidelines by a wide margin,” Stillman told

According to guidelines established by the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART), women under 35 should get no more than 2 embryos.

However, during her most recent IVF treatment, Suleman decided to have multiple embryos implanted in her womb with the intention of having “just one more girl,” her mother, Angela Suleman, told reporters on Jan. 30.

According to reports, the single mother originally chose in vitro fertilization due to a problem with her fallopian tubes that kept her from conceiving naturally.

Now, Suleman, a single mother, has the eight new babies, plus an earlier set of twins and four other children -- for a total of 14. Six of the children are between the ages of 2 and 7.

Stillman said the transfer of multiple embryos is not a question of ethics but one of medical safety and medical judgment.

But Andrew Light, director of Center for Global Ethics at George Mason University, does question the ethics of Suleman’s fertility clinic.

“Transferring that many embryos increases the risk of harming the mother and the children,” Light said. “It’s unethical for doctors to do this.”

Light adds that “the ability to provide” should be considered when administering IVF to a mother of six.

With IVF, once the subject gets pregnant, the remaining embryos get discarded, or -- as in Suleman’s case -- frozen.

The embryos that resulted in Suleman’s octuplets were frozen leftovers from her previous treatments. When IVF yields multiple pregnancies, the procedure calls for selective abortion, something that Suleman refused to go through.

Judie Brown, the president and co-founder of American Life League, said she is concerned about the ethics and morality of IVF itself. She said the Suleman case illustrates why the Catholic Church considers in vitro fertilization to be “gravely evil.”

One dare not point a finger at a mother in Suleman’s situation without pointing even more at the incredibly abhorrent practices made available to her in the first place,” Brown said, adding that babies in contemporary society are treated like products that can be either stashed or thrown away.

She points out that the eight babies that were born are not evil, but the practice of IVF is deplored by Catholic medical ethics.

Suleman’s physicians, meanwhile, denied they have done anything wrong – or questionable.

"Our patient was counseled regarding her options for the pregnancy. The options were to continue the pregnancy or selectively abort. The patient chose to continue the pregnancy," Kaiser Permanente’s Dr. Harold Henry told MSNBC.

In the end, Suleman, like all other fertility patients in the U.S, has the last word in deciding on the amount of embryos, according to Stillman.

“This isn’t China, we can’t say ‘You had six kids, that’s enough’,” the fertility expert said. “If she wanted seven children then that’s really up to her in many ways, in most ways, and not up to the physician.”

Stillman said he -- and other fertility experts -- are pleased that there were no complications in the birth of the eight babies and that the octuplets are doing well.

Nevertheless, he warned, multiple embryo transfer resulting in multiple pregnancies is an undesirable result of fertility assistance because it increases health risks among the women and fetuses.