The recent birth of octuplets in California has riveted the nation’s attention with the strange story of Nadya Suleman, who had six young children at home but went back to a fertility clinic for more. The 33-year-old Suleman says she used in vitro fertilization to have six embryos implanted, and that two of those embryos split into twins. But the incident has shone a bright light on the $1 billion fertility industry, and has many people wondering about the ethics of implanting so many embryos simultaneously. The California Medical Board says it is investigating the doctor who implanted Suleman…. The consequences could range from a reprimand to loss of medical license [CBS News].
The American Society for Reproductive Medicine adopted guidelines in 2008 encouraging the transfer of only one embryo for women under 35, and no more than two, except in extraordinary circumstances. The guidelines allow more for older women, up to a maximum of five. But unlike some other countries, the United States has no laws to enforce those guidelines [The New York Times]. Given the expense of each attempt at in vitro fertilization and the fact that not all implanted embryos develop successfully, many women prevail upon their doctors to implant multiple embryos–according to federal statistics, only 11 percent of in vitro procedures in the United States involve a solitary embryo.
Fertility doctors say that higher-order multiple births (defined as three or more babies born together) are dangerous for babies and the mother. Infants born prematurely face the risk of breathing problems and brain injuries that may cause permanent disability. Problems in premature babies, including learning disabilities or cognitive delays, are often not apparent until years after their births [Los Angeles Times]. The California octuplets were born about nine weeks early, were extremely small (the tiniest baby was 1 pound, 8 ounces), and originally couldn’t breathe on their own, but they have reportedly been doing well in the hospital.
Other doctors note that women who come to fertility clinics are often under considerable emotional stress as they may have been battling infertility for some time, and say that part of the doctor’s job is to assess the woman’s mental condition. Dr. Daniel Potter, a fertility doctor in California, says the doctor must consider the health of the patient and her potential babies first, before considering the patient’s wishes. “If someone came in and wanted to transfer six embryos in a situation like we’re talking about, we have an obligation to protect the patient and not let the patient do things that are unreasonable,” Dr. Potter said [The New York Times].
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