Federal records show that the Beverly Hills doctor whose fertility treatment led to the birth of Nadya Suleman's octuplets -- and her six previous children -- has one of the worst success rates of any fertility clinic in the country, the LA Times reported.In fact, Suleman's children represent a sizable portion of the pregnancy rate at his clinic over the last several years, the Los Angeles Times reported.
The identity of the doctor who provided Suleman with the in vitro fertilizations became public Monday. In the NBC interview, Suleman did not identify her doctor by name, but said that she went to the West Coast IVF Clinic in Beverly Hills — where Dr. Michael M. Kamrava is director — and that all 14 of her children were conceived with help from the same doctor. In 2006, Los Angeles TV station KTLA ran a story on infertility that showed Kamrava treating Suleman and discussing embryo implantation.
Kamrava, 57, has presented himself in interviews and on his Web site as a medical pioneer who discovered a breakthrough in in vitro fertilization procedures, the Times reported. But according to federal records reviewed by The Times, of the 61
procedures he conducted in 2006 -- the most recent data available -- only five resulted in pregnancies and only two of those resulted in births, the newspaper reported. One of those births was Suleman's twins.
"These are the worst numbers I've ever seen. This is absurdly low," Dr. Mark Surrey, another fertility specialist in Beverly Hills, told the newspaper.
Kamrava attended medical school in Ohio. He would not comment on Suleman's octuplets, but told reporters outside his clinic on Rodeo Drive that he had granted an interview to one of the television networks. When asked to provide more detail, he said, "Watch the news."
Without identifying the doctor, the Medical Board of California said last week it was looking into the Suleman case to see if there was a "violation of the standard of care." The medical board said Monday it has not taken any disciplinary action against Kamrava in the past.
Kamrava graduated from the University of Illinois and went to medical school at Case Western Reserve University in Cleveland, according to state records and his Web site.
Some fertility specialists said Kamrava is a controversial figure in the field.
"He's tried some novel techniques and some of those methods have been controversial," said Dr. John Jain, founder of Santa Monica Fertility Specialists.
Jain criticized the decision to implant so many embryos, saying: "I do think that this doctor really stepped outside the guidelines in a very extreme manner, and as such, put both the mother and children at extra high risk of disability and even death."
Dr. Jeffrey Steinberg, a professional acquaintance of Kamrava's, said Kamrava worked to develop an embryo transfer device that allows doctors to implant an embryo — or sometimes sperm with an unfertilized egg — directly into the uterine lining.
"Usually we inject the embryos into the uterus and they float around and attach themselves," Steinberg said. However, Steinberg said there was no evidence the method improved success rates for pregnancy.
It was not immediately known if the technique was used on Suleman.
Suleman said she had six embryos implanted for each of her pregnancies. The octuplets were a surprise result of her last set of six embryos, she said, explaining she had expected twins at most. Two of the embryos evidently divided in the womb.
Medical ethicists have criticized the implanting of so many embryos. National guidelines put the norm at two to three embryos for a woman of Suleman's age, except in extraordinary circumstances.
Kamrava's clinic performed 20 in vitro procedures on women under 35 in 2006, according to the most recent national report compiled by the Centers for Disease Control and Prevention. Of those 20 procedures, four resulted in pregnancies and two in births. One woman delivered twins.
The average number of embryos he transferred per procedure for women under 35 was 3.5, the report said. Fertility doctors often implant more than one embryo to increase the chances that one will take hold.
An in-vitro procedure typically costs between $8,000 and $15,000. Asked on NBC how she was able to afford the treatments, Suleman said she had saved money and used some of the more than $165,000 in disability payments she received after being injured in a 1999 riot at a state mental hospital where she worked.
She also told NBC that she does not intend to go on welfare, though her publicist confirmed Monday that Suleman already receives food stamps and child disability payments to help feed and care for her six other children.
Suleman's publicist Mike Furtney said she receives $490 a month in food stamps. Three of Suleman's previous children are disabled, Furtney said, but Suleman did not want to disclose the nature of the disabilities, or the type or sum of the payments.
"In her view these are just payments made for people with legitimate needs and are not, in her view, welfare," Furtney said. "She just believes that there are programs for people with needs and she and her children qualify for some of them."
Dr. Richard Paulson, who heads the fertility program at the University of Southern California, cautioned against rushing to judgment about the fertility treatment in this case because questions remain about the quality of Suleman's eggs and whether there were any extraordinary circumstances that would lead Kamrava to transfer so many embryos.
As for the technique Kamrava pioneered, "those of us who are the scientists in the field do not feel this is a significant improvement," Paulson said. He said some doctors advertise that technique as "a way of making patients feel that they are trying something new."
Suleman, who is 33 and single, told NBC's "Today" show she was "fixated" on having children. Suleman said her doctor "did nothing wrong" and had warned her of possible complications to the pregnancy and risks to the development of the babies.
The octuplets were born nine weeks prematurely but appear relatively healthy. Their names have a Biblical theme: Noah, Jonah, Jeremiah, Josiah, Isaiah, Maliyah, Makai and Nariyah. All share the middle name Angel and the last name Solomon.
On Sunday, Suleman's mother, Angela Suleman, seemed to contradict her daughter's account, telling a Web site the fertility specialist who helped her daughter give birth to the octuplets was not the one who aided in the birth of her first six children.
In an interview with celebrity news Web site RadarOnline.com, Angela Suleman said she and Nadya's father pleaded with her first fertility doctor not to treat their daughter again. She said her daughter went to another doctor.
"I'm really angry about that," Angela Suleman said of the doctor's decision to perform the procedure. "She already has six beautiful children. Why would she do this? I'm struggling to look after her six. We had to put in bunk beds, feed them in shifts and there's children's clothing piled all over the house."
Angela Suleman said Nadya's boyfriend was the biological father of all 14 children, but that she refused to marry him.
"He was in love with her and wanted to marry her," she said. "But Nadya wanted to have children on her own."