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Archive for the ‘Michael Kamrava’ tag

Infertility Podcast Series: Journey to the Crib: Chapter 32: Octomom

By David Kreiner MD

December 1st, 2013 at 8:26 am

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Thirty-Two: Octomom. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=146


A year ago, the Medical Board of California revoked the license of Dr. Michael Kamrava, finding he “did not exercise sound judgment” in transferring 12 embryos to Nadya Suleman, who already had six children at home. The ruling, while not surprising, was illuminating, and it’s worth reflecting on the five things we learned from Octomom:

 

1.      Know How to Say “No”: There is a point where physicians have to make a judgment call. Pregnancies with triplets – let alone eight infants – put the mother at high risk of serious medical complications and put unborn children at risk for developmental disabilities. Physicians need to rely on their professional expertise and experience to know when to turn down a patient request no matter how vehemently it is made.

 

2.      Beware the Patient with Tunnel Vision: Often when a patient comes to a fertility doctor, unsuccessful pregnancy attempts have made her anxious and determined. She might want to get pregnant regardless of the risks that pregnancy may present.

3.      Less is More: In 1999, 35 percent of all transfers involved four or more embryos. In 2009, only 10 percent had four or more. And those high-number transfers are generally reserved for patients with significant fertility challenges. In contrast, Octomom already underwent multiple successful IVF (in vitro fertilization) procedures and had given birth to six children when she had her 12-embryo transfer.

 

4.      Know When to Deviate: While Dr. Kamrava’s deviation from guidelines was an extreme departure, deviations do occur for specific reasons, such as repeated IVF failure, age-related infertility and poor egg quality. It is important to know when implanting several embryos is appropriate.

5.      “Reduce” Risk: Dr. Kamrava complained that Octomom refused to undergo “selective reduction,” which would have reduced the number of embryos she carried to term. Here, again, is an argument for fewer transfers. Had he transferred fewer embryos, Octomom would not have had to face such a difficult decision.

 

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Was this helpful in answering your questions about what could have been done differently to prevent the Octomom case? How much weight do you give your doctor’s recommendation on the number of embryos to transfer?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.

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Octomom’s Fertility Doctor Loses License

By Tracey Minella and David Kreiner MD

June 7th, 2011 at 1:16 am

Eight small steps for mankind; one giant leap backwards for reproductive technology.

According to ABC News*, Dr. Michael Kamrava has had his license to practice medicine revoked. His name may not be familiar. But he’s notoriously well known as the fertility doctor responsible for transferring 12 embryos at one time into the uterus of Nadia Suleman, thereby creating the American phenomenon known as the Octomom. That’s 6 times more than the current national average.

Her delivery of eight IVF babies in January 2009 shocked the world on its own, but when the whole story came out, including her being a single, unemployed mother of six other young IVF children, it sent up red flags to anyone with half a mind. And its negative press set back the IVF movement by showcasing the sensational event.

Thankfully, he can no longer put the lives of mothers and babies at risk with his poor judgment and wanton disregard of the standards and procedures followed by responsible and ethical reproductive endocrinologists.

Only time will tell if those 14 kids grow up to kick his butt.

Read on for a flashback to Dr. Kreiner’s original post on the horror of the Octomom experience and why you’ll never be an Octomom at ECF:

The American public has been stunned by the news of a mother of six giving birth to octuplets. This shocking news is compounded by the stories broadcast by the mass media regarding the woman’s family situation and that she used IVF for these pregnancies.

Physicians have known for many years the dangers of multiple pregnancies and have worked steadily to formulate evidence‐based guidelines for the number of embryos to transfer in IVF cycles. The current rate of triplets in IVF cycles nationally has dropped in 2005 to only 2% of cycles. At East Coast Fertility our triplet rate has been below 1% since 2002 and not one of these occurred from transfer of more than 2 embryos. In fact a financial incentive is offered to patients to transfer a single embryo. Cryopreservation of embryos is offered for free as well as storage for up to 1 year. In addition, up to 3 frozen embryo transfers are offered for free until a baby is born. Patients are encouraged by this program not to put all their eggs in one basket. Unfortunately, this was not the case for this woman. Success rates with IVF, especially, in the good prognosis patients exceed 50% even when 1 or 2 embryos are transferred. It is hard to imagine a situation where it would make sense to take such an extraordinary risk like was done in this case in California.

We should keep this case in mind when considering how many embryos to transfer. It is rarely worth the risk to put more embryos back when one can alternatively keep the embryos in frozen storage until a patient is ready to conceive again.

* http://abcnews.go.com/Health/wireStory?id=13735735

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