Wednesday, February 11, 2009

The Octuplets Story Continues – Does the “Baby Business” Need to be Regulated?

There is a lot to talk about when it comes to the story of the octuplets, but what strikes me as the most concerning is the regulation question. Should reproductive clinics – and their patients – be regulated on matters like how many embryos should be transferred into a woman’s uterus? And, if so, who should be the regulator? The media keeps looking to the government, which is one avenue – one that I am guessing is not favored by the reproductive clinics. Another method of regulation is insurance companies. When something is covered by insurance there are rules around what they will and will not cover. Generally speaking, insurance companies don’t pay for experimental procedures; treatments outside the scope of the industry’s standard of care (e.g. which would help enforce ASRM’s guidelines); etc. This leaves me wondering: can we seize this opportunity and kill two birds with one stone? Improved regulation and increased access…


  1. I think that woman's reproductive endocrinologist should be outed in the media and lose his/her medical license. What s/he did is unethical.

  2. Related article in the NYT about regualtion:

    Great minds think alike!

  3. How could a physician who takes the Hippocratic Oath ("I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.") risk the mother's life and the potential children's lives and well-being by transfering 6 embryos into a woman that previously had little problem getting pregnant via IVF??

    The potential outcome (a healthy child) was not worth the risks (including death of the mother and the babies). Was there an alternative? Sure! Thaw fewer embryos and transfer only 2 and then if the woman did not get pregnant, thaw another 2 and transfer.

    The physician is lucky Suleman survived her pregnancy. Now she must wait to see what this will cost her children. How many will survive? How many will have life-altering consequences for the rest of their lives?

  4. I would like to add another perspective. As someone who has been trying for some time to have a child, and who has not yet been successful, should someone who already has six children, and who is a single mother, even have access to IVF?? Would that doctor's time not be better served working with people who don't have children yet, and who would like to, and for various reasons, are having trouble conceiving? This is just my humble opinion, but wanted to share my thoughts.

  5. While mistakes were clearly made in the Suleman case, perhaps we should not be too hasty in our outrage to slap regulations on reproductive clinics. After all, many people seeking fertility treatments receive little or no help from their insurance companies. This has created an incentive for women to ask that more embryos be implanted at a time. Despite this fact, most fertility doctors appear to be doing a good job reducing multiple births. It seems to me that these are judgment calls doctors make based on the individual patient--especially in the case of cancer patients seeking fertility treatment. I would be concerned at this point that regulation from, say, the government might do more harm than good. As for insurance companies acting as regulators -- yikes.