Nadya Suleman's fertility doctor flouted national standards by implanting her with a dozen embryos in the pregnancy that resulted in octuplets, according to testimony at a licensing hearing.
The number of embryos was far in excess of the two recommended for women her age, Deputy Attorney General Judith Alvarado said Monday.
National guidelines issued by the American Society for Reproductive Medicine specify no more than two embryos are to be used in in vitro treatments for a healthy woman under 35. Suleman was 33 at the time of her last treatment.
Dr. Michael Kamrava's action endangered the mother, her babies and violated national standards of care, Alvarado said at the first day of the Medical Board of California's hearing to consider revoking or suspending the Beverly Hills physician's license.
Kamrava "knew that a 12-embryo transfer was unsafe," Alvarado said in her opening statement.
Year after year, Suleman was implanted with too many embryos in her unabated attempts to become pregnant, said Alvarado. For the pregnancies prior to her octuplets, she was implanted with between four and seven embryos.
Since the octuplets were born in Jan. 2009, Suleman has repeatedly said she was implanted with six embryos for each of her six pregnancies, and two of them split when she had octuplets.
The 35-year-old, divorced, single-mother of 14 has also claimed that she only underwent in vitro because she did not want to lay waste to frozen embryos, but testimony Monday alleged that fresh embryos were used in every treatment and she still has 29 frozen embryos.
High-order multiple births can result in long-term developmental delays, cerebral palsy and various life-threatening ailments.
There are no hard-and-fast rules, but fertility specialists have criticized Kamrava's methods, saying he endangered Suleman's health and the long-term health of the babies. Suleman's babies, born nine weeks premature in January 2009, are the world's longest-surviving set of octuplets.
The board has set aside two weeks for the hearing to determine whether Kamrava was negligent. Testimony is expected to continue Tuesday, with cross examination of Dr. Victor Y. Fujimoto, the medical board's expert witness.
On Monday, Fujimoto testified that he couldn't imagine any colleague transferring a dozen embryos, and that Kamrava repeatedly made "extreme departures from the standard of care" by failing to recommend Suleman for a mental health evaluation and implanting a high number of embryos.
Records obtained by The Associated Press show that before 2001, Suleman was treated with Celexa and Sonata for depression and sleeplessness, and Clonopin for anxiety.
The board's accusation says Kamrava was also negligent in his treatment of two other patients.
© 2010 The Associated Press.