06 June 2011
ByAppeared in BioNews 610
The US fertility doctor who helped 'octomum' Nadya Suleman give birth to a total of 14 children through repeated IVF treatments, has had his licence revoked by the Medical Board of California.
The Board said it decided to revoke Dr Michael Kamrava's licence to protect the public, although the evidence presented did not establish him as a 'maverick' or 'deviant physician'.
The Beverly Hills fertility doctor has acknowledged in one instance implanting six times the recommended number of embryos into Ms Suleman, which resulted in the birth of octuplets. The Board ruled Dr Kamrava was 'oblivious to standards of care in IVF practice' and 'certainly demonstrated that he did not exercise sound judgement' in the transfer of 12 embryos.
During his hearing last year, Dr Kamrava argued he implanted 12 embryos at Ms Suleman's request and that she had consented to undergoing fetal reduction if too many of the embryos became viable. However, he reportedly told the hearing that he never heard from her after the treatment, despite his best efforts to contact her.
High orders of multiple births are associated with health risks to mother and child including long-term developmental delays in the child, cerebral palsy and various life-threatening ailments.
The American Society for Reproductive Medicine (ASRM) recommends that women aged 35 or younger should receive no more than two embryos during one cycle of IVF and up to five embryos for women over 40. But it encourages fertility doctors in the US to exercise their clinical judgement and not rely solely on the recommendations.
Dr Kamrava had also been accused of mistreating two other patients, something which further influenced the Board's decision. 'This is not a one-patient case or a two-patient case; it is a three-patient case and the established causes of discipline include repeated negligent acts', it said.
A previous court ruling found Dr Kamrava had implanted seven embryos in a 48-year-old patient, resulting in a quadruplet pregnancy. One fetus did not survive, however, and the remaining triplets were delivered by caesarean section six-weeks premature - one has reported developmental problems.
In another case, Dr Kamrava proceeded with IVF when treating a 42-year-old woman, despite abnormal test results which indicated the presence of a tumour. The patient was later diagnosed with stage-three ovarian cancer and needed to have her uterus and ovaries removed before undergoing chemotherapy.
A judge had earlier recommended that Dr Kamrava instead be put on five years of probation, but the ultimate licensing decision rested with the Board which firmly disagreed. The revocation will take effect on 1 July.