Strollerderby

Octo-Doc Not the Only One Breaking the Rules

Posted by Madeline Holler

A report by the Associated Press says that fewer than 20 percent of fertility clinics abide by the guidelines set out by their profession. So 80 percent break the rules? Why? And how?

The guidelines are purely voluntary, which is how it's not uncommon for multiple embryos to be transferred to a young woman's uterus, as was the case -- more than once -- for Octo-mom Nadya Suleman.

What do the doctors say?

From AP (via Salon):

Fertility doctors say there are many reasons clinics skirt the guidelines: pressure from patients who want to use more embryos to improve their chances of getting pregnant; financial concerns from those who are paying for their treatment out of their own pockets; and the competition among clinics to post good success rates.

And the only penalty for violating the guidelines is expulsion from some of the industry's professional organizations, though that can affect whether insurance companies will cover a clinic's treatments.

"You have patients who are desperate and you have doctors who are driven by success rates. It's not a good combination," said Pamela Madsen, founder and former head of the American Fertility Association.

The open outrage over Suleman and the simmering anger of the expense of the often sick children in these mega-multiples births are prompting some professionals to try to turn the guidelines into laws.

Think that'll happen?

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Photo: mishl982.blogspot.com

 


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Comments

 

Laure68 said:

There is one aspect of this I have not seen written about, and I am curious. Say, as in this case, the clinic still has 8 embryos from the parents. Who do these belong to? If they belong to the parents, then can the doctors tell them what to do with them?

I wonder if, while the guidelines are still voluntary, can a parent walk into the clinic and demand to have all the embryos transferred?

I think it was very dangerous to have so many embryos transferred at once, but I do wonder about the ethical/legal dilemma. It seems like the technology has moved much faster than the law can keep up.

February 20, 2009 5:43 PM
 

Shannon LC Cate said:

Yes, Laure, they do belong to the patient and she can demand the transfer, which is kind of what happened here.  But medical guidelines and even laws could be changed to say that you may "own" embryos, but a doctor may not transfer more than a certain number at a time.

As for insurance companies not paying for clinics that lose professional associations--since very few insurance companies cover IVF and some don't cover much ART at all, this probably makes very little difference to a clinic.  Most patients are paying mostly out of pocket anyway.

February 20, 2009 8:14 PM
 

Sheri said:

There are states that mandate that infertility be treated as any other medical issue.  Maybe if it were covered more by insurance, women who have this procedure wouldn't be pressuring their doctors to transfer too many eggs.  I know I am going to be slammed by this statement, but most women who believe that it shouldn't be covered are fertile.  

Until you have been there, done that, the sheer terror, desperation and longing you feel can sometimes cloud your judgement.  And the doctor, who knows that you can and will go elsewhere if you don't get what you want, will succomb too.  

February 21, 2009 10:34 PM
 

Shannon LC Cate said:

Sheri, I don't know anyone who thinks it shouldn't be covered--fertile or otherwise.

February 22, 2009 8:05 PM
 

Manjari said:

Unfortunately, there are plenty of people who don't think fertility treatments should be covered. I have read/heard plenty of comments from people who don't want to pay for infertility treatment when "god" or "nature" has decided that we shouldn't reproduce, and we should all just adopt.

February 23, 2009 8:15 AM
 

leahsmom said:

No matter what your medical condition is, some nasty people who don't have it think insurance shouldn't cover it - and it's heartbreaking to hear.  To me, fertility is not different than a heart condition or diabetes - someone's body isn't working the way it's supposed to, and there is a medical remedy to fix it.  

February 23, 2009 8:54 AM

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