Comments on: Were the octuplets a result of IVF?

By: IVF-MD

IVF-MD — Mon, 02 Feb 2009 22:57:20 +0000

Thank you for the kind words. The math is a simple binomial distribution. The model is a simplified representation of the reality, for several reasons. I have a blog post that I’ll finish some day on this. One of the most obvious reasons that this model is less than perfect is that when you transfer 3 embryos, not all three have the exact same odds of implanting. You might have an 8-cell embryo with no fragmentation and then two 5-cell embryos with moderate fragmentation. This will mean that each embryo has different odds of success. The main imperfection of this whole model is that we don’t really know the exact % chance of success per embryo. We can only estimate it based on patient’s age, patient’s past history, stage of embryo, degree of fragmentation and cell number. One other flaw in the model is that the chances of each embryo implanting are not truly independent. For example, in the unfortunate event that you have a traumatic transfer, you will end up hurting the chances of ALL the embryos. If you have a perfect “10-point landing” transfer, then you boost the odds of all the embryos, leading to a skew towards the more extreme outcomes of no implantation or all implanting. I use these calculations sometimes when counseling patients, but I have never seen it published. I came up with it myself, based on my love of math and probability theory.

By: fujinkai

fujinkai — Mon, 02 Feb 2009 20:31:45 +0000

Dr. Lee,

I really liked your clear explanation of the chance of singleton or multiple pregnancy. I also liked how statistically it looked like it was being modeled after a Fibnocci sequence. Is there anything published on using this as a counseling method on chance of a multiple pregnancy?

By: IVF-MD

IVF-MD — Sat, 31 Jan 2009 17:18:50 +0000

You are so right.

Here are some additional thoughts. If she were an egg donor, she could have done a shared-cycle arrangement where she was paid to donate AND was given control over some of the embryos for her own use. This is unlikely, because it’s usually one or the other. We can’t really rule out the fact that some of the statements from the mother or from her family are inaccurate.

Embryos are frozen as singles or pairs. If for some crazy reason, hers were frozen all together as eight, there is still the option of thawing them, transferring two or three and then refreezing the rest. Not optimal, but possible.

It’s really a mystery how this came about, but I am not so sure that this was a foreign IVF program. As we find out more, we can comment further on what sanctions might be taken.

By: MLO

MLO — Sat, 31 Jan 2009 17:05:06 +0000

This story is getting more and more bizarre:

http://news.yahoo.com/s/ap/20090131/ap_on_re_us/octuplets

Now, I know, and participated in a study where participated in a study where drug costs were defrayed. I have never heard of someone in the USA getting paid to have their own IVF cycle.

Also, traditionally, aren’t embryos frozen in “packs of two”? If this really was an FET, why on earth would they thaw eight? I don’t think there is any clinic that has an unreasonable storage fee considering the actual technology and energy costs involved.

I am also not convinced that this was done in an American clinic. Though, the bizarreness of this story is making me wonder if it was a less than legitimate clinic that was involved (not a SART member or close to being fined or even closed by the CDC.)

By: Jayne

Jayne — Sat, 31 Jan 2009 03:17:37 +0000

Just watched your clip on KCAL 9. Thanks for sharing!

By: IVF-MD

IVF-MD — Sat, 31 Jan 2009 00:50:37 +0000

Yes, possible, but by rough estimate less than 1 in a billion chance.

By: Syn

Syn — Fri, 30 Jan 2009 23:58:27 +0000

Is it possible that four were placed and all four split?