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November 11, 1995Egg Thefts During Exams Alleged
Records and interviews show that eggs were stolen during routine procedures at the UCI fertility clinic.This story was reported by Register staff writers Susan Kelleher, David Parrish, Michelle Nicolosi, Ernie Slone and Kim Christensen. It was written by Christensen.
At least nine women who were anesthetized for what they
believed were routine surgeries to diagnose reproductive problems
instead had their eggs stolen at the world-famous UCI fertility
clinics, records and interviews show. The stolen eggs were implanted in other women and resulted in
at least three births, making the donors mothers without their
knowledge. These new incidents are strikingly different from previous
allegations that have engulfed the fertility clinic at the
University of California, Irvine, raising the 6-month-old scandal
to new levels. Previously revealed cases involved illicit transfers from
women who knew their eggs were being harvested for reproductive
purposes. These most recent cases involve the theft of eggs from
women who believed they were merely undergoing routine examinations. Prior to the surgical examinations, known as laparoscopies,
records show the women were given fertility drugs to stimulate egg
production, drugs so powerful and potentially harmful that medical
experts said they should not have been used under those
circumstances. UCI doctors told patients that their eggs could only be used
for testing, not to help them achieve pregnancy. "It is completely and utterly unjustifiable," said Dr. Arthur
Caplan, director of biomedical ethics at the University of
Pennsylvania. "It's like picking someone's pocket, except that it's much
worse because you're stealing their reproductive material while
they're present for the crime." Dr. Ricardo H. Asch and his partner, Jose P. Balmaceda, have
denied wrongdoing. UCI officials say they have no direct knowledge of the thefts,
but stepped up efforts to contact patients after The Orange County
Register reported last Saturday that at least 60 women -- nearly
double the number the university had acknowledged -- were involved
in illicit egg transfers. The nine laparoscopy patients are among
those 60. "If this is true it would appear to fit the pattern of unethical
conduct by the doctors," Chancellor Laurel L. Wilkening said Friday. Interviews and records show that the nine alleged egg thefts
occurred during diagnostic laparoscopies -- surgical procedures in
which a tiny optical instrument is inserted into the abdomen to
examine reproductive organs for conditions that might cause
infertility. The nine women were on a handwritten list of 26 names under
the heading "laparoscopy." Three others said they gave consent. The
Register was unable to reach the remaining 14 women on the list,
which a former clinic biologist said she prepared in 1994 at the
doctors' request. At least two of the nine women who appear to have had eggs
stolen said they did not know that any eggs had been harvested
during the operations until they were shown records by the Register. Others did know, but said they were told by doctors that their
eggs were removed only to be examined or tested in an effort to
solve their infertility problems. "I never consented to give eggs to anyone -- ever," said
Pamella Kaoud, 42, who resides in the Riverside County community of
Nuevo. In January 1989, Kaoud was a patient at the UCI clinic at
AMI/Garden Grove Medical Center. She said she knew that Balmaceda
harvested eggs during her laparoscopy, but believed they would be
used only in "scientific tests" to determine why she wasn't getting
pregnant. However, records show that a total of nine eggs -- including
some taken from Kaoud during her laparoscopy and others from a
second patient -- were implanted in a third woman. Records indicate
no pregnancy resulted. Kaoud and her husband were trying desperately to have a child
at the time and would never have agreed to donate eggs to someone
else, she said. Instead, she said, they ordered the destruction of all eggs
not used for her medical diagnosis. "I would consider it a sin to give a baby away to somebody
else," said Kaoud, has two children from a previous marriage and
two from her current one. The UCI clinic closed in June amid state and federal criminal
investigations of egg theft, research misconduct, mail fraud and
tax evasion. A second clinic, directed by Balmaceda at Saddleback Memorial
Hospital Medical Center, also has closed. Asch's lawyer, Ronald G. Brower, did not return phone calls
Friday. Patrick Moore, who represents Balamaceda, said he would be
unable to fully investigate the allegations because patient records
have been seized by authorities. Dr. Sergio Stone, who joined Asch and Balmaceda's partnership
when the clinic moved from Garden Grove to the grounds of the UCI
Medical Center in Orange in 1990, also has denied wrongdoing. His lawyer, Karen L. Taillon, declined comment Friday but has
said in previous interviews that Stone's practice did not include
egg transfers. Both Asch and Balmaceda have sold their Orange County homes and
left the country in late summer. Asch, a native of Argentina, has
been on a lecture tour in Europe and reportedly opened a practice
in Mexico. Balmaceda has returned to his native Chile to be with
his family, his lawyer has said. In their absence, the scandal has grown dramatically from the
two cases of alleged egg theft first reported by the Register in
May. Records and interviews now show that at least 60 women,
including the laparoscopy patients, were unknowingly involved in
illicit egg or embryo transfers by UCI fertility doctors. On Wednesday, after repeatedly denying that they had access to
an embryologist's records indicating additional cases of egg theft,
UCI officials admitted that their lawyers had overlooked the
documents since receiving them in early October. The documents apparently include former clinic biologist Teri
Ord's seven-page handwritten list of more than 200 patients
referred to in the Register's reports, UCI officials said. The list tracks donations from 110 women to 93 recipients,
reflecting at least 51 pregnancies and an unknown number of births.
