Sextuplets spotlight difficult choice for parents

updated 11:06 a.m. ET June 27, 2007

MINNEAPOLIS - After years of infertility treatments and three heartbreaking miscarriages, Molly Magnani stared at the black and white monitor as an ultrasound wand moved over her belly. She saw one fetus, then another. Then — wait — were there more?

You have four, her doctor said. Her 8-year-old son cheered. Her husband, David, turned white and was told to sit down.

“And I just was laying there thinking, ’What have I gotten myself into?”’ Magnani recalled. “You’re overjoyed and excited, but I remember being scared to death.”

For infertile couples who have longed to fill their homes with children, the sudden prospect of twins, triplets or more can be thrilling at first. But the risks of a multiple pregnancy means they may quickly face the agonizing decision of whether to abort some fetuses to give the others a better chance to live.

It’s an issue highlighted this month by the births of sets of sextuplets in Minnesota and Arizona. Four of the six babies born June 10 to a Minnesota mother have died, and the others are in critical condition. In Arizona, the mother was treated for acute heart failure after giving birth.

“I think that these instances give the whole question of fertility treatment a black eye because the results are so tragic, and the costs are so enormous,” said Dr. Theodore Nagel, a reproductive endocrinologist at the University of Minnesota.

Having a high number of fetuses can be prevented if the treatments are done carefully, he said.

Reducing fetuses
The random removal of fetuses is called multifetal reduction. More frequent is selective reduction, in which couples pinpoint fetuses to be removed — perhaps those with abnormalities.

The parents of the Minnesota sextuplets, Ryan and Brianna Morrison, used fertility drugs. Doctors encouraged them to consider removing some of the fetuses, but it was “not an option for us,” the couple wrote on their Web site.

“We understand that the risk is high, but we also understand that these little ones are much more than six fetuses. Each one of them is a miracle given to us by God,” they wrote before the births.

The Morrisons have declined to be interviewed.

msnbc.com special report Part 1: Have kids? Sure ... someday Readers debate best age for baby-making Part 2: Baby-making at a crossroads U.S. women going abroad for fertility help How far is too far? Readers weigh in Part 3: 2-for-1 is no baby bargain Media goes gaga for megamultiples   Video: Parents manage joyful abundance Readers weigh mixed blessings of multiples Part 4: Are men becoming obsolete? His biological clock is ticking, too Should kids be conceived after a parent dies?  Dads don't come from labs, readers say Part 5: Not giving up hope for biological baby Getting off the infertility-treatment treadmill Readers share their own 'baby quests' Full coverage   Discuss the series

Prematurity is the prime complication in multiple births, where underdeveloped babies are more likely to face serious problems like cerebral palsy, mental retardation and chronic lung disease. While just 7 percent of twins are born early, 92 percent of triplets are born prematurely, said Dr. Diane Ashton, deputy medical director of the March of Dimes. Quadruplets or higher-count births are always premature, she said.

The Morrison sextuplets were born about 4½ months early, and they ranged in size from just 11 ounces to a little more than a pound.

That gestation period is right on the edge of viability. Babies born at 21 weeks usually do not live, Ashton said; at 23 weeks, viability jumps to about 70 percent.

Nagel, who is not involved in the Morrison case, said it’s important to control infertility treatments. Skilled doctors manage the process to avoid the possibility of multiples. But sometimes, he said, fertility drugs are administered inappropriately by obstetricians, gynecologists and internists without special training.

Even when the drugs are properly managed, multiple-fetus pregnancies do happen.

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