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Editorial: Eight is too much

Multiple births are a wake-up call for the fertility industry

Friday, December 25, 1998

People marvel at superlatives - the biggest, the tallest, the fastest, the strongest. Anything that pushes the bounds of what was previously considered humanly possible causes awe.

Thus the birth and survival of octuplets in Houston this week understandably is creating a sensation. But just because something is possible doesn't mean it should be done.

Nkem Chukwu, the mother of the babies, had been receiving drug treatments for infertility. Some experts are questioning the specifics of the treatment, wondering, for example, why she was given her final hormone shot, which made her large clutch of eggs available for fertilization.

Ms. Chukwu and the babies' father, Iyke Louis Udobi, are overwhelmed. Ms. Chukwu is recovering from surgery for bleeding and is reported to be in good spirits. The newborns, weighing between 10 and 26 ounces, are not doing as well.

All but one are on ventilators, and one is on oxygen. They can look forward to another two or three months hospitalization (at a cost of about $250,000 each) while doctors watch for complications like bleeding into the brain, infection and hearing, sight and developmental abnormalities. Nearly a quarter of babies born as early and small as the octuplets experience some developmental difficulties.

Whatever the future holds, the six girls and two boys are gifts, as all babies are. We hope they defy the odds and survive and thrive.

But while their lives merit celebration, the unconstrained, no-holds-barred fertility industry should take stock. Human beings were not meant to give birth to litters. The human anatomy makes that clear.

But the number of multiple births has surged in the last decade as more and more couples turn for help in conceiving. Thirty-seven percent of those who use aggressive fertility treatments have multiple births compared to 2 percent in the general population.

Such births are loaded with risks for mother and children. "This scares me," said Dr. Alan Copperman, director of reproductive endocrinology at Mt. Sinai-NYU Medical Center and Health System. "It seems there is almost an acceptance these days of quads or quints or even more, and the outrage gets less and less. . . . The fact is that the vast majority of these cases end in disaster, sometimes for mom, most often for babies."

Infertile couples no longer must accept the verdict of unassisted nature - they can turn to medicine for the miracle of life. By helping them conceive, doctors perform an important service.

But the miracle of eight births is not a success for fertility treatments, it is a failure.

And it is a challenge to ethicists and an imperative for the doctors to do a better job for the desperate couples who turn to them for help and hope.



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