After learning that the California woman who gave birth to eight babies Monday was already a mother of six, ethicists and fertility experts said that her so-called mega-multiple pregnancy was even more troubling.
Particulars of the case remain sketchy. Neighbors have told ABC News that the woman is a single mother in her 30s whose first name is Nadya. Hospital staff have refused to release the name of the mother, also declining to comment on whether she had received fertility drugs that have been linked to instances of multiple births.
But the details that have trickled from sources close to the mother have made this already unusual case even more shocking, experts say. The woman's mother, Angela Suleman, told the Los Angeles Times that her daughter had indeed undergone fertility treatments. Moreover, she said that her daughter had an operation last year to have embryos implanted in her uterus, suggesting that an in-vitro fertilization (IVF) procedure may have been involved.
Suleman also has said that when the woman learned she was carrying multiple babies, she opted not to reduce the number of embryos.
University of Pennsylvania bioethicist Arthur Caplan said the new information brings several ethical concerns into play, not the least of which is the question of why a woman who already had six children would have a medical procedure that allowed her to have eight more.
"In my view, it would be irresponsible to treat a woman who was fertile with infertility drugs or techniques," he said. "It is not clear if the six children are hers or adopted or foster kids or what. But if they are hers, then something very unethical may have happened."
And then there is the specific matter of IVF. While fertility experts originally told ABC News that they suspected that the multiple pregnancy was likely the result of drugs designed to make a woman release many eggs at once, increasing her odds of pregnancy after sex, it appears possible now that an actual operation was involved. That would dramatically increase the likelihood of such a risky and costly pregnancy.
"[Experts] would be astounded if a fertility specialist actually implanted eight eggs," ABC News medical contributor Dr. Tim Johnson said on "Good Morning America" today. "Current guidelines, which are guidelines, not law, would suggest between one and four. ... A vast majority of experts would say that [implanting eight] is bad practice."
Likewise, bioethicist Caplan Tuesday told ABCNews.com that, "anyone who transfers eight embryos should be arrested for malpractice."
Neonatal experts were equally concerned.
"Someone with six children is not an obvious candidate for fertility treatments," said Dr. Ian Holzman, chief of newborn medicine at the Mount Sinai School of Medicine in New York. "Because multiples are at increased risk of prematurity and all of the complications associated with prematurity, such a decision is not one taken lightly."
"The physician was irresponsible or the woman ignored all advice, and both are unacceptable," agreed Dr. Siva Subramanian, chief of neonatal and perinatal medicine at Georgetown University Hospital in Washington, D.C.. "We need to curb the idea that this is some kind of heroic or miraculous thing by the press."