"MONTEBELLO, Calif. — Pictures of children, his trophies, decorate Dr. Tien C. Chiu’s office.
"Three smiling siblings, he says, were the first Japanese-American triplets conceived in a laboratory, while the robust-looking quadruplets were born after sperm was injected into their mother’s eggs with a needle."To the couples who turned to Dr. Chiu to have families, the babies were special gifts. To the government and fertility industry, though, such large multiple births have begun to look like breakdowns in the system. The issue has taken on renewed scrutiny since a California woman, Nadya Suleman, who already had six children conceived through in vitro procedures, gave birth to octuplets near here last month.
"Nearly a third of in vitro births involve twins or more. The government, along with professional associations, have been pushing fertility doctors to reduce that number, citing the disastrous health consequences that sometimes come with multiple births — infant mortality, low birth weights, long-term disabilities and thousands of dollars’ worth of medical care.
"The American Society for Reproductive Medicine, the association of fertility doctors, even adopted guidelines in 2008 encouraging the transfer of only one embryo for women under 35, and no more than two, except in extraordinary circumstances. The guidelines allow more for older women, up to a maximum of five.
"But unlike some other countries, the United States has no laws to enforce those guidelines. The Centers for Disease Control and Prevention has a surveillance system that collects data on fertility clinics, but reporting is voluntary and there are no government sanctions for not reporting."
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