Birth of Octuplets Raises Questions

The Washington Times (Washington, DC), March 8, 2009 | Go to article overview
Save to active project

Birth of Octuplets Raises Questions


Byline: Dr. R. Dale McClure, SPECIAL TO THE WASHINGTON TIMES

Like most observers all over the country and indeed the world, I was disturbed by the news of the octuplet birth in Southern California. The problem was compounded by the unsettled situation of the mother and the number of children she already had. Regardless, a pregnancy with eight human babies is a medical failure, even when it ends with all eight infants surviving. It is difficult to discuss some aspects of this case because we don't know the facts. We can't even say the regulatory system failed because the incident is still under investigation and we don't know what the final sanctions will be. But I can offer some perspective on the medical issues raised by this case.

The most important medical fact to consider is that the occurrence of any multiple pregnancy after an IVF cycle is undesirable. High-order multiple pregnancies are particularly problematic because they bring with them high risk of prematurity, birth defects and long-term disabilities. Thanks to surveillance data first collected by the Society for Assisted Reproductive Technology (SART) in 1988 and by the Centers for Disease Control and Prevention (CDC) since 1995, we can track the number of births resulting from assisted reproductive technology (ART) treatments.

Until 1996, we were seeing an increase in the number of high-order multiple births. Recognizing that increase and understanding the consequences, SART and its parent group, the American Society for Reproductive Medicine, moved to address the problem.

Starting in 1998, we issued guidelines on the number of embryos to transfer in ART procedures. In the subsequent 10 years, we have revised those guidelines downward four times to the point where current guidelines for women under 35 with a good prognosis encourage single embryo transfer and only allow the transfer of more than two embryos in less than favorable circumstances.

It is very clear that these guidelines have worked. Articles have been published in prestigious medical journals that attest to their effectiveness. In addition, everyone can go to the SART Web site (www.sart.org) and see that the triplet rate has dropped from more than 6 percent of all IVF cycles in 2003 to only 1.8 percent in 2007. We are pleased the data allowed us to issue and revise these guidelines, gratified our members complied with them and proud of the resulting drop in triplet and higher births.

Looking at these outcomes, it is evident that the vast majority of U.S. physicians performing IVF have acted with the best interests of their patients and babies in mind seeking to maximize the chance of success while reducing risks associated with multiple pregnancy. The determination of the precise number of embryos to be transferred is a highly personalized decision made between patients and their physicians. When making a recommendation, the physician takes into account the diagnosis of the patient, her age, her prior experiences with medical treatment and the quality and quantity of embryos available.

As you can imagine, this is a very complex decision that must be individualized for each patient each time she seeks treatment. It simply does not lend itself to blanket regulations for all patients in all circumstances. A government mandate dictating the same treatment for all women in all circumstances would be bad medicine and an unprecedented intrusion into the patient-physician relationship.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Birth of Octuplets Raises Questions
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?