Octuplet Births Raise Ethical Dilemmas in IVF


Without the power to request medical records, the ASRM and other societies had no facts to go on other than what was being broadcast on often-sensational news shows. The physician's name, the number of embryos transferred, and even details about Ms. Suleman's family and financial circumstances were all purely speculative, Dr. Paulson argued.

“What on earth are you going to say? Whatever it was that they did, we strongly condemn it?” he asked rhetorically.

“Everyone was hoping that the California Medical Board would have some sanctions,” said Dr. Russell Foulk, a reproductive endocrinologist and infertility specialist in private practice in Reno, Nev.

However, no specific statutes may have been violated. The Medical Board of California's investigation into the circumstances of the Suleman case is ongoing, according to a spokeswoman at the board's headquarters in Sacramento. The board has not linked a physician's name with the case, although Ms. Suleman has identified Dr. Michael Kamrava of Beverly Hills, Calif. as her infertility specialist for all seven pregnancies.

The presumed facts of the case suggest that Dr. Kamrava, who is not board certified, acted “grossly below the standard of care,” but that may not be enough to justify discipline by the board, said Dr. Paulson, chief of the division of reproductive endocrinology and infertility at the University of Southern California in Los Angeles.

The Centers for Disease Control and Prevention's Fertility Clinic Reports Web site for 2006 includes statistics from Dr. Kamrava's clinic and indicates that the average number of embryos transferred in women under 35 was 3.5. Of a total of 52 cycles in women of all ages, two live births resulted, both in women under 35 and one, a twin gestation.

A spokeswoman at Dr. Kamrava's office, the West Coast IVF Clinic Inc., said he would not be interested in doing an interview for this story.

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