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Houston Fertility Center

Concerns About the Octuplets' Conception

By Sonja Kristiansen, MD on February 02, 2009

The birth last week of octuplets -- eight babies from one pregnancy -- is widespread news. For those of us whose work is all about helping creating new life, the news is bittersweet.

As strong as the yearning for a child can be, virtually no one believes that multiple pregnancies and births are the optimal situation for either the parents or the children. I do occasionally encounter hopeful parents-to-be who get excited at the prospect of completing their family with two or three children in one pregnancy. More babies than that, however, present far more soul searching opportunity than most people encounter in a lifetime.

Details of the California octuplets' conception are now being shared publicly, with the babies' grandmother reporting that her daughter (the mother) indeed used IVF. Reproductive experts would find the transferring of eight or more embryos into a woman's uterus after conception by in vitro to be medically unethical. High-order multiples (more than twins) are most often the result of unchecked use of superovulation medication and possibly intrauterine insemination.

The responsible use of ovulation medication includes monitoring to check on the drugs' effects and, sometimes, canceling a cycle if too many eggs became available for fertilization whether by IUI or intercourse. The reason for such cancellation is to ensure the health of the patient and to avoid a pregnancy with high-order multiple babies.

With IVF, there was a time when fertility experts routinely transferred up to five embryos, depending on the cause of infertility and, notably, the woman's age and health condition. But because of how different facets of the IVF process have improved, that practice is no longer necessary. Now, we routinely transfer only two or three embryos per IVF cycle and even a single embryo when the patient would have a good chance at pregnancy with only one.

Everyone is breathing a sigh of relief at the relatively good condition of the eight babies and their mother. Still, reports about the mother's family-building goals and that she was assisted by a still-unnamed fertility expert leave us all dismayed and concerned.

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