Birth Trauma / Medical Malpractice

Date: 2/10/2009

LOS ANGELES (AP) — The American Society for Reproductive Medicine says it’s investigating whether fertility treatment guidelines were broken in the case of a Southern California woman who gave birth to octuplets last month.

The society said in a statement issued Monday that it asked Nadya Suleman and the doctor for more details about her latest pregnancy. Suleman’s six other children were conceived through in vitro procedures.

The voluntary, nonprofit organization has guidelines for the number of embryos that should be implanted to prevent multiple births. But the group can’t stop doctors from practicing.

“It seems that the guidelines may not have been followed in Ms. Suleman’s case,” Dr. R. Dale McClure, president of the American Society for Reproductive Medicine, said in a statement.

In an interview broadcast Monday on NBC’s “Today,” Suleman said she underwent in vitro fertilization at a Beverly Hills fertility clinic run by Dr. Michael Kamrava.

The birth of the octuplets has raised questions over the ethics of implanting numerous embryos in a woman who already had six children.

Without identifying the doctor, the Medical Board of California said last week it was looking into the Suleman case to see if there was a “violation of the standard of care.” The board said it has not taken any disciplinary action against Kamrava in the past.

Kamrava, 57, would not comment on the issue.

In the NBC interview, Suleman did not identify her doctor by name, but said that she went to the West Coast IVF Clinic in Beverly Hills — of which Kamrava is director — and that all 14 of her children were conceived with help from the same doctor. In 2006, Los Angeles TV station KTLA ran a story on infertility that showed Kamrava treating Suleman and discussing embryo implantation.

Suleman said she had six embryos implanted for each of her pregnancies. The octuplets were a surprise result of her last set of six embryos, she said, explaining she had expected twins at most. Two of the embryos evidently divided in the womb.

Medical ethicists have criticized the implanting of so many embryos. National guidelines put the norm at two to three embryos for a woman of Suleman’s age, except in extraordinary circumstances.

Kamrava’s clinic performed 52 in vitro procedures in 2006, according to the most recent national report compiled by the Centers for Disease Control and Prevention. Of those, five resulted in pregnancies and two in births. One of the births were Suleman’s twins.

Kamrava’s pregnancy rate that year was one of the lowest in the country. Experts say many factors affect a clinic’s success rate including a patient’s health and types of procedures done.

The average number of embryos Kamrava transferred per procedure for women under 35 was 3.5, compared with 2.3 nationally the report said. Fertility doctors often implant more than one embryo to increase the chances that one will take hold.

Suleman’s octuplets were delivered nine weeks premature but doctors have said they appear relatively healthy.

Copyright 2009 The Associated Press.