Octuplets doctor has another patient expecting quadruplets

A few months after Dr. Michael Kamrava helped Nadya Suleman become pregnant with octuplets, he transferred at least seven embryos to another patient.

She was in her late 40s and wanted just one baby.

Now she's five months pregnant with quadruplets and hospitalized at Los Angeles County-USC Medical Center, according to several sources familiar with the situation.

The new case could add to concerns about Kamrava's practice and about whether the fertility industry needs more regulation.

In fertility medicine, any pregnancy greater than twins is considered a poor outcome because of the danger it poses to the mother and the babies. Quadruplet births are rare, with an average of 14 sets born in California each year, according to state records.

"Historically, we have been very hesitant to regulate anything close to procreation from parents making judgments about how many children they will have and when," said Kirk O. Hanson, ethics professor and executive director of the Markkula Center for Applied Ethics at Santa Clara University.

"However, that worked under a natural process of fertilization and incubation. There are serious questions about whether it works in an era of scientifically enhanced procreation."

The woman in the latest case arrived recently at Good Samaritan Hospital in Los Angeles for unspecified treatment but was transferred last week to County-USC Medical Center because she lacks insurance. Doctors placed her on bed rest until the birth of the babies, which could be two or three months from now.

The California Medical Board has said it is looking into the octuplets' case to determine whether a doctor may have violated any standards of care.

The American Society for Reproductive Medicine, which has guidelines limiting the number of embryos that can be transferred depending on the woman's age and other circumstances, said it is also examining the doctor's practice. No laws govern this issue.

The guidelines allow for the transfer of more embryos in older women. But in this case, the woman was using embryos made from eggs donated by a woman in her late 20s -- which fertility specialists said increased the possibility of a multiple birth.

"I do think it is concerning, and dangerous, especially to the mother. She is close to 50. When women get to be that age, our fear is the cardiovascular complications, such as stroke or heart attack. That's how serious this is," said Dr. John Jain, a fertility specialist with knowledge of the case.