California Legislator to Introduce Bill to Establish Stricter Standards on Fertility Clinics

State Senator Gloria Negrete McLeod (D-Chino) intends to introduce a measure that will establish accredidation standards and guidelines for the operation of fertility clinics.  The intent is to better protect the public because of the increasing number of surgical procedures being performed outside of the walls of a hospital.  The measure would essentially bring fertility clinics under the jurisdiction of the Medical Board of California requiring the establishment of standardized procedures and protocols to be followed in the event of complications and to govern emergency and urgent care situations.

This bill will also affect other clinics, such as plastic surgery centers.  This bill also recommends some additional requirements including disclosure; however, this just appears to be the first of many regulations to come after the wake of the octuplets. 

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Theresa M. Erickson, Esq.
Surrogacy Lawyer & Egg Donation Lawyer 
www.EricksonLaw.net

Subscribe to my blog at: http://www.surrogacyeggdonorblog.com/subscribe.html

 

California Legislator to Introduce Bill to Establish Stricter Standards on Fertility Clinics

State Senator Gloria Negrete McLeod (D-Chino) intends to introduce a measure that will establish accredidation standards and guidelines for the operation of fertility clinics.  The intent is to better protect the public because of the increasing number of surgical procedures being performed outside of the walls of a hospital.  The measure would essentially bring fertility clinics under the jurisdiction of the Medical Board of California requiring the establishment of standardized procedures and protocols to be followed in the event of complications and to govern emergency and urgent care situations.

This bill will also affect other clinics, such as plastic surgery centers.  This bill also recommends some additional requirements including disclosure; however, this just appears to be the first of many regulations to come after the wake of the octuplets. 

Click Here for Complete Article

Theresa M. Erickson, Esq.
Surrogacy Lawyer & Egg Donation Lawyer 
www.EricksonLaw.net

Subscribe to my blog at: http://www.surrogacyeggdonorblog.com/subscribe.html

 

Multiple Births via IVF and the Octuplet Mess that is Increasing Scrutiny of the Industry

The octuplet "mess" will just not want to go away, especially now with a sperm donor claiming to be involved in the mix as shown on Good Morning America.

However, there were several articles over the last few days that I think will help everyone take a look at the real costs of multiples births, as well as how this one case may end up forcing the industry to take a good look at itself. 

The first one is through the New York Times, and it takes a hard look at the fertility industry.  They think that the octuplets' birth is a real wake up call:

"The American Society for Reproductive Medicine, the association of fertility doctors, even adopted guidelines in 2008 encouraging the transfer of only one embryo for women under 35, and no more than two, except in extraordinary circumstances. The guidelines allow more for older women, up to a maximum of five.

But unlike some other countries, the United States has no laws to enforce those guidelines. The Centers for Disease Control and Prevention has a surveillance system that collects data on fertility clinics, but reporting is voluntary and there are no government sanctions for not reporting.

As a result, experts say many doctors are still implanting too many embryos to increase the chance of pregnancy. Only 11 percent of in vitro procedures in the United States involve single embryos, according to 2006 data from the C.D.C."

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Furthermore, in Newsweek, an article by Dr. Mark Evans talks about the other side of multiple births - selective reduction.  He states the following:

"When I first heard that a California woman had given birth to octuplets after undergoing in vitro fertilization, I couldn't believe it. As the details of Nadia Suleman's story emerged, it became only more incredible. As it turned out, a clinic transferred six embryos (two of which later split into identical twins) to Suleman, who had six children already, meaning she was extremely fertile. I have nothing against IVF. More than 2 million women worldwide have children because of it. But with the increase in fertility treatments, the U.S. birthrate of twins has more than doubled in the past 30 years. Overlooked in the happy news, though, are the troubling surges in neonatal deaths, developmental disabilities and other long-term problems.

For those reasons, doctors prefer to avoid multiple births. But with each cycle of IVF costing more than $10,000, there's enormous pressure to get patients pregnant—fast. Guidelines of the American Society of Reproductive Medicine and the Society of Assisted Reproductive Technologies say that in women under 35, usually only one or two embryos should be transferred to the uterus in any cycle. The U.S. average is 2.4. A third of such pregnancies result in twins, and 4.3 percent yield triplets or more. In women over 35, the overall pregnancy rate falls dramatically, and the proportion of multiples goes up."

He goes on to talk about the criticism that he receives regarding selective reduction as a solution in some cases:

"Of course, selective reduction can be an agonizing decision for a parent, but most of the couples who come to me have had a longstanding infertility problem. For them, selective reduction is just one more hurdle to deal with. But they are better able to cope when they know the facts: a woman with a quadruple pregnancy has about a 25 percent chance of losing all four babies, but she can decrease the loss rate to about 5 percent by reducing to twins. The risks of prematurity, cerebral palsy and genetic abnormalities (if tested) are all reduced, too.

Reduction will always be controversial. A woman has an abortion because she wants—for whatever reason—to not have a child. But women who have reductions are often desperate to have children. In high-risk situations, reduction may be the best way—sometimes the only way—for that to happen. I realize that in the minds of pro-lifers, this reasoning is flawed. But if performing this procedure means that couples who have suffered years of anguish can have their own healthy children, I'll take all the criticism I get."