It does not show whether patient consents were obtained, but at
least 28 "donors" have told the Register they did not consent. Most of the women who said they did not consent were patients
whose eggs were being harvested for their own use during
assisted-reproduction procedures that cost thousands of dollars and
had made Asch and Balmaceda famous and wealthy. Kaoud and other laparoscopy patients said in interviews that
they were told they were given potent fertility drugs to stimulate
their ovaries to see if the drugs would work, or so their eggs
could be tested. But prescribing fertility drugs to create eggs not intended
for implantation has never been a standard practice, according to
pharmaceutical manufacturers and other fertility specialists. Doctors sometimes give fertility drugs to see if a woman will
produce enough eggs to make an in-vitro fertilization or GIFT
procedure worthwhile. If the woman produces too few eggs, the
doctor may cancel the cycle without ever retrieving the eggs, said
Dr. Richard Paulson, who heads the University of Southern
California fertility clinic. But there are no circumstances under which a doctor would take
eggs just to look at them, Paulson said, because little can be
determined by such an examination. The best way to see if an egg is
good is to implant it, he said. "The proof of the pudding is in the eating. The proof of the egg
is whether they implant," Paulson said. He said fertility doctors retrieve eggs from a patient for one
purpose: to try to get the woman pregnant. Most of the women whose eggs were taken during laparoscopies
said they were given Pergonal, a widely prescribed fertility drug
with potentially serious side effects. The pamphlet that accompanies the drug states that after
taking Pergonal, some women have suffered acute respiratory
distress syndrome, stroke, ovarian cysts, abdominal pain, fever,
chills, joint pains, nausea, headaches, malaise, vomiting,
diarrhea, bloating, body rashes and heart palpitations. "In rare cases ... complications ... have resulted in death,"
the pamphlet states. While women who are trying to become pregnant are willing to
take such risks, fertility specialists and a spokeswoman for the
drug's maker, Serono Laboratories, said they have never heard of
the drug being used to produce eggs not intended for implantation. "Perganol would be used in a procedure where you are trying to
get a patient pregnant -- period," said Gina Cella, a Serono
spokeswoman. Balmaceda's lawyer, Moore, said he could not comment on the
allegations of misuse of fertility drugs without the patient
records. "To evaluate that, you have to determine whether Dr. Balmaceda
was the one who prescribed the Perganol," Moore said. Patients who have since found out that records show their eggs
were given away said trying to achieve pregancy with eggs harvested
during laparoscopies was not presented as an option. "We said 'Can we use these for ourselves?' We were told no" by
Asch, said the husband of an Orange County nurse who had a
diagnostic laparoscopy in 1989. "It was a flat no, period." The Register has agreed not to publish the names of fertility
patients who request anonymity to protect medical confidentiality
and familial privacy. In addition to the nine patients who said they did not consent
to donate their eggs, two said they did consent -- but only because
doctors misled them. Ashley MacCarthy of Irvine said that in 1989 Asch persuaded
her to donate by saying her 15 eggs would go to women who did not
have the money for the expensive fertility procedures. But she said
she recently learned from UCI that her eggs were sold to other
patients. Now she wonders if the famed fertility specialist had a profit
motive for putting her on the fertility drugs. "I feel like I was just an egg factory for Dr. Asch," said
MacCarthy, 39. A second woman said she was prescribed Pergonal and consented
to donate her eggs because doctors told her that using them herself
was not an option. A third consenting donor said she did not recall
being given fertility drugs. Another Orange County woman, who wound up adopting children
after her fertility treatments were unsuccessful, said Asch also
prescribed Perganol for her and told her it was necessary to check
the viability of her eggs. "This was done as a diagnostic procedure -- period," she said of
the 1987 laparoscopy, explaining that she did not consent to donate. Records show, however, that three of her eggs were given to
another Orange County woman, who had a child. "They put me under just to take my eggs," she said. "That's
really scary. " In many cases, the scandal has deeply shaken not only the women
whose eggs were taken, but their spouses as well. "We have been raped on a genetic level," said the nurse's
husband. 'They have literally taken my children from me, or the
possibility of those children. We were robbed of that extra chance
to have children."
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