When a California woman gave birth to eight babies last month, doctors crowed about the medical miracle because it was only the second time in U.S. history that a set of octuplets had been born.
But the jubilation in the delivery room quickly gave way to a rancorous medical ethics debate. Just because modern medicine can push the boundaries of what is humanly possible, should such procedures be permitted?
Nadya Suleman, 33, is an unmarried graduate student who lives with her parents and already had six children, ages 2 through 7, each the result of in vitro fertilization. She will face physical, economic and emotional challenges that are unimaginable.
The medical costs alone for her eight premature babies -- they are more likely than full-term babies to face long-term disabilities -- will be astronomical. The logistics will be beyond difficult. Already, Ms. Suleman's six "older" children sleep in cribs, bunk beds and on mattresses on the floor of her mother's three-bedroom home.
Yet, in interviews, Ms. Suleman, an only child, seems unwilling to acknowledge the demands that are to come.
She casually describes her motivation as a mere desire to have the large family that she herself was denied. Her own mother describes her as being "obsessed with babies."
Did her fertility specialist -- the same doctor apparently implanted the embryos in all of Ms. Suleman's pregnancies -- conduct any psychological evaluation? And why did he implant so many embryos?
The American Society for Reproductive Medicine, which had been alarmed by an increase in multiple births resulting from fertility treatments, has recommended limiting the number of embryos transferred to women under 35 to one or two, and no more than five in older women.
Ms. Suleman identified her doctor as Michael Kamrava of the West Coast IVF Clinic in Beverly Hills, and the Medical Board of California is investigating to determine whether he violated standard medical practice.
Ms. Suleman's outcome demands it, but further scrutiny of the burgeoning fertility industry is warranted, too. Nationwide, the number of in vitro procedures has doubled in just 12 years and accounts for more than $1 billion in business. Each year, 50,000 children are born through in vitro fertilization.
Ms. Suleman's experience suggests that voluntary medical guidelines don't provide sufficient safeguards in this most personal medical specialty. Just because something can be done doesn't mean it should be.
First published on February 18, 2009