Modest Goddess

Of all the ways that infertility could have exploded on the national scene, it seems incredibly unlikely that it would be through a woman who appears not to have actually been infertile.

Nadya Suleman's story is not that of a typical IVF patient who struggles to bear one child, but about someone who had 14 -- which appears to us IVF veterans way more than her fair share.

While we may be annoyed with her, one of the case's most disturbing developments is that now, various elected officials and newspaper editorial boards are making rumblings about how her case shows that in vitro fertilization needs to be better regulated.

No, thank you.

Suleman's case is only that of an outlier, nothing more, and while her doctor should be investigated by an ethics board, as California's is doing, her case should not be used as any kind of an example to pen in vitro legislation. After my trip through three infertility clinics, seeing around half a dozen doctors in the process, having doctors tell me about the possibility of multiple births and selective reduction, speaking with friends who have also undergone in vitro and reading hundreds of messages about treatments on Web sites, I can say through my own experience that I perceive doctors who are trying their best to get us pregnant, who are also very aware of the risks of multiple births, and who want to keep their patients healthy. These doctors are already overseen by their state's medical boards and in most cases they belong to the professional groups Society of Assisted Reproductive Technicians and the American Society for Reproductive Medicine, which maintain guidelines for in vitro fertilization.

There's also an informal referral network going on. Good doctors are discussed lovingly in places like IVF Connections. Bad doctors -- the ones who make you cry, who don't know what they're doing -- are thoroughly panned. Never underestimate the power of a bunch of well-educated, angry women. (Case in point: The oft-disproved and oft-resurfacing austim-vaccine connection.)

There are some countries where only one embryo can be transferred for women under 35, reducing the risks of multiple births. But the catch is that these countries also mandate in vitro coverage, in many cases three cycles, so women know that if the first cycle fails, they'll get another crack at it -- and statistics show the odds of IVF success go up over three cycles. These patients are not going bankrupt trying to pay for a single all-or-nothing cycle.

I was lucky on two counts. First, we met the income guidelines for a New York State grant that paid for two cycles. And on that second cycle, I got pregnant. However, although I was under 35, I had two embryos transferred per cycle (and the word is "transferred," not "implanted." If embryos were implanted, there'd be a lot more pregnant IVF patients.). I trusted my doctor to make the best decision for me, and it turns out she did. What if I was only allowed to have one embryo transferred per cycle? Would I have gotten Little Big Man?

IVF veterans fear that Suleman's case will end up restricting what their doctors can do to help them, and one thing IVF patients don't need is another obstacle to getting pregnant. Anyone thinking about how IVF needs to be regulated should be thinking first about how we can mandate insurance coverage for IVF, making sure every woman who needs IVF can get it, which would do far more to reduce the risks of multiple births.