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Octuplets case makes fertility experts cringe

| Friday, Feb. 13, 2009

As a reproductive specialist, Dr. Carolyn Kubik's job is to do everything possible to help women get pregnant.

But even Kubik said she was shocked by the news of Nadya Suleman's octuplets last month, and she worries about people's perceptions of reproductive services.

"I knew that it would reflect unfavorably on our program and what we do," said Kubik, a reproductive endocrinologist at Reproductive Health Specialists in Penn Hills. "What (the doctor) did was perfectly legal, but certainly it may be reviewed by the societies that develop the guidelines for programs."

Suleman, 33, of Whittier, Calif., was implanted with six embryos and gave birth to eight babies by Caesarean section Jan. 26. A single mom of six children already, she is unemployed and receives government assistance.

Her story raised questions about fertilization assistance and ethics in the field.

"The bottom line is, there's significant guidelines that we, as infertility doctors, are provided ... to minimize the incidence of multiple births," said Dr. Joseph Sanfilippo, director of the Division of Reproductive Endocrinology and Infertility at Magee-Womens Hospital of UPMC. "Some of us might try to add to the upper limits if the quality (of the embryos) aren't good ... but I can't think of any circumstances to put six in."

The Beverly Hills fertility clinic Suleman visited is a member of the Society for Assisted Reproductive Technology. Its guidelines stipulate that, for women under 35, no more than two embryos should be implanted unless there are extraordinary circumstances such as unsuccessful past treatments or if a woman has endometriosis, a condition in which uterine cells grow outside the uterus.

No laws govern the number of embryos that can be implanted, Kubik said.

Amanda Wray of Shaler, who underwent the procedure, said she was astonished at Suleman's story.

"I just think (she) just did this to get famous," said Wray, 40, who had in vitro fertilization at Reproductive Health Specialists, where she coordinates the egg donor program. "But the clinic that did this, our jaws are just dropping around here."

The number of assisted reproductive procedures has more than doubled during the past decade, according to the Centers for Disease Control and Prevention. More than 54,600 children were conceived using assisted reproductive technology in 2006, the most recent data available. That was 2,500 more babies than in 2005.

Wray was 38 when she opted for in vitro after trying to get pregnant for seven years, she said. Since it was her "last chance" to get pregnant, she had three embryos implanted and gave birth to twins, she said.

"My husband and I talk about (Suleman's story) all the time," Wray said. "And we wonder who would do that if a person already has six children."

Sanfilippo said assisted reproduction gives couples with no alternatives a chance to have children.

"I don't want this episode to jeopardize that for other couples," he said.

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