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Should IVF Be Regulated?

With Multiples More Apt to Have Medical Problems, Doctors Face Ethical Dilemma

Improved Counseling for High-Risk Pregnancies

Dr. Paula Mahone, medical director of the Perinatal Services at Iowa Methodist Medical Center, who treated the McCaughey septuplets in 1997, said that she doesn't think regulating the number of implanted embryos is the best way to prevent multiple births.

Instead, Mahone advocates improved counseling for mothers carrying high-risk pregnancies.

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"The most ethical thing to do is to first let parents know that I realize the path that took them to this point was very difficult and hard and they still have some hard decisions to make," said Mahone. "They may be happy they've conceived but there's a chance they may not have any children to bring home and raise."

In addition to discussing selective reduction procedures, Mahone says she warns expectant mothers to be extra cautious of symptoms they may otherwise ignore. She says that while she -– like most physicians -– does not favor multiples, she does provide care for those patients who carry such high-risk pregnancies to term.

Mahone says that even if a woman has multiples as a result of her first IVF treatment, subsequent implantation should not be scaled back as a precaution against more sets of multiples. In other words, there is no evidence showing that just because IVF produced multiples at one point that it ever will again.

"Medically, we know that if the mom is still infertile [when she tried IVF a second time] then she will still be less likely to have an embryo attach to the uterus," said Mahone. "And because it's such an extensive procedure, I understand wanting to have the best chances at having one viable fetus."

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