The Beverly Hills fertility doctor who assisted Nadya Suleman in conceiving octuplets was wrong to implant her with a dozen embryos but mostly respected her wishes and "standard" procedure, a fellow fertility specialist testified Wednesday at a state medical board hearing.
Dr. Michael Kamrava's medical license could be revoked if it is determined that he was grossly negligent in his treatment of Suleman and two other female patients: a 48-year-old who suffered complications after she became pregnant with quadruplets and a 42-year-old diagnosed with advanced ovarian cancer after receiving fertility treatments.
Dr. Jeffrey Steinberg, who has worked in the fertility field for 35 years, was hired to interview Kamrava, review his records and testify before Administrative Law Judge Daniel Juarez in downtown Los Angeles as part of a series of hearings to evaluate Kamrava.
Steinberg said Kamrava's treatment was aggressive but justified because Suleman, who was in her 30s, had fertility problems more typical of an older woman and wanted a large family and because Kamrava's in vitro fertilization lab was having trouble getting patients pregnant.
In all, Kamrava helped Suleman conceive six children before the octuplets. Kamrava, who was present Wednesday, testified last month that before Suleman conceived the octuplets in July 2008, he had recommended implanting her with four instead of 12 embryos or using embryos she already had frozen; but she disagreed and he acquiesced, later realizing what he had done was wrong.
Under questioning from Deputy Atty. Gen. Judith Alvarado, Steinberg conceded that Kamrava's records were incomplete, that he erred in implanting Suleman with so many embryos in 2008 and that at the time, he should have referred her for counseling.
But he said fertility specialists are not responsible for deciding how many embryos patients can use or how many babies they should have at a time.
"In our eyes, those embryos belong to the patients and they have to make decisions about them," Steinberg said.
Alvarado pointedly asked Steinberg if he was a proponent of radical fertility treatments such as genetically screening embryos to select sex, eye color and other traits so parents can create so-called "designer babies." Steinberg, who has clinics in New York and Guadalajara, defended the technique, called pre-implantation genetic diagnosis, saying it is primarily used to screen embryos for cancer, albinism and other conditions.
Alvarado plans to call her final witness, a consumer safety officer with the U.S. Food and Drug Administration, on Thursday. Then Juarez is expected to submit his opinion to the state medical board, which will make the final decision about Kamrava.