By Dr. Lorna Marshall

As specialists in the field of fertility, we cringe every time a higher order multiple pregnancy (three or more gestations) receives special attention. Almost every Mother’s Day contest for “Mother of the Year” selects a woman who has carried and delivered four, five, or six babies at once. Jon & Kate Plus 8, which chronicles a couple raising twins and sextuplets, has become one of the most popular reality TV shows. To fertility specialists, such pregnancies are associated with preterm labor, tiny babies that need weeks or months of special care in the nursery, and likely one or more children with long-term health or behavioral difficulties. So, in a way, the public outcry against the recent birth of octuplets by Nadya Suleman can have a positive effect.

It’s hard to believe that any conscientious professional would ever consider transferring six embryos into a young woman’s uterus. The current guidelines by the American Society for Reproductive Medicine state that women less than 35 should have one or two embryos transferred into their uterus. Indeed, there are times when medical judgment suggests that perhaps three instead of two embryos can be transferred when their quality is poor or when there have been multiple failed cycles. And, yes, a patient has a right to make her own decisions about health care, but her physician has an obligation to ensure that those decisions are well-informed. Dr. Kamrava’s decision to transfer six embryos into the uterus of 32-year-old Nadya Suleman deviated so much from professional guidelines that every agency that has the power to sanction him should.

When medical care falls below the standard of care, there are many avenues available to reprimand the physician. Hospitals can withdraw privileges, medical societies can expel a member, state licensing boards can suspend the physician’s license, and patients can file a liability claim. Whatever official sanctions are imposed, the negative publicity has significantly harmed, if not ruined, Dr. Kamrava’s career. The public backlash should strongly deter other physicians as well.