Medical society probes octuplet fertility doctor

LOS ANGELES -- A national medical society is investigating whether a fertility doctor followed its guidelines when he implanted six embryos into a Southern California woman who gave birth to octuplets last month.

The American Society for Reproductive Medicine confirmed Tuesday that it's investigating because Nadya Suleman says she received in-vitro fertilization for all 14 of her children at the same Beverly Hills fertility clinic.

Suleman, 33, told NBC's "Today" show that she was implanted with six embryos in each of her six pregnancies, resulting in four single births, a set of twins and the octuplets. No more than three embryos are considered the norm for a woman her age, and fertility experts and medical ethicists have been critical of the Jan. 26 birth of the octuplets.

The society has contacted Suleman and her doctor, and is prepared to assist the Medical Board of California, which is also looking into the pregnancy, the society's president, Dr. R. Dale McClure, said in a statement.

"Our guidelines provide the flexibility to give each patient treatment individualized to her needs, and her best chance to become pregnant without risking high-order multiple pregnancy," said McClure. "However, it seems that the guidelines may not have been followed in Ms. Suleman's case."

Neither the society or the medical board identified Suleman's physician, Dr. Michael Kamrava.

Kamrava, a specialist who pioneered a method of implantation, was identified Monday as a result of an NBC interview with Suleman, who said she went to the West Coast IVF Clinic in Beverly Hills and that all 14 of her children were conceived with help from the same doctor. In 2006, Los Angeles TV station KTLA ran a story on infertility that showed Kamrava, the center's director, treating Suleman and discussing embryo implantation.

Kamrava, 57, did not return calls seeking comment Monday or Tuesday. When confronted by reporters outside his clinic Monday, he said he had granted a television interview but would not give details.

In an NBC "Dateline" interview that aired Tuesday night, Suleman said the octuplets were a sign from God that she should stop having children. She also said she still intends to go back to school and finish her master's degree.

The state medical board said last week it was looking into the Suleman case to see if there was a "violation of the standard of care." The medical board said it had not taken any previous disciplinary action against Kamrava.

Kamrava's clinic is a member of the Society for Assisted Reproductive Technology, a sister organization of the American Society for Reproductive Medicine.

Clinics that clearly violate guidelines can be kicked out of SART. Neither group is a regulatory agency so a removed doctor could still practice medicine.

The state medical board cannot close the clinic if it is found at fault, but it can censure the doctor, putting the violation on his record.

Kamrava's clinic performed 52 in-vitro procedures in 2006, according to the most recent national report compiled by the Centers for Disease Control and Prevention. Of those, five resulted in pregnancies and two in births. One of the births were Suleman's twins.

Kamrava's pregnancy rate that year was among the lowest in the country. Experts say many factors affect a clinic's success rate, including a patient's health and types of procedures done.

According to court records, Kamrava has been named in at least five medical malpractice lawsuits since 1991. He also has been involved in other cases against him or his clinic, including at least one alleging fraudulent conveyance.

In one case, a former employee accused him and his wife of hiding income to avoid taxes and defrauding insurance companies. Former office administrator Shirin Afshar sued Kamrava in 1998, claiming discrimination, harassment, wrongful termination and infliction of emotional distress.

Over a seven-year period, Afshar said, Kamrava and his wife didn't report about $400,000 in income to the state and the Internal Revenue Service. Afshar claims Kamrava made patients who had no insurance pay in cash and that money was turned over to Kamrava's wife. The transactions were neither entered into an office computer nor deposited in a bank, the lawsuit said.

She said she was fired when she complained to Kamrava about what was going on.

Afshar also claimed she had an abortion in 1992 because she feared she would lose her job. When she told Kamrava she was pregnant, she claims her boss chastised her.

"How can you take care of this baby with no job, no family and no money?" Afshar claimed Kamrava said.

The lawsuit was settled in 1999 for an undisclosed amount.

The IRS did not immediately have any information about Afshar's tax claims.