Or has he mistaken himself for God? After investigating the clinic for more than a year, UC Irvine officials shut it down this month and fried a lawsuit accusing Asch and two partners–Dr. Jose Balmaceda and Dr. Sergio Stone –of stunning ethics lapses. According to the university’s legal complaint, the doctors prescribed an unapproved fertility drug, performed research on patients without their consent and, in effect, stole eggs or embryos from some of their patients to create pregnancies in others. Federal, state and local authorities have all launched investigations, and the Orange County prosecutor’s office is contemplating criminal charges. Asch and his partners insist they never knowingly violated their patients’ wishes. But the scandal –the nastiest in the history of high-tech baby making – has inspired new fears among infertile couples. Asch’s former patients are calling a university hot line, seeking reassurance about the origins of their own kids. And though no one believes embryo switching is common, vulnerable couples all over the country are seeing just how much power they’ve placed in the hands of the new fertility wizards.
The Irvine scandal started last year, when whistle-blowers accused the clinic of misappropriating eggs and of hiding income that should have been reported to the university. School officials set up independent panels to investigate those and other allegations, and the panels confirmed a number of irregularities. According to documents examined by NEWSWEEK last week, financial auditors found that nearly $1 million went unreported, and a committee of physicians found that eggs from at least six women had been transferred under questionable circumstances.
In February of this year, the university asked Asch to suspend all human research at the clinic. Officials had hoped to keep the affair out of the courts and the newspapers, but they say Asch made that impossible when he blocked their efforts to investigate yet another allegation. According to court papers, a Bakers field, Calif. woman complained this spring that Asch was asking her to sign a retroactive consent form authorizing the donation of eggs he had harvested two years earlier. When university officials learned of the woman’s charges, they asked Asch to turn over the relevant records. “We demanded them,” says executive vice chancellor Sidney Golub. “We repeated our demands, and finally we had no choice but to seek relief in court.”
The university’s legal complaint, filed May 16, might not have gotten much attention on its own. But three days later, The Orange County Register broke the case open with a story headlined FERTILITY FRAUD: BABY BORN AFTER DOCTOR TOOK EGGS WITHOUT CONSENT. The story centered on an Orange County woman who checked into the clinic in 1991 to try the GIFT procedure, which involves harvesting fertile eggs from the ovaries, mixing them with sperm and placing them in the fallopian tubes in hopes of sparking a pregnancy. The woman said Asch had told her he extracted seven eggs, reinserted four with her husband’s sperm and fertilized the remaining three in test tubes so they could be frozen for the couple’s future use. But clinic records obtained by the newspaper indicated that something very different had happened.
Three eggs: According to those records, Asch harvested 14 eggs from the woman, reinserted four – and had three others fertilized and implanted in another patient two days later. The woman who produced the eggs didn’t conceive under Asch’s care (she has since succeeded), but the unnamed recipient of her three eggs bore a son roughly nine months later. The clinic records didn’t show whose sperm was used to fertilize the transferred eggs, or whether the recipient knew they came from someone else.
University officials say they’re investigating two similar incidents, including one that the Register disclosed on May 24. In that ease, records obtained by the paper showed that an Orange County woman bore two babies after receiving the fertilized eggs of a couple from Riverside County (who conceived a son). The couple’s file included a consent form on which a box had been marked to authorize the use of their leftover embryos. But a color photocopy showed that the ink in the box didn’t match the ink in the signatures–and the couple denied marking the option. “There’s no way I would have checked that,” the sobbing, unnamed woman reportedly told the paper. “We feel like we’ve been tremendously violated.” Her husband agreed, saying, “This is not something like giving away some extra books. This is part of yourself.” The Riverside couple told the newspaper they had no intention of trying to reclaim the kids they may have conceived.
Not approved: Asch and his partners aren’t commenting on the allegations they face, but they continue to deny, through lawyers, that they have knowingly done anything wrong. Asch has acknowledged giving two patients the fertility drug HMG Massone, which is marketed in other countries but not approved for use in the United States. And the doctors concede they have made trivial errors in trying to follow federal guidelines for obtaining consent from research subjects. But they deny trying to alter critical evidence, as the Bakersfield woman has alleged. And they insist that in withholding records from the university, they are merely trying to protect their patients’ privacy. “If there was any misuse of eggs or embryos,” says Asch’s criminal-defense lawyer, Ronald Brower, “it was by inadvertence or mistake of the staff, and not the result of any intentional act by Dr. Asch.”
The scandal raises questions about an industry that has grown wildly over the past decade. Some 200,000 to 800,000 people attend the nation’s 315 fertility clinics every year, and critics say the field should be monitored more closely. “You have this combustible mix of big money, rapidly changing technology and very vulnerable people,” says Rep. Ron Wyden, the Oregon Democrat who sponsored a 1992 bill compelling clinics to report their success rates. “It’s kind of like Dodge City before the marshals show up.” Most clinics do publicize their success rates, but as California state Sen. Tom Hayden says, the pressure to produce more pregnancies could drive physicians to cheat.
Could Asch have misappropriated some patients’ eggs in a misguided attempt to help others achieve their dreams? Brower dismisses the idea. “Here’s the most prominent fertility expert in the world,” he says with a bit of hyperbole. “He’s successful academically, medically and financially. Why would he do that? There’s absolutely no incentive.” Maybe not, but by stonewalling the investigation of his clinic, Asch leaves every infertile couple to wonder what it really means to seek help in conceiving a child.
One in every 11 American women between ages 15 and 44 is infertile.
An estimated 300,000 men and women receive treatment for infertility each. year.
Since 1981 more than 40,000 couples have become parents through high-tech intervention.
Since 1982 the number of U.S. infertility clinics has grown fromto 315.
A medical specialty with few regulations, the infertility industry takes in about $2 billion annually.
IVF (in vitro fertilization); In the lab, an egg is fertilized with sperm, then placed into the womb.
GIFT (gamete intrafallopian transfer): An unfertilized egg and sperm are placed into the fallopian tube.
ZIFT (zygote intrafallopian transfer): A fertilized egg and sperm are placed into the fallopian tube.
SOURCES:NATIONAL CENTER FOR HEALTH STATISTICS, AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE
