The dangers of multiple births

Triplets are passe now, thanks to the growing use of IVF; but big multiple births are still regarded unofficially as unquestionably "good news" stories.

The carefully controlled news release this morning of images and interviews at Oxford's John Radcliffe Hospital suggested a win-win situation.

There would be no burden to the NHS, as Russian philanthropists footed the six figure bill, and it would be a great bit of publicity for British medical care; the five babies are alive and doing "better than expected"- already defying the 80 per cent survival rate of babies born at 26 weeks.

But there are plenty of ethical questions to ask. The babies' 29-year-old Russian mother had taken a powerful ovarian stimulant in what even her consultant admitted was "an unsupervised environment". No IVF involved.

One paediatrician suggested the drug might even be illegal in Britain. We've come a long way from the sad case of a British mother, Mandy Allwood, who conceived eight embryos back in 1996 in a similar way and "sold" the story about how she was going to have them all to a tabloid paper.

She lost all her babies. British fertility regulation is pretty tough now. Such multiple pregrancies are rare.

The rules for IVF now restrict the number of embryos to just one or two - not the three that significantly increased triplet births and the consequent risks.

But with more desperate British couples heading abroad for ethically questionable fertility treatments currently unavailable here, could we start to see British women coming back to the NHS to deal with the difficulties of multiple gestation?

Both the paediatrician and the consultant who treated the Russian quins and their mother described the case as "exciting". From their point of view a new frontier has been secured, with improved survival rates for difficult pregnancies and births.

But beyond survival, the cost to the children and their family is more complex: powerful drugs and even surgery to articifically arrest the mother's premature labour; steroids to forcibly develop the babies' lungs; babies separated in intensive care units 50 miles apart in Oxford and London; the significant possibility of handicap - which may not be known for some time.

Another comparable case is that of the Iowa family, the McCaugheys. In 1997 Bobbi McCaughey, like the Russian mother, had ovarian stimulating treatment and then conceived seven embryos.

She also said she wouldn't consider a selective termination for "religious" reasons - although God's view on her decision to take powerful fertility drugs is not known.

After a complex pregnancy with massive medical intervention, all seven babies survived, but there were significant health problems.

Two have cerebral palsy. Of course many naturally conceived babies are born prematurely or with handicaps.

The question isn't whether the NHS should help such families but whether, when we get pictures of five little babies and their delighted, grateful parents, we are in danger of ignoring the man-made dangers and pain that, all too often, go with pushing the frontiers of fertility.

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