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THESE DOCS ARE BAD EGGS

HAD medical guidelines been followed, it’s doubtful Nadya Suleman would have ever had triplets, let alone octuplets.

Following their miracle birth, many have asked: Would a physician really transfer six embryos into a woman who had already had five prior in vitro fertilization pregnancies and already has six children at home?

Those who practice infertility know that in some instances it is appropriate to put back more embryos, depending on the age of the patient and her history. However, this patient was not one that justified transferring more embryos than the two our guidelines recommend.

Why would a physician expose a patient and babies to such medical risk?

It has always been known that replacing a single embryo in IVF has lower pregnancy rates than replacing more, but the risk of multiples increases with the number of embryos.

It wouldn’t shock me if there was a doctor who would do this, but it would greatly disappoint me.

I wouldn’t have allowed all six embryos to be thawed, because from what I have read, I don’t think anyone could have talked this woman out of it.

In 1992, Congress passed a law requiring fertility clinics to report their pregnancy rates. It came about because a rogue practitioner was telling patients the success rates of in vitro fertilization based on national statistics and neglecting to mention that his own clinic had none. Thus a national registry was born, financed by taxpayers.

But the implications of a government-published report were unanticipated, and it changed behavior. Since clinics were measured by pregnancy rates, there was incentive to implant more embryos to a patient, which had the unwanted consequence of a boom in twins and triplets.

The American Society of Reproductive Medicine and its subgroup, the Society for Assisted Reproductive Technologists, recognized the problem and published guidelines for the number of embryos to transfer to maximize pregnancy rates but minimize multiple gestation, especially triplets and beyond.

We have now published three iterations of these guidelines since 1999 with a significant decline in the incidence of triplets and higher. Millions of IVF cycles have occurred in the United States since the first IVF birth in 1978. Millions of babies have been born to couples who might otherwise be childless. If it is discovered that six or eight embryos were transferred in this medical misadventure, it represents one deviant from years of good practice.

But passing a law for the one outlier may have unintended consequences that are worse than the one deviant.

Dr. Jamie Grifo is a professor of obstetrics and gynecology and the program director at the NYU Fertility Center