Octuplets Fallout: Should Fertility Doctors Set Limits?

Richard Paulson, director of the fertility program at the University of Southern California, helped write the original professional recommendations regarding embryo transfer. Although he decries the birth of triplets, he's irritated at calls to legislate assisted reproduction. Doctors aren't the problem, he contends; laws are. Some European countries limit the number of embryos transferred, but that doesn't allow for physicians to take into account individual medical histories; generally, the older the patient, the less likely embryos will implant.

The California octuplets are only the second set to be born in U.S. history. "We're picking out this incredibly rare event, and all of a sudden, we want to pass laws," says Paulson. "Would we write laws limiting the size of someone's family to six? Would we write laws mandating selective reduction?" he asks, referring to the option of aborting some embryos if a high number successfully implant in the uterus. "Restricting reproductive rights would be a minefield."

In the meantime, the subject of how the California woman came to deliver eight babies — 10 years after a Houston woman gave birth to the first-known living octuplets — is preoccupying fertility doctors across the country. The ASRM is caught up in the craziness too. "If this resulted from an IVF treatment, we can say that transferring eight embryos in an IVF cycle is well beyond our guidelines," the group's president, R. Dale McClure, said in a statement issued four days after Kaiser Permanente Medical Center in Bellflower, a Los Angeles suburb, announced the babies' birth. "We have a process for looking into these kind of matters and taking appropriate action."

But at most, all the group can do is revoke society membership from a clinic gone astray. "We have no legal authority to stop someone from practicing," says Tipton, the group's spokesman.

Over the weekend at Duke Fertility Center in Durham, N.C., the extraordinary birth was on everyone's mind. Fertility clinics are round-the-clock operations, and women came and went for fertility monitoring. Susannah Copland, who oversees the IVF program at Duke University, was on call and noticed that "everyone was buzzing about the octuplets." Some were shocked, others unnerved. "I don't want eight babies," they told her.

"And we don't want you to have eight babies," she responded.

"I will continue to counsel patients that one embryo is the way to go," says Copland. "What does Mother Nature usually give us? One baby at a time."

Yet she worries that some patients may be inspired by news of the octuplets. "It's a pebble dropped in the pond," she says, "and who knows where the ripples will go?"

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