Missouri House bill seeks limits on embyro implants

Thursday, March 5, 2009 | 5:21 p.m. CST; updated 9:39 p.m. CST, Thursday, March 5, 2009

JEFFERSON CITY — In response to the now-infamous case of a Los Angeles-area woman who gave birth to octuplets after being implanted during an in-vitro fertilization process with twice as many embryos as is medically recommended, a measure has been filed that would punish doctors who do the same thing in Missouri.

The bill would require that physicians in Missouri implant no more embryos into a woman than is recommended by the American Society for Reproductive Medicine's guidelines. Those guidelines recommend limiting implants to between two to five fertilized eggs, depending on the woman's age, health and other mitigating factors.

The legislation's sponsor, state Rep. Bob Schaaf, R-St. Joseph, said he wants Missouri to avoid the same sort of taxpayer burden that occurred with the mother in California.

"This is a taxpayer trying to protect the taxpayers of Missouri," he said. "The people of this state don't need to be paying millions of dollars for some woman who has eight babies at once. That's ridiculous, and we need to stop it."

Nadya Suleman made national headlines in late January after giving birth to eight children at once. Her doctor, whom she identified as Michael Kamrava of the West Coast IVF Clinic in Beverly Hills, Calif., implanted her with six embryos, three more than the ASRM recommends for a woman her age. Two of the embryos split and became twins, leading to the eight births. According to The Los Angeles Times, Suleman, 33, was already a single mother of six before the treatment and is unemployed, creating a large financial burden for her home state.

Schaaf, himself a family physician and a former president of the Buchanan County Medical Society, said the bill would only lead to sanctions for a doctor who violates the ASRM's guidelines, not the intended mother. Although there are no specific punishments mentioned in the bill, Schaaf said a physician who violates this law would be subject to discipline from the state's medical board, depending on the severity of the infraction.

Bill co-sponsor state Rep. Gayle Kingery, R-Poplar Bluff, said it is not unreasonable to mandate limits on implants that protect a woman from physical injury.

"Looking at the medical practice, if you don't need more than two embryos to have a child, then let's make sure that doctors don't put women in harm's way and that children aren't in danger," Schaaf said. "And we are following physicians' guidelines."

The ASRM's guidelines are for those who want to give birth to just one child. Carrying any more fetuses than that at one time, Schaaf said, puts the woman at a much higher risk of diabetes and other illnesses, and the children are less likely to survive birth. Even at just 7 weeks of age, Suleman's children are already the longest-surviving set of octuplets in U.S. history, according to The Associated Press.

At a recent hearing for the bill, state Rep. Jeanne Kirkton, D-Webster Groves, expressed some reservations about the bill, but she said that because it is deferring to the judgment of a medical society, she supports it. No witnesses testified for or against the legislation.

"I can see concerns with individual freedoms, with people being concerned that the government is telling them how many children they can have," she said. "But when you put more embryos in you than is needed, you really put yourself at a lot of risk health-wise. We regulate a lot of things with regards to medicine, and this could be one of them."

The ASRM itself has said it supports the bill, while opposing a similar piece of legislation in Georgia. That state's measure would limit all women under age 40, regardless of health or past births, to only two implanted embryos per fertilization process. Sean Tipton, the organization's director of public affairs, said Missouri's proposed law would listen to doctors' wishes, while Georgia's would ignore them.

"In Missouri, the bill relies on expert advice, whereas Georgia's presumes that politicians know what is best for these women and not physicians," Tipton said. "We are very supportive of the bill in Missouri because it defers to medical knowledge and experience, and protects both women and unborn children."

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