Birth of Octuplets Raises Ethical Issues With In Vitro Fertilization

On January 26, 2009, Nadya Suleman gave birth to the country’s second set of octuplets.  Initially, it appeared that everyone was overjoyed at the medical marvel.  The joy quickly turned to disapproval once the circumstances were revealed.   Nadya Suleman is a thirty-three year old unemployed, divorced single mother who lives off welfare and is now mother to fourteen children.  Questions of reasonableness, responsibility, and abuse of discretion immediately come to mind.  As soon as these circumstances became known to the public, a scrutinizing response quickly came from both the general public and specifically those in the medical field. 

The American Society for Reproductive Medicine recommends medical guidelines for in vitro fertilization.  These guidelines indicate that women under the age of thirty-five should only be implanted with up to two embryos.  These guidelines cannot be legally enforced; however, most fertility doctors follow them when dealing with their patients.  Nadya Suleman was implanted with six embryos, where two of the embryos split into twins.  She was also previously impregnated through in vitro fertilization for her previous six children.  These facts have led to an investigation by the California Medical Board to determine whether there was a violation of the standard of care by the fertility doctor who implanted Nadya Suleman. 

It seems these circumstances beg the question of whether new legally enforceable medical guidelines ought to be implemented for in vitro fertilization.  The 2008 guidelines recommend only implanting a single embryo and having several implantations as opposed to multiple embryos implanted.   However, women who are desperate to get pregnant plead with doctors to implant several embryos regardless of the medical guidelines to increase their chances.  But when stories like that of Nadya Suleman result, it seems like there ought to be bounds put on the amount of embryos implanted.  When several embryos get implanted, the result is increased chances of pregnancy but also increased chances of multiple fetuses.  When there are multiple fetuses, higher health risks result for both the mother and child.  Thus, in spite of how desperate a woman may be to get pregnant, the health of both mother and child ought to preempt that desire and be incorporated through legally enforceable rules. 

It seems as though at least one other consideration should also be done through the medical guidelines prior to implantation.  Clearly, any woman who wants to have children should be allowed to have them.  But, when a woman has trouble getting pregnant and staying pregnant, there ought to be a limit on the number of in vitro fertilization treatments following successful prior implantations.  This will ensure the health and safety of the mother while keeping the welfare of the child in mind.