Suleman octuplets

The Suleman octuplets are six male and two female children conceived via in vitro fertilization (IVF) and subsequently born to Nadya Suleman on January 26, 2009, in Bellflower, California. They currently reside in La Habra, California. They are only the second full set of octuplets to be born alive in the United States and, having survived more than a week, surpassed the previous worldwide survival-rate for a complete set of octuplets set by the Chukwu octuplets of 1998. The extremely controversial circumstances of their high order multiple birth has led to debate in the field of assisted reproductive technology as well as an investigation by the Medical Board of California of the fertility specialist involved, regarding the transfer of twelve embryos at once.^[1]

Background

Conception

Suleman's octuplets were conceived by in-vitro fertilization (IVF), conducted by Dr. Michael Kamrava. Suleman claimed to have requested implantation of six embryos that she had accumulated from previous IVF treatments, despite being informed that the recommended guideline limit for a woman her age was three.^[1] She stated she wanted all six transferred, as they were all that remained from previous harvest cycles, and she neither wanted to destroy them nor continue paying for their frozen storage.^[2] A subsequent Medical Board of California investigation revealed that 29 embryos remained in frozen storage, nevertheless, Suleman underwent a fresh embryo transfer cycle, and Dr. Kamrava transferred twelve fresh blastocysts into Ms. Suleman at her request.^[3] The mother's health and gestational status were followed from her first trimester.

Birth

The delivery, via a scheduled Caesarean section, involved 46 medical personnel, and was practiced twice beforehand at the Kaiser Permanente hospital in Bellflower, California. Suleman carried the babies to 31 weeks. Doctors anticipated seven babies, so the eighth came as a surprise.^[4] Born over the course of five minutes, all eight babies were immediately reported in stable condition, though two required intubation and a ventilator, and another required extra oxygen.^[5]

Names

The babies' names are Noah, Maliyah, Isaiah, Nariyah, Jonah, Makai, Josiah, and Jeremiah. Suleman has stated that she chose biblical names and gave all eight the middle name Angel, and that their surname would be Solomon, after the biological father.^[6][7][8]

The following data from Kaiser Permanente indicates their birth order, birth time, weight, and given name at the time of discharge:^[5]

Baby C (Isaiah) was the largest of the children at 3 lbs, 4 oz, and Baby E(Jonah)was the smallest. Baby H (Jeremiah) had been "hiding from the ultrasound".^[5]

Post delivery

Two days after birth, five of the eight infants received their first tube-feeding of donated breast milk. Josiah rejected his first tube-feeding and was returned to intravenous feeding, as his stomach was unable to absorb breast milk. At that time, three of the other infants had been fed intravenously since birth, and had yet to receive their first tube-feeding.^[9][10][11]

Six days after birth, all eight babies were breathing without assistance, and were being fed donated breast milk, as well as intravenous nutritional supplements. A hospital spokesman said the octuplets were expected to remain in the hospital for several more weeks.^[12]

One week after birth, the Suleman octuplets became the longest-living octuplets in United States history, as the smallest of the Chukwu octuplets born in Houston in 1998 died seven days after birth.^[13][14] Suleman set the Guinness World Record for Most Children Delivered At Birth To Survive.^[15]

Ten days after the birth of her octuplets, Suleman was released from the hospital. In her February 5, 2009, interview, Suleman stated that she holds each of the octuplets for 45 minutes a day, holding the smallest, a son named Jonah (born at 1 lb., 8 oz.) the longest.^[16][17]

The hospital where the octuplets were expected to spend seven to twelve weeks requested significant reimbursement from Medi-Cal, the state's Medicaid program, for care of the eight premature babies.^[18]

Family

Paternity claims

Suleman's mother stated that a single sperm donor named David Suleman^[19] was used to produce the octuplets as well as her daughter's previous six children.^[20][21] Suleman stated that she dated David once, but realized after that she only wanted him to father her children and not pursue any relationship with him.^[22] The octuplets' grandfather and others have accused Suleman of making up a fictitious David Solomon as she had used the name for the father on birth certificates of her other children, but with a different birth date.^[23][24][25]

On the February 23, 2009, edition of ABC's Good Morning America, a man named Denis Beaudoin claimed to be the biological father of Suleman's children. He said they had dated from 1997 to 1999 and that Suleman asked him if he would donate the sperm. Beaudoin requested a paternity test to verify his claim. Suleman denied that he was the donor.^[26][27][28]

Suleman's ex-husband, Marcos Gutierrez, who divorced Suleman in 2006, also denied being the biological father.^[29]

Grandparents

The octuplets' maternal grandfather, 67-year-old Edward Doud Suleman, identifying himself as a former Iraqi military man, said he would be returning to his native Iraq as a translator and driver, in order to financially support his daughter and her fourteen children.^[30][31][32] Their grandmother, 69-year-old Angela Victoria Suleman, a retired teacher, has helped to look after the first six children. She has indicated that she is overwhelmed looking after them, and has been critical of her daughter in her public statements in 2009. For example, she said that her daughter does not contribute toward housing or food costs.^{[33][34][35][36][37]}

Reception

News of the octuplets caused an international media sensation.^[38] Most public response has been negative, including some death threats, which police are investigating.^[39] Suleman has even gone into hiding.^[40]

There has been much public discussion about Nadya Suleman's decision to implant and give birth to octuplets,^[41][42] including a minor protest outside the Suleman home, though Nadya Suleman was living elsewhere.^[43] Many expressed concern that Suleman's decision for more children, despite being unemployed and unmarried, would burden taxpayers via public support.^[44]

State Senator Gloria Negrete McLeod introduced legislation to have fertility clinics placed under the jurisdiction of the Medical Board of California.^[45] The implantation of twelve embryos in a woman under 35 years of age who already had children raised many controversies and led to calls for legislation to limit the number of simultaneous embryo transfers.

Dr. Kamrava Investigation

The Medical Board of California announced on February 6, 2009, that it was investigating Dr. Kamrava, the physician who transferred the embryos, in an attempt to substantiate if there was a violation of the standard of care. The American Society for Reproductive Medicine expressed interest in assisting the Board in its investigation.^[46][47][48] Kamrava had also provided fertility treatment to a 49-year-old woman who was uninsured, 5 months pregnant with quadruplets, and hospitalized at Los Angeles County-USC Medical Center, where at least seven embryos were used.^[48][49] In October 2009, the American Society for Reproductive Medicine announced that it had expelled Dr. Michael Kamrava.^[50]

In January 2010, charges were filed with the California Medical Board in direct relation to the conception of the octuplets. The complaint also stated that he exercised gross negligence and acted "beyond the reasonable judgment" of any physician and used a number of embryos that "far exceeded" existing guidelines.^[51][52]

On June 1, 2011, the California Board announced that Dr. Kamrava's license would be revoked effective July 1.^[3][53] The charges also include the assertion that fresh, and non frozen, embryos were used each time.^[51][54]

On May 8, 2013, the State Medical Board of Ohio denied Kamrava restoration of his medical license after he filed an appeal to practice there as it was the state where he was educated.^[55]

See also

• Chukwu octuplets, born in 1998 in Texas
• McCaughey septuplets, the first set of septuplets to survive infancy
• Dionne quintuplets, the only female identical quintuplets ever recorded
• List of multiple births
• Natalism
• Quiverfull

References