Just about the time that eight babies began growing inside a California woman's womb, some nationwide policies about fertility treatment were being codified. In June, the American Society for Reproductive Medicine (ASRM) issued updated "Guidelines on Number of Embryos Transferred." Women under age 35 — the octuplets' mom is reportedly 33 — should attempt to transfer no more than two, and preferably only one, fertilized embryo at a time. Women over age 40 should attempt no more than five. (See pictures of multiple births.)

How the California woman, apparently a single mother who already has six young children, including a set of twins, got pregnant is the subject of rampant speculation. But regardless of whether the octuplets are the result of in vitro fertilization (IVF) or fertility drugs — the latter has historically been available on the cheap in Mexico — there is little doubt that from a medical and ethical perspective, something went very wrong. And fertility specialists now find themselves on the defensive, trying to fend off the perception that theirs is an undisciplined, irresponsible profession. ...

Physicians may advise a patient to transfer only one or two embryos, but the patient may insist on double the number — or more. "Doctors' attorneys are advising them, 'You have to do it,' " says Sean Tipton, spokesman for the ASRM. "The courts have made clear that decisions about what to do with embryos are in the hands of patients, not in the hands of physicians."

A doctor, after all, is not the same as a judge.

If women who already have a bunch of kids were to approach Stillman for help conceiving more, he says he'd be obligated to help. "As a parent of two kids, I may think they're crazy, but I'd tell them what I always tell patients: our goal here is as many children as you want, but preferably one at a time."

Labels: donor conception, fertility treatment, medical ethics

VOTE