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'Octomum's' IVF doctor expelled from ASRM

20 October 2009
Appeared in BioNews 531

The US fertility doctor responsible for transplanting six embryos into a woman who gave birth to octuplets last January has been struck off by the American Society for Reproductive Medicine (ASRM) - although he is still able to practice as membership of the professional society is only voluntary.

The ARSM made the decision in September following an investigation but did not name the doctor until last weekend. Speaking to USA Today, Sean Tipton, spokesman for the ASRM said that the doctor concerned was Dr Michael Kamrava who runs the West Coast IVF Clinic in California. Nadya Suleman sought IVF treatment at the clinic last year and Dr Kamrava transferred six embryos - four more than the recommended number. Two of the embryos divided in utero and Suleman gave birth to eight children, in addition to the six she already had also conceived through IVF. The event gathered media attention and the ASRM looked into the doctor's practice. Suleman was 33 years old at the time and a single mother receiving state benefits. Following the controversy, some US states, including Georgia and Missouri, looked into introducing legislative measures to limit the number of embryos that can be implanted at any one time. The Medical Board of California also launched an investigation into the doctor's possible 'violation of the standard of care'.

'Within the last few years, we have changed our by-laws to allow us take disciplinary action against members and, just this week, have expelled a member for cause,' Tipton said. 'We have a disciplinary committee that gathers information, we give people an opportunity to explain themselves, and then we take action if the committee thinks it's necessary,' he explained. The ASRM said that Dr Kamarava displayed a 'pattern of behaviour that was detrimental to our field and not up to our standard.' The society recommends that for women under 35 years old up to two embryos should be implanted, but increases this to a maximum of five for women over 40. However, the society is likely to announce even stricter guidelines at its annual conference in Atlanta this week. There are health concerns over transferring more than one embryo during IVF because of the increased chances of multiple births, which is risky for both mother and child, and can lead to developmental problems and increased risk of miscarriage. Suleman's octuplets were nearly 10 weeks premature with low birth-weights ranging between 1.8 and 3.4 pounds. Specialists say it may be years before the extent of their medical issues are known.

Speaking to NBC News in February, Suleman explained her decision to have all six embryos implanted. 'Those are my children. And that's what was available and I used them. I took a risk. It's a gamble. It always is,' she said. Dr Kamrava has declined to comment on the issue. It is reported that he has previously treated another women in her late 40s and transferred at least seven embryos. The women in question then gave birth to quadruplets.

The ASRM does not have the power to revoke medical licenses from its members but Tipton said that some insurance policies fertility doctors are required to take out to practice will only cover its members. 'I think it's our responsibility to set standards of care,' he said.

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