Octuplet Mom: Where Do We Draw the Line on IVF?
At first, I didn't believe Nadya Suleman, the infamous mother of octuplets. No doctor would have the gall to transfer more than two embryos into a 33-year-old woman, right?
My initial guess was that she had pulled a Bobbi McCaughey. While trying to conceive, McCaughey took Pergonal and became the mother of septuplets, born in 1997. She did not have an ultrasound to determine how many eggs were waiting for the sperm.
As a result, McCaughey had seven premature babies, one with hypotonic quadriplegia and one with spastic diplegia. The situation seemed avoidable if she'd been under the care of a responsible reproductive endocrinologist who could have warned her against trying to conceive that particular month.
I've since learned that Pergonal was not to blame for Suleman's conception. She did indeed have six embryos implanted by in vitro fertilization (IVF), two of which split, creating eight premature babies who may suffer a host of problems (including heart and brain defects).
If you purposely create more than one child in utero, there's a good chance they're going to have to come out early. Who in the world would wish prematurity upon their children? And what physician would consent to a massive embryo transfer?
The parents in my community have been discussing this situation almost nonstop since the story broke. While everyone agrees that Suleman made a terrible decision and her complicit doctor should be punished, no one can agree what the guidelines should be. Here are some of the suggestions:
"How about no IVF after three kids?"
Sounds responsible. But then I think of the well-to-do mother whose fourth child (an IVF baby) takes swim lessons with my daughter. Would I deny her the right to a fourth child just because she is over 35 and her reproductive system stopped cooperating?
"You have to show you can financially support your embryos before you create them."
But if this were the case for natural conception, so many kids wouldn't be here today. And the bills related to assisted reproductive technology (ART) tend to drain the savings accounts of even the most fiscally responsible parents. Most insurance companies don't cover ART, acting as an artificial barrier to prevent low-income women from conceiving through IVF.
Next Page: Should the doc have to pay? [ pagebreak ]"The doctor who transferred those embryos should have to pay for those kids' medical bills"
A friend of mine transferred five embryos in her IVF procedure. Her reasons? The quality of the embryos was low, she was over 35, and she'd had failed attempts in the past. That IVF cycle failed for her as well, but what if all five had worked—and split? Would I judge her as I am judging Nadya Suleman? What makes the difference? Is it that my friend is married?
Suleman explains that six embryos were transferred for each of her IVF treatments. This simply doesn't make sense. Only one or two of those embryos made it out of six, in a healthy woman under 35? What did the clinic do so poorly the first few times, only to knock it out of the park on the seventh try? I maintain my skepticism on this point.
"No way should a single woman be allowed to have 14 kids with a sperm donor."
Yeah! But wait—where are we going to draw the line? Will we deny, for example, California lesbians the right to use donated sperm because they aren't technically married?
Then I learned that Suleman had experienced multiple pregnancy losses in her journey, and a light clicked on for me. For me, my definition of an embryo changed dramatically after I lost two of them. They became people; they were my babies. I agree with Suleman that the idea of simply discarding unused embryos feels totally unacceptable to me. But to transfer the entire gang at once seems like a misguided solution.
It seems that Nadya Suleman comprises our worst fears regarding the use of ART. Any one component of her life would not be shocking, but the combination —single, six older kids, no money—makes for a cumulative moral question mark.
I can't imagine a world in which reproductive endocrinologists are forced to make moral judgments before proceeding with IVF or other treatments. The California Medical Board is reviewing the clinic's records, but it is not against the law—simply against "professional guidelines"—to transfer more than two embryos made from the eggs of a woman under 35.
No one wants to wade into the murky legislative territory with this one, but at the same time, we can't look away. To continue operating without legal standards seems unfair to the embryos and unjust to the society which must care for them when ART is used irresponsibly.
Do you think there should be legal standards? What should they be?