DR ALEXANDER'S BLOG,
CALIFORNIA OCTUPLETS

My goal as a fertility specialist is to help our patients have a full term healthy singleton baby. In the midst of attempting to accomplish this goal, we are faced with many decisions that play a big role in how many eggs will be obtained and ultimately how many embryos will potentially develop. Some patients may take a very low dose of ovulation induction medication and yet make an overwhelmingly high number of eggs, while others require tremendous dose and barely make a few eggs. Hence, we call infertility therapy, "an art." The beauty of helping patients get pregnant is truly breathtaking in my eyes.

In the wake of the news of the California octuplets, my practice has been flooded with phone calls. I belong to the American Society for Reproductive Medicine (ASRM) and their statement best describes the standard of care for treating fertility patients and implanting embryos. My clinical practice follows these guidelines because they've been proven to work. The pioneers of IVF in the Unites States, Drs. Georgeanna and Howard Jones first performed IVF in the Unites States using the natural cycle with one embryo and the first IVF baby was born on December 28, 1981. ASRM first reported guidelines for embryo transfers in 1996. These guidelines are very helpful when discussing how many embryos to place back into the uterus after IVF with the ever present goal of a single pregnancy not multiple pregnancies. It's important to know that embryos may secrete different molecules, including nitric oxide, that help each of the other embryos stick. As we increase the number of embryos we place back in the uterus, we also increase the chances of higher order multiple pregnancies. Unfortunately, that's the reality we face when helping patients conceive but we try to limit risk of multiples, especially higher order multiples or "supertwins."

What are your hopes for a pregnancy? Singleton, twins… more? I'd like to hear your thoughts so add your comments below and if there's something on your mind be sure to submit a question. An open dialogue with a qualified medical professional is an important part of your fertility journey and will help give you your best chance to conceive.

Dr. Carolyn Alexander, MD