Controversy Over the Birth of Octuplets Calls for Tougher Regulations

Controversy over the birth of octuplets to a 33-year-old woman in California who underwent in-vitro fertilisation -IVF has amplified calls for tougher regulations on assisted reproduction.

When the eight babies were born in late January, the event was hailed as a heart-warming miracle.

But as the world learned more about the mother, Nadya Suleman, and the role of health professionals in facilitating her pregnancy, delight turned to anger.

Suleman, it turned out, was a single mother who already had six other children, aged seven and younger.

All 14 babies were born through IVF, whereby eggs were fertilised in a laboratory by donor sperm and implanted in her womb.

Within the medical profession, experts are aghast, for multiple pregnancies are notoriously linked to premature births, low birthweight and neurological damage.

It's the most irresponsible thing that I have ever heard in terms of fertility, said Peter Bowen-Simpkins, a British specialist who is spokesman for the Royal College of Obstetricians and Gynaecologists.

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High-order multiple births should never be considered a medical success story, said Sean Tipton, spokesman of the American Society of Reproductive Medicine ASRM.

Bowen-Simpkins pointed the finger at glaring shortcomings in oversight.

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Many countries have only guidelines rather than legally-binding regulations for limiting the number of implanted embryos and some countries have no restrictions at all.

The mother's maximum age, the parent's psychological suitability and the use of surplus or discarded embryos may likewise be lightly regulated or not at all.

In December, a 70-year-old woman in India who had received IVF therapy gave birth to her first child. Another Indian, also 70, had twins through IVF earlier in the year. A similar case of twins occurred in Spain in 2007.

Improved technology and the plunging cost of setting up an IVF clinic have helped open the way to IVF tourism.

In essence, an infertile couple seeking donor eggs or sperm, an elderly woman craving a baby, or a man looking for a surrogate mother can shop around to get the service they need, said Bowen-Simpkins.

He said the Mediterranean island of Cyprus had become a centre for what he described an absolutely horrifying practice whereby young Russian women were flown in and given hormones to stimulate ovulation.

Their eggs were harvested and then sold to women seeking donor eggs for IVF.

I think it is a very worrying trend, Bowen-Simpkins told AFP. He spoke of a backlash among governments and the public. A lot of countries are getting very frightened about the way things are going. The responsible European countries are taking steps.

In Britain, he pointed out, the Human Fertilisation and Embryology Authority HFEA tightly controls IVF practices, limiting the number of implanted embryos to two at a time. Just a single embryo will be allowed from 2011.

In France, there is no anonymous donor sperm, single women are excluded from IVF treatment and only heterosexual couples are allowed to apply for it. Italy tightened up IVF regulations after controversial cases involving insemination of women in their sixties.

But, conscious that differing legislation within the European Union EU offers plenty of loopholes for IVF tourism, movement is afoot to set up an EU-wide agency with tough powers of scrutiny, he said.

Where Suleman received the IVF treatment for the octuplets is unknown.

In the United States, there are no national regulations on IVF, as rules and oversight vary from state to state but are often minimal or absent.

The ASRM's guidelines say a woman of Suleman's age should have no more than two implanted embryos. This could be increased to three from 35 to 37 years, to four embryos for ages 37-40, and five for a woman aged over 40.

Most clinics in the US are pretty responsible, but we have had over the years a series of troubling cases, Arthur Caplan, who directs the Center for Bioethics at the University of Pennsylvania, said.

They included embryos stolen to make babies at an infertility programme in California and a woman from Spain who had triplets through IVF in California, and was later diagnosed as schizophrenic.

In some cases, people are using sperm and embryos to make children from parents who are dead, effectively making orphans, he said.

It is part of a trendline that says the business of infertility treatment in the US has become too much of a business.

Source-AFP
SPH