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Fertility doctor should have said 'no' to octuplets mother Nadya Suleman, expert says

October 18, 2010 |  2:14 pm

An expert witness testified Monday that Nadya Suleman still has 29 frozen embryos.

Dr. Victor Fujimoto, a professor of reproductive science at UC San Francisco said Dr. Michael Kamrava deviated from the standard of care by failing to use those frozen embryos in 2008 and instead allowed Suleman to undergo fertility treatments to create new embryos, never referring her for mental health screening.

Suleman underwent 13 rounds of fertility treatments at a cost of about $18,000 each, Fujimoto said. He said frozen embryos would have cost a fifth of that.

"What's the point of freezing embryos if you're not going to use them?" Deputy Atty. Gen. Judith Alvarado asked.

"I'm not sure," Fujimoto answered.

Fujimoto deemed each round of fertility treatments an "extreme departure" from the accepted standard of care.

He said doctors can say "no" to patients "when it is beyond the reasonable standard of care which is established for that situation."

"You have to protect the patient from themselves?" Alvarado asked.

"Sometimes," Fujimoto said. "... more is not necessarily better."

Fujimoto said Suleman's medical records show Kamrava used 16 of her eggs to create 14 embryos and implanted her with a dozen of them on July 19, 2008, when she was 33 and already had six children, all through in vitro fertilization procedures with Kamrava. National guidelines would have required no more than two embryos to be implanted, ideally one, given Suleman's age and history of successful pregnancies.

"I cannot imagine any of my colleagues transferring that many," Fujimoto said of the embryos.

He said Suleman's medical records show Kamrava had recommended transferring four embryos, which was still too many.

Alvarado said it was unclear what would become of the frozen embryos.

"There's no legal guidelines or standards. She is free to use those," Alvarado said.

Alvarado said she does not plan to call Suleman or the other two patients named in the accusation as witnesses, although they may be called by Kamrava's attorney.

The hearing is expected to last at least a week and could determine whether Kamrava's medical license is suspended or revoked.

The Medical Board of California has accused Kamrava of gross negligence related to Suleman's case as well as two others: a 48-year-old woman who became pregnant with quadruplets and another woman who was diagnosed with advanced ovarian cancer after he allegedly ruled it out and gave her fertility treatments.

Alvarado said she does not plan to call additional witnesses. Kamrava's attorney said he plans to call at least two doctors, Dr. Tien C. Chiu, Suleman's previous fertility doctor, and Dr. Jeffrey Steinberg, who has fertility clinics in Los Angeles, Las Vegas and New York. Steinberg has publicly defended Kamrava and has been quoted as saying: "Who am I to say that six [children] are the limit? There are people who like to have big families."

Kamrava has already been expelled from the American Society of Reproductive Medicine for a pattern of behavior detrimental to the industry. He continues to practice in Beverly Hills.

Kamrava has remained largely silent since the birth of Suleman's octuplets but defended his actions in a "Nightline" interview last year. He said that Suleman's case "was done the right way ... under the circumstances."

-- Molly Hennessy-Fiske