There is no question that there was no justification in transferring this many multiple embryos.
Fairfax, VA (Vocus) March 17, 2009
With the recent barrage of publicity covering the so-called “Octuplet Mom” in California, many people have been wondering about the safety of in vitro fertilization, and how this particular IVF pregnancy resulted in the birth of eight infants. Doctors who specialize in IVF treatment are also asking questions. The case of Nadya Suleman has raised a number of alarms in the in vitro fertilization community, especially since Suleman has gone on record saying her doctor treated her with six embryos. Guidelines set forth by the American Society for Reproductive Medicine (ASRM) advise specialists to transfer no more than two embryos in an IVF procedure for someone of Suleman’s age and previous history of pregnancy.
Dr. Suheil Muasher is a board certified Washington DC, Fairfax, Virginia infertility specialist. He says that, while all the facts are not yet known in Ms. Suleman’s case, the transfer of six embryos into her uterus should not have happened. “There is no question that there was no justification in transferring this many multiple embryos.”
In an interview with the Washington Times, Dr. Muasher says that most in his specialty are outraged, and the Suleman case reflects badly on an area of science that has worked for decades to help women who have trouble getting pregnant. Dr. Muasher says he wants to reassure women who may be reconsidering IVF treatment because of the case in California. “We tell patients that the vast majority of IVF babies, greater than 97%, are either singletons or twins. There is no reason to fear IVF treatment simply because there is a higher chance of a multiple pregnancy.”
Dr. Muasher is head of The Muasher Center for Fertility and IVF, specializing in IVF for Washington DC, Fairfax, Virginia, and Maryland-area patients, as well as those from around the world. He participated in the original research that ultimately led to the IVF protocol used in most clinics today. Dr. Muasher says his facility tries to educate patients that the best possible outcome of in vitro fertilization is to have a healthy singleton baby. “Education is very important as many patients do not truly understand the increased risks of multiple pregnancy. We also try to follow the guidelines of our professional societies in limiting the number of embryos transferred.”
Those guidelines from ASRM stipulate that: women under 35 with a favorable prognosis of carrying a fetus to term should have 1-2 embryos transferred; those under 35 with less favorable prognoses should have 2 embryos transferred; women ages 35-37 (favorable prognosis) should have 2 embryos transferred; those with an unfavorable prognosis should have 3. The guidelines typically increase the number of embryos recommended for transfer depending on the patient’s age and prognosis, but the guideline never goes above a 5-embryo transfer recommendation (for patients over 40.
Dr. Muasher says although some individuals and couples would like to have a multiple pregnancy, he tells patients at his Washington DC / Fairfax, Virginia-area infertility clinic that multiple pregnancy, even twins, carries a higher risk of complications for both babies and mother. “Even though many of our patients want to have twins, there is no justification in increasing the number of embryos transferred as this will also increase the number of triplets and higher order multiple pregnancy. In favorable patients who are younger than 37 years old the incidence of twins is approximately 20 to 25%, per total pregnancies, with the transfer of two embryos.”
Since the ASRM first issued its guidelines in 1997, multiple pregnancies from IVF treatments have been on the decline. In the wake of the “Octuplet Mom” story, some have asked if there should be laws restricting the number of embryos a reproductive endocrinologist can transfer during an IVF procedure. Although Dr. Muasher does not believe there should be strict laws limiting the number of embryos, he says most specialists adhere to the ASRM guidelines. “In the US, we are lucky that medical decisions are left to the patient and her doctor. In some other countries strict laws have lead to negative outcomes and are not necessarily in the patient’s best interests. However, the medical community needs to speak out whenever there is a situation when the practice of medicine deviates a lot from the standard of care, as it was in this case.”
For more information on In Vitro Fertilization in Washington DC, Fairfax, Virginia, Maryland and the surrounding area, Dr. Suheil Muhasher can reached at The Muasher Center for Fertility and IVF - 8501 Arlington Boulevard, Suite 500 Fairfax, Virginia 22031 – (703)542-3610. http://www.mcfivf.com