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Fertility clinic in octuplets case has low pregnancy rate

Beverly Hills clinic has achieved many of its pregnancies with one patient -- Nadya Suleman.

February 10, 2009|Alan Zarembo, Jessica Garrison and Kimi Yoshino

The Beverly Hills doctor whose fertility treatment led to the birth of Nadya Suleman's octuplets -- and her six previous children -- has one of the worst success rates of any fertility clinic in the country, according to federal records reviewed by The Times.

In fact, Suleman's children represent a sizable portion of the pregnancy rate at his clinic over the last several years -- and taxpayers are already footing part of the bill.

Suleman receives at least $490 a month in food stamps, and three of her first six children are disabled and receiving federal benefits. Moreover, Kaiser Permanente's Bellflower Medical Center has asked California's health plan for the poor to cover the enormous cost of medical care for the eight premature infants in its care, according to multiple sources familiar with the case.

The disclosures came as the identity of the doctor who provided Suleman, a 33-year-old single mother, with the in vitro fertilizations became public Monday. In an interview on NBC, she identified the clinic as West Coast IVF Clinic, which is run by Dr. Michael M. Kamrava.

Kamrava, 57, has presented himself in interviews and on his website as a medical pioneer who discovered a breakthrough in in vitro fertilization procedures.

But according to federal records reviewed by The Times, of the 61 procedures he conducted in 2006 -- the most recent data available -- only five resulted in pregnancies and only two of those resulted in births. One of those births was Suleman's twins.

The pregnancy rate achieved by his clinic was so low that it probably spurred a professional association to offer him help in improving his record.

"These are the worst numbers I've ever seen. This is absurdly low," said Dr. Mark Surrey, another fertility specialist in Beverly Hills.

But in Suleman, Kamrava found a patient who got pregnant and gave birth every time.

For seven years, Suleman attempted to get pregnant through artificial insemination and fertility drugs. When she finally tried in vitro fertilization at Kamrava's clinic, it worked the first time -- and each time after that.

Among IVF specialists in Southern California, Kamrava is known for promoting techniques to improve success rates.

He has been a proponent of placing newly created embryos in a capsule and cultivating them inside the vagina for a few days before transferring them to the uterus in hopes of achieving a pregnancy. More recently, he has promoted a little-used technique employing a camera to help place embryos in the lining of the uterus. In 2006, he and Suleman appeared together in a KTLA-TV Channel 5 news segment about how the technique could boost the chances of success.

And on his website, he touts his "breakthrough technology that has revolutionized IVF."

In fact, Kamrava's clinic has a much lower rate of pregnancies and births than the vast majority of fertility clinics across the country.

His history of poor results comes despite the fact that Kamrava places more embryos per procedure than all but 10 of the nation's 426 fertility clinics for patients younger than 35. In 2006, he averaged 3.5 embryos per in vitro fertilization treatment, compared with the national average of 2.3.

Other fertility specialists said that placing high numbers of embryos is a common way that poorly performing clinics try to boost their pregnancy rates. But that increases the risk of multiple births, which pose a danger to the women and their babies.

Dr. Philip McNamee, a fertility specialist in Honolulu, said Kamrava may have believed he had little to worry about when he transferred six embryos to Suleman last year since his success rates were so low and her embryos had been frozen and thawed. Frozen embryos lead to pregnancy less frequently than fresh ones.

"That is one logical explanation of why he thought in his mind he could do it," McNamee said.

Still, he and other doctors strongly condemned the decision, especially because Suleman had a history of successful pregnancies.

Not only did all six embryos take, two of them led to twins, Suleman told NBC.

In the interview, Suleman defended her doctor. She called her treatment "very appropriate," particularly because of her history of miscarriages and scarred fallopian tubes.

"The most I would have ever anticipated would have been twins," Suleman said. "It wasn't twins times four."

Kamrava declined to comment to reporters who swarmed his office Monday.

This is not the first time he has faced controversy. At least two of his former employees have sued him, including Shirin Afshar, an office administrator who alleged that Kamrava engaged in systematic insurance and tax fraud. She also said he routinely asked her to participate in medical procedures even though she was not licensed to do so.

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