The Beverly Hills fertility doctor who assisted Nadya Suleman in conceiving octuplets and six previous children said during testimony Wednesday that his goal with each pregnancy was to produce a single baby and that Suleman agreed to reduce the number of fetuses if the treatment were to result in multiple births.
"We don't really intentionally want to make it a multiple pregnancy — our goal is a single term pregnancy," said Dr. Michael Kamrava. "However, this is not an exact science."
Kamrava could have his medical license revoked if he is found grossly negligent in his treatment of Suleman, 35, of La Habra 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.
The fertility doctor testified for the first time Wednesday at a hearing on the accusations before Administrative Law Judge Daniel Juarez in downtown Los Angeles. Suleman and the other two patients are not expected to testify, lawyers said.
Kamrava said Suleman first went to him for treatment in 1997.
"She said 'I want to have 10 kids. I just want to have a large family. That's my idea, that's my goal,'" Kamrava said.
He described Suleman as "very intelligent and knowledgeable in comparison to other women her age." He considered her for fertility treatment because she had been trying to get pregnant for four years and had taken fertility drugs for two years but miscarried.
Suleman told him she was single but had a live-in partner whom Kamrava said he met during her office visits.
Kamrava said he did not refer Suleman to a psychologist, despite the number of children she was seeking.
"I didn't make any judgment on that — that's a personal decision," he said.
In the years that followed, Kamrava said he advised Suleman "extensively" about the possible risks of repeated hormone therapy and in-vitro fertilization, including multiple babies.
It was not clear why Suleman did not reduce the number of fetuses.
Kamrava said he told her it would be cheaper to use frozen embryos — she has 29 frozen embryos — but she opted against that.
"It was her choice — she wanted to do a fresh cycle," Kamrava said.
He said Suleman often went to see him soon after she had delivered, seeking to get pregnant again, and that he told her to wait at least six months before resuming fertility treatments.
Kamrava graduated from Case Western Reserve University School of Medicine in 1976 and has been in private practice since 1982. He said his in vitro treatments have resulted in few multiple births: three sets of triplets and fewer than 10 sets of twins.
Dr. Suraj Achar, associate professor of clinical medicine at UC San Diego School of Medicine, testified Wednesday that his daylong visit to the fertility doctor's office showed Kamrava was "remorseful" and "contrite" and had improved patient consent forms to show that he adheres to national guidelines limiting the number of embryos he can implant.
But earlier this week, Dr. Victor Y. Fujimoto, director of UC San Francisco's In Vitro Fertilization Program, testified that Kamrava repeatedly failed to screen Suleman for mental health issues and to limit the number of embryos she had implanted or frozen.
He said Suleman's medical records show that the octuplets were the result of Kamrava implanting a dozen embryos. The babies were born nine weeks premature and remain the world's longest-living group of octuplets.
Fujimoto also faulted Kamrava in his treatment of the 48-year-old patient who conceived quadruplets with seven embryos, saying Kamrava should have implanted no more than two, and for not doing a better job of screening the third patient for cancer, proceeding instead with fertility treatments.
Kamrava is scheduled to continue testifying Thursday.