THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, January 22, 1995 TAG: 9501200037
SECTION: COMMENTARY PAGE: J4 EDITION: FINAL
TYPE: Letter
LENGTH: Medium: 51 lines
The Jones Institute for Reproductive Medicine did not ``recommend'' to the Taylors (who had conceived quadruplets at our institution) that one or two of their babies be sacrificed to permit the others to go to term, as reported in your article (news, Jan. 10).
We go to great lengths to avoid the occurrence of triplets and quadruplets by limiting the number of embryos replaced in the uterus (in most cases, three or four, with freezing all the excess embryos available). With all methods of assisted reproduction, it is standard practice to transfer multiple embryos in order to increase the pregnancy rate for patients with a longstanding history of infertility.
Although there are no rules or guidelines in the United States regarding the maximum number of embryos to be transferred, we at the Jones Institute have long adopted voluntary guidelines that will limit the incidence of triplets and quadruplets to less than 1.5 percent. On only five occasions in the past 14 years have patients of ours had quadruplets (out of a total of 1,172 pregnancies and 1,474 babies).
Rather, we discussed the options available to them in their situation, which included (1) letting nature take its course and (2) having a fetal reduction.
While the latter choice is distasteful, repugnant and, for some, even unethical, it is not our place to hide this option from those who might choose it.
Apart from the significant risks to both mother and fetuses with a quadruplet pregnancy, the best available evidence suggests that more children will survive such pregnancies if one or two fetuses are reduced than if all are left alone. It would be unethical for us not to tell parents about this difference.
We are very happy for the Taylors that their dream for children has been realized four times over. We are gratified that all their children are doing well. We look forward to the whole Taylor family coming to our institute to show off their bundles of joy, as we do to all our patients.
SUHEIL J. MUASHER, M.D.
Director
Advanced Reproductive Technologies
The Jones Institute for Reproductive Medicine
Eastern Virginia Medical School
Norfolk, Jan. 11, 1995 by CNB