How Many Babies Is Too Many?

Opinion CategoryLike many of you, I have watched as the world has been captivated by the birth of the octuplets to Nadya Suleman. To say that this case has opened heated debates on the ethical and psychological issues related to in vitro fertilization (IVF) would be a gross understatement. What makes this case especially newsworthy is the fact that Ms. Suleman not only has a total of 14 children, all with the help of IVF, but is also single and unemployed.

This is not the first octuplet birth to rock the medical community worldwide. In London 12 years ago the The Lancet produced an editorial on the story of Mandy Allwood. That case was also interesting for its many ethical questions: Ms. Allwood was secretly taking fertility drugs without medical supervision or informing her significant other. In the early stages of the pregnancy, doctors also recommended that she reduce the number to twins in order to ensure safe delivery and development, advice which she refused. Accusations that decisions were made based on financial incentives were compounded by statements made by her public relations consultant Max Clifford. He implied that the more children who were born, the more money there was to be made. Tragically, all eight of the babies died within an hour of birth at 22 weeks.

Exactly how many children can a woman carry safely to term and are there any limits imposed on fertility doctors?

DucklingsRecommendations have been made by the American Society for Reproduction Medicine that a maximum of two embryos should be placed in a female. However, there are those who would argue that fertilized embryos are already a life, that selective termination of some fetuses to increase survival of the others should not be done and that all embryos should be implanted and given the opportunity to become a full term pregnancy. Last year, Evans and Britt presented a review that showed fetal reduction in cases of multi-fetal pregnancies improved the overall outcome. Despite these results, it is understandably a difficult decision for many to make. IVF parents are especially reluctant and feel a special attachment part partly because of their previous difficulties conceiving.

One of the major issues that has arisen out of the Suleman octuplet story is that the fertility doctor should not have made the choice to implant this many embryos. Also, there is the question of what if any, psychological screening was conducted on Ms. Suleman before proceeding with the procedure.

What are your thoughts on this issue? Should restrictions be placed on the practices of IVF? How far away are we from so-called “designer” babies, selecting not only gender but other desirable characteristics as well? Should there be stricter psychological testing for women and couples undergoing IVF and why should the process be different for women who have children naturally?


M DEAN (1996). British octuplet pregnancy upsets the medical applecart The Lancet, 348 (9027), 605-605 DOI: 10.1016/S0140-6736(05)64810-6

American Society for Reproduction Medicine

MI Evans, DW Britt (2008). Fetal reduction 2008. Current Opinion in Obstetrics and Gynecology. 2008 Aug;20(4):386-93.

  • Dick

    Her 14 children will reproduce to eventually become an additional 2.1 million people, on an already overcrowded planet, a thousand years from now, assuming normal natality.

    If just one messed up woman can have that much impact on future world population, we REALLY need to think more about the expanding human population and what it means for the future.

  • The question should be “Should a unemployed, single woman with children be given the right to have IVF treatment at all?” . I thought there was a screening process for IVF?

    That doctor should be placed under serious investigation. He’s obviously going to cash in on this in some way.

  • See related legal blog article on the California Octoplets by California State Bar Certified Family Law Specialist, attorney Marshall Waller at .

  • Before doing such procedure we should have some process and investigation to ensure that the result will have a great thing in the future.

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  • RCarlson

    Unless the recipient can prove their ability to support the children, IVF requests should not be accommodated. I should not be required to support those children and ultimately, that is what I/we are doing. I’m very curious who paid for those invitro treatments.

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  • Alena

    I agree with RCarlson! If you do not have the means to support a child, IVF should not be an option especially in this case. This woman already had children that apparently she couldn’t support financially. What I don’t understand is where did she get the money for the IVF? Why didn’t she use that money to take care of the kids she already had???

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  • Frank

    And to think our tax dollars were used to pay for this carzy persons multiple implants, not to mention the costs of $100,000 per child per day while in the hospital, and than include her food stamps and welfare! The world is already grossly owercrowded and the doctor knew full well that she did not have the ability to care for the previous six children she already had. To make matters worse, she did it for the most selfish of reasons as disclosed in an interview when she said that she has children, “to fill a void in MY life.”
    What is wrong with a society that encourages such irresponsible behavior via taxpayer assistance?
    Now she has a web site asking for donations because she is unable to pay the mortgage on her new “Hummer Home”.

  • Its not just supporting the kids and giving them good education, one would have to think about the future of the planet..At this rate we would have to look out for living space in the outer planets…

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  • already grossly owercrowded and the doctor knew full well that she did not have the ability to care for the previous six children she already had. To make matters worse, she did it for the most selfish of reasons as disclosed in an interview when she said that she

Maria Goddard, MD

Maria Goddard, MD, is a medical doctor who has worked in medical research and clinical practice for several years. Her interests include traditional and alternative medicine as well as the sociological implications of certain diseases in particular populations.

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