In Vitro Fertilization

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.

For more than five years, Patty and Scot Shier tried unsuccessfully to have a child. With every trip to the doctor they were told one medical obstacle or another stood in their way. So after their first attempts at in-vitro fertilization failed, they tried to increase their chances: Instead of the usual four embryos, they asked their doctor to implant seven. "We were just praying for one child," said Scot, noting that he and his wife are both only children unaccustomed to large families.

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.

Six years of frustration and heartbreak. That's how Gina Rathan recalls her attempts to become pregnant. Finally, she and her husband, Cheddi, conceived a daughter, now 3, through in vitro fertilization. About a year later, she became pregnant with a second child, naturally. Their family was complete. Then, a year ago, the Fountain Valley couple received a bill reminding them that their infertility journey wasn't quite over.

BIOPSIES are a pain. When they're medically necessary we put up with them. When they're not, most of us would just as soon remain un-punctured. When the patient is a 3-day-old embryo, it's especially fair to ask for some evidence of a clear medical benefit. Pre-implantation genetic diagnosis, or PGD, is a procedure sometimes performed in conjunction with in vitro fertilization to improve the quality of the embryos selected.

AFTER two years of infertility treatments -- from temperature monitoring and artificial inseminations to hormone injections and laparoscopic surgery -- Augusta Roman felt her last, best hope for bearing a child was only hours away. Her doctor had retrieved 13 eggs from her ovaries, and six had been fertilized with the sperm of her husband, Randy Roman.

Two weeks ago, Brianna Morrison gave birth to six babies in Minneapolis. Less than a day later, Jenny Masche delivered six babies in a Phoenix hospital. Both of the women had been treated for infertility and had used fertility-enhancing drugs. The two families expressed joy, but many fertility doctors were dismayed. For years, doctors have been pushing to lower the rate of multiple births due to fertility treatment.

At last, Chad and David Craig's quest to become fathers is over. They say they feel more happy, and more tired, than they have ever been. The gay couple, whose attempt to create a pregnancy through a gestational surrogacy arrangement was followed last year in a Los Angeles Times series, welcomed their son, O. Jansen Hodge Craig, into their lives nine weeks ago. "We just look at him and think he's a miracle," Chad said last week as he drew Jansen, clad in a snug jumpsuit, close to his chest.

CHAD HODGE LIKED #694. She was a 21-year-old college student, 5-feet-5, 135 pounds, with straight brown hair, blue eyes and a narrow nose. She had won 16 awards in high school for academics and music, and scored a 1210 on the SAT. She was outgoing, intelligent, responsible and friendly, or at least she said she was. Chad wanted her to be the mother of his children. But David Craig, Chad's partner of seven years, had his heart set on #685.

WHEN the Massachusetts Supreme Judicial Court voted to legalize gay marriage in 2003, its opinion rested squarely on the argument that determining the best interests of a child "does not turn on a parent's sexual orientation or marital status." Three years later, the top court in neighboring New York also cited the welfare of children -- but took precisely the opposite stance.