Tuesday, March 03, 2009

Octo-mom: could it happen in Canada?

 
The short answer is .... no.

The University of Toronto Bulletin publishes an interview with fertility expert Robert Casper [Octo-mom: could it happen here?"
Q. The woman in California who gave birth to octuplets was single. Is this common?

Yes. While couples (both heterosexual and same-sex) comprise the majority of IVF patients, we see many single women using donated sperm as well. We don’t discriminate.

Q. The California woman was implanted with six embryos using in-vitro fertilization. Could something like this happen in Canada?

In Canada no reproductive infertility specialist would be putting back that many embryos.
There’s no law in Canada—it’s up to the doctor and the patient to decide. Our guidelines are to transfer up to two embryos in women under 35, up to three for women between 35 and 39 and up to five for women 40 and older. The reason that the number of embryos goes up as you get older is that there are more and more chromosomal abnormalities that accumulate in the eggs as a woman ages. By the time a woman is 40, for example, 90 per cent or more of her eggs have a chromosomal abnormality that would be incompatible with a live birth. So the idea of putting more embryos in an older patient is to try and ensure that there’s one healthy normal embryo that will actually implant.

Q. So, in a nutshell, this is pretty much unheard of?

To put six embryos in someone who is 33 is way, way outside what it is considered to be normal standard of care.

Q. Any thoughts on what the doctor was thinking?

I have no idea what was happening in that clinic. It sounded like they didn’t have much experience. They put a lot of embryos in to increase her chances—I don’t think they were counting on the fact that she was so fertile or thinking about the fact that she had six previous children.

Q. Are women counseled psychologically before receiving IVF? This woman had six other kids – should her doctor have discouraged her from trying to have more?

Psychological counseling is mandatory—a standard of care in Canada—for women using donor sperm. However, we wouldn’t turn away a woman who has six children and wants another—it’s her decision if she wants to have another child. But at 33, we would encourage that she have only one embryo put back, especially, as with the case with this woman, she has proven very high fertility.


2 comments :

  1. I don't see any obvious difference between Canada and the US in this case. Both have IVF society guidelines that recommend only 1 or 2 implantations in a woman under 35. Neither has any law that makes implantation of 6 embryos illegal or even explicitly unethical.

    At least, that's the situation as far as I can discern based on reports in the lay press. If so, I think it's naive to think something similar could never happen in Canada. Of course, I fervently hope it won't, but it doesn't sound like Canada has any more in place to prevent this than does the US.

    ReplyDelete
  2. I have to second what Qetzal said. Those are pretty much the same safeguards that the US has. It's naïve to think the same couldn't happen in Canada.

    ReplyDelete