The birth of octuplets due to in vitro fertilization would be highly unlikely in Canada, because industry guidelines limit the number of embryos that can be implanted, says one expert.
Nadya Suleman, a 33-year-old single mom from California, recently gave birth to octuplets -- her pregnancy attributed to IVF.
She already had six children -- all conceived using IVF -- with the recent births bringing her total to 14.
Dr. Ed Hughes, a professor of obstetrics and gynaecology at McMaster University, said there are no hard and fast rules in Canada, but that industry guidelines limit the number of embryos that can be transferred to two, he told CTV.ca.
However, three can be implanted in cases where the patient is older, in her 40s, for example, and has a lower chance of getting pregnant.
Hughes said both the U.S. and Canada have patient-pays IVF industries, and at thousands of dollars a cycle, clinics are often under pressure to do whatever it takes to increase the chance of conception.
"If they're under 35, many would do well with a single embryo, but because they're paying $10,000 dollars per cycle they may be reluctant to go that route, so they may prefer to have two embryos put back," he told CTV.ca.
He added: "It would be absolutely inappropriate to transfer large numbers of embryos -- totally inappropriate."
Suleman's pregnancies have all been attributed to IVF, but Hughes suggested the birth of the octuplets could be the result of ovulation induction, a separate procedure that he said is much harder to control.
In Canada, measures are in place to prevent such an outcome, he said. In addition to clinical practice guidelines in the country, all IVF data is collected and audited each year.
As well, he said, there is a partnership between the industry and the federal Agency for Human Reproduction to reduce multiple pregnancies.
But ultimately, patients and doctors share the responsibility for how many embryos are implanted, he said.
"It's a joint decision. Obviously the clinicians are responsible for their advice and their responsible for their parameters but patients clearly have some input."
Dr. Simon Fishel, a renowned fertility expert and managing director of CAREfertility, told Canada AM it would be against regulations in England to implant more than three embryos.
"It would be reprehensible to put back more than three embryos," he said, of the California case.
"What we would want is to try and improve the chances of pregnancy and deliver a healthy baby without the risk of multiple pregnancy."
High multiple-birth rate
Because in vitro fertilization treatment isn't funded in Canada, many women use fertility drugs in an effort to become pregnant. Those drugs have been blamed for the high number of twin births.
Hughes said Canada should follow the example of a number of European nations and fund in vitro fertilization in order to lower the country's high multiple birth rate.
He said the high rate of twin births results in a serious financial strain on the nation's health care system.
Pregnancies that involve twins have a five-fold higher risk of birth defects and death. As well, twins have a higher chance of being born prematurely and typically require weeks of costly care in neonatal units.
"Provincial governments would do well to look at funding IVF linked with single-embryo transfer because they ultimately would save money by reducing multiple pregnancies which are in turn very expensive to care for," Hughes said.
He said Canada should follow the lead of a number of European countries that have experienced the benefits of providing state funding for IVF.
"In Germany, in Sweden, in Belgium we're seeing multiple pregnancy rates drastically reduced by funding for single-embryo transfer IVF, to less than 10 per cent.
And in Canada our twin rate is still around 25 per cent," Hughes said.
Story for sale
Suleman has reportedly offered to sell her story for $2 million, but Joann Killeen, a spokesperson for Suleman, said Wednesday that financial gain "was not her intention" and that the woman "always wanted to be a mom."
Suleman's previous six children were between the ages of two and seven when she birthed octuplets on Jan. 26.
Killeen said Wednesday doctors have not yet decided when Killeen and the babies will be released, but said they are all doing well.