Click Here for Complete Article
 

Theresa M. Erickson, Esq.
Surrogacy Lawyer & Egg Donation Lawyer 
www.EricksonLaw.net

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Octuplets and Regulation - What Should We Do with Fertility Treatments?

I am still waiting for this controversy to finally die down, but it sure does not look that way with new information coming out about the mother and her fertility doctor.  But, today I want to stay away from that and look more to the regulations that everyone is literally screaming for at the top of their lungs.  I understand that everyone wants some control since it looks like the tax payers are ultimately going to pay the bill for her decisions, but I also want to make note of how regulations will also affect the millions of other fertility patients that do make sound decisions in their family planning.

First, in other countries that have regulations surrounding the number of embryos being implanted, I want to note that the government actually foots the bill for a certain number of IVF cycles - thereby giving patients an added assurance that they can try one embryo at a time because their government will pay for another (possibly) cycle.  Here, in the US, we do not have that luxury as this is a cash business.  Very few, if any states and insurance companies cover the costs of IVF.  These patients are then placed in the dilemma of not having enough funds to cover another cycle if this one does not work.

Now, with that in mind, I want to encourage everyone to look at the issue of regulations with an open mind, and look at what Dr. James A. Grifo, the program director of the New York University Fertility Center at the Langone Medical Center and a professor of obstetrics and gynecology at the university’s School of Medicine, has to say in the following piece:

"The fascination with the octuplets born last week has dominated the news media. But after the initial marvel of the miraculous feat faded, we were left wondering why an unemployed mother of six wanted more. Responses from around the country, and within the medical community, included cries of malpractice and demands for new laws regulating fertility treatment.

But where would this lead? A knee-jerk response to one outlier does not always prevent the next. Legislation about how to practice medicine threatens doctor-patient relations and has unintended consequences that may be worse than the actual problem. We live in a country that doesn’t regulate family size. If we were to decree a proper number, who would decide?

In 1992, Congress passed a law requiring fertility clinics to report their pregnancy rates. It came about because a rogue practitioner was telling patients the success rates of in vitro fertilization based on national statistics and neglecting to mention that his own clinic had none. Thus a national registry was born, financed by taxpayers. The clinics that refused were listed as non reporters, hardly a punishment.

But the implications of a government published report were unanticipated and it changed behavior. Since clinics were measured by pregnancy rates, there was incentive to implant more embryos into a patient — creating the unwanted consequence of a boom in twins and triplets.

The American Society of Reproductive Medicine and its subgroup, the Society for Assisted Reproductive Technologists, recognized the problem and published guidelines for the number of embryos to transfer to maximize pregnancy rates but minimize multiple gestation, especially triplets and beyond. We have now published three iterations of these guidelines since 1999 with a significant decline in the incidence of triplets and higher. This happened without laws being passed; it was simple cooperation of clinicians doing the right thing for positive change to happen.

Medicine cannot be practiced in a vacuum or by legislation. It requires a patient and physician dialogue, it requires decision-making that minimizes risk and maximizes good outcome, and it requires patients and physicians to make good decisions. Indeed, that is already happening but that story is lost in the tsunami of one unusual case whose facts are not known."

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Theresa M. Erickson, Esq.
Surrogacy Lawyer & Egg Donation Lawyer 
www.EricksonLaw.net

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The Octuplets and Regulations - What Should We Do?

I have been trying to show restraint with my opinion on the octuplets because I believe strongly in reproductive freedom for everyone in America, and I also understand an individuals strong desire for children.  But, I really enjoyed the piece written by George Dvorsky on the Institute for Ethics and Emerging Technologies Blog.  He makes quite a few good points involving common sense and restraint.  As many have cited, he wants ASRM to set up and give their guidelines some teeth.  I am not certain if that will happen or if it should happen, but let me know what you think. 

"Like a lot of people last week, I was shocked to find out that Nadya Suleman, the mother of the octuplets born last week in Los Angeles, already has 6 children—all between the ages of 2 and 7.

And that she is a single mother who has already filed for bankruptcy, and that she is a self-described “professional student” who lives off education grants and parental money.....

Looking at this case one gets the feeling that some fertility clinics look upon their patients as nothing more than customers. Given the nature of their work, however, this attitude will simply not do.

A lassez-faire approach to repro-tech won’t work to protect the interests of those hoping to use these technologies and to protect those lives that are created as a result. I agree that regulation should be very liberal and accommodating to a diverse set of interests, but complete de-regulation would be both dangerous and facile.

But establishing regulations and guidelines is one thing, enforcing it is quite another.

In some cases, this one included, it would be perfectly reasonable for the state to intervene and deny access, or at the very least compel clinics to follow a strict set of guidelines to prevent this sort of thing from happening. It’s time to empower groups like the ASRM—particularly now as new reproductive technologies are emerging quickly. This way, fertility clinics will be compelled to follow the rules and be held accountable for their actions.

It’s clear that this has to happen. Clinics won’t regulate themselves.

But why should we have expected them to? They’re not the ones who now have to raise these children. "

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See Also Article by the Reproductive Rights Prof Blog

Theresa M. Erickson, Esq.
Surrogacy Lawyer & Egg Donation Lawyer 
www.EricksonLaw.net

Subscribe to my blog at: http://www.surrogacyeggdonorblog.com/subscribe.html