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In 2007, Kamrava's clinic transferred an average of 4.1 embryos per treatment to women under 35 — higher than the national average of 2.2 embryos for the same age group.
An administrative law judge recommended that the Beverly Hills fertility doctor who treated "Octomom" Nadya Suleman be placed on five years probation by the state medical board, according to papers released Monday.
"The public would be adequately protected by a period of probation that includes, among other things, terms and conditions requiring (Kamrava) to complete an ethics course," Juarez wrote. "It does not appear likely that (Kamrava) will repeat acts like transferring an excessive number of embryos as he did in the cases of (Suleman and another patient), especially given the national publicity surrounding (Suleman's) case.
"However, during his testimony, (Kamrava) asserted he might still deviate from the ASRM (American Society for Reproductive Medicine) guidelines, after initially asserting that he would strictly adhere to them," Juarez wrote. "This inconsistency warrants oversight of (Kamrava's) practice to ensure he properly assesses individual patients and uses good judgment in practice."
Under the recommendation, Kamrava could still lose his license if he violates any of the terms of probation suggested by Juarez.
The Medical Board of California is expected to review Juarez's recommendation Thursday, when it meets in Burlingame.
During a hearing last fall, Deputy Attorney General Judith Alvarado said Kamrava acted like "a cowboy" by disregarding established guidelines in his treatment of Suleman.
"He admitted ... he knew it was a mistake," Alvarado said, adding that a defense argument that doctors can deviate from standards "is ridiculous."
Kamrava's medical license "needs to be revoked," she said.
But in his summation, defense attorney Henry Fenton said Kamrava was merely following the wishes of his patient, who had told him she wanted a large family.
"The guidelines don't say people can only have one or two babies ... that's her prerogative," Fenton said. "It's not the doctor that's going to decide how many children this lady is going to have."
Fenton said Kamrava initially set out to help a patient who was having trouble getting pregnant.
Suleman had "bad, bad ovaries ... and couldn't get pregnant," the lawyer said.
He said it did not appear that Suleman required psychological counseling.
"This was like a perfect storm that happened to Dr. Kamrava," Fenton said.
Kamrava treated Suleman beginning in 1997, leading to the birth of all 14 of her children, including her famed octuplets, who were born Jan. 26, 2009.