The Octodoc

The more I hear about Dr. Michael Kamrava, who practices some facsimile of reproductive medicine in California, the more outraged I become.

From what I've been reading, I am already convinced that he should probably be considered for malpractice based on the Nadya Suleman case because of a departure from standard medical practice. Consider that the American Society for Reproductive Medicine suggests one or two embryo transfers maximum for a woman of Nadya's age (33), and she received six embryos. Consider that in vitro fertilization, a billion dollar industry which has doubled in terms of procedures to 135,000 with 50,000 live births over the past decade, has also been policed increasingly by the ASRM and that multiple births (triplets or more) have decreased from 7 percent to 2 percent over this period of time. We don't have proper laws in the U.S. to police medical criminals like Octodoc, but we do have standards of care.

A malpractice claim is unlikely though, because the patient, Nadya Suleman, doesn't seem inclined to bring a suit. But even if she signed a consent for the embryo transfer, it also seems likely that she is suffering from a psychiatric disorder and was not correctly informed about the risks. Does Nadya know that the risk of postpartum depression in a normal woman, even without her social and financial difficulties, is close to 25 percent?

I was getting ready to blog about the need for the state of California to go after Octodoc's license on ethical grounds (each state has a medical ethics committee which governs licensure), when I heard about the second case. A 49-year-old woman was apparently impregnated by seven donor eggs (from a woman in her twenties which increases their chance of being viable substantially). She is now carrying quadruplets.

The ASRM suggests no more than five embryos for a woman in her 40s, and if you add to that the fact that the woman herself reportedly only wanted one child, and at her age is at risk for medical complications including high blood pressure and stroke, the handling of her case appears to be another abomination.

Octodoc's low success rate at successful births is no excuse for tawdry practices. I'm glad to hear that ASRM is investigating him. The state of California should stop him in his tracks.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of "False Alarm: The Truth About the Epidemic of Fear"and "Bird Flu: Everything You Need to Know About the Next Pandemic." Read more at www.doctorsiegel.com