'Octomum' doctor could still be struck off

'Octomum' fertility doctor, Dr Michael Kamrava, could still be struck off despite a judge's recommendation to the contrary, according to a decision made by the Medical Board of California, the state's medical licensing body.

The board refused to exclude revoking Dr Kamrava's medical licence as a possible sanction, rejecting recommendations made last month that he should instead be placed on probation. A licensing panel is now expected to deliberate later this year on the Beverly Hills fertility doctor's fate.

At a previous hearing, Administrative Law Judge Daniel Juarez did not find 'an absence of qualification, ability or fitness'. He noted that Dr Kamrava successfully defended the majority of the allegations and was unlikely to repeat his mistakes given the intense public scrutiny, not withstanding 'inconsistency' in his testimony about his willingness to adhere to fertility guidelines in future. But the medical board disagreed that 'the public would be adequately protected' by a five-year supervised probation, including an ethics course.

Dr Kamrava had testified that when providing IVF to Ms Nadya Suleman he was 'apprehensive' but had transferred 12 embryos at her fully informed insistence, resulting in octuplets born nine-weeks premature. Previously he maintained he did nothing improper but admitted in the hearing that he had made a mistake.

Defence attorney Henry Fenton argued that Dr Kamrava simply followed his patient's informed wishes to establish a large family. 'The guidelines don't say people can only have one or two babies... that's her prerogative', he said. 'It's not the doctor that's going to decide how many children this lady is going to have'.

But State Deputy Attorney General Judith Alvarado rebutted that Dr Kamrava knew 'that a 12-embryo transfer was unsafe and below the standard of care' and acted like a 'cowboy'.

Judge Juarez found Dr Kamrava to be grossly negligent in transferring an excessive number of embryos to Ms Suleman and negligence in two other cases. One case involved a 48-year-old who suffered complications after a seven-embryo transfer led to a pregnancy with quadruplets and the six-week premature birth of triplets, one of whom has severe developmental delays.

The American Society for Reproductive Medicine (ASRM) recommends that women aged 35 or younger should receive no more than two embryos during one cycle of IVF and up to five embryos for women over 40. It expelled Dr Michael Kamrava in 2009 during the 'octomum' controversy, but does not have the authority to review medical licences. US guidelines are not legally binding but dictate good medical practice and reflect expert consensus on treatment standards and medical knowledge.

A panel of the Medical Board of California is next scheduled to meet in May when it is expected to consider the case further.