A Fertility Nightmare
07/24/1995 at 01:00 AM EDT
BY THE TIME DEBBIE AND JOHN CHALLENDER went to see Dr. Ricardo H. Asch at the University of California at Irvine's Center for Reproductive Health in September 1991, the Corona, Calif., couple had spent more than a decade trying to conceive a child. "We'd see doctors, do the tests, try anything," says John, 46, a trucking-company supervisor. "Nothing worked." Asch's overwhelming confidence that he would succeed where others had failed gave the couple new faith. "That first meeting, Dr. Asch told me I would become pregnant," recalls Debbie, 36, a nurse. "He was very definite."
Asch removed 46 of Debbie's eggs and fertilized them with John's sperm in petri dishes. Within a few days, 21 of these had developed into embryos, which Asch froze for use when the Challenders were ready. In November, Asch implanted five of the embryos in Debbie's uterus. Nine months later, Debbie gave birth to a son, James Dominic, and the couple was singing Asch's praises. "He was great, gentle, wonderful—an excellent salesman," says John, who paid $10,000 for the procedure.
Asch, however, was apparently selling more than just hope. In May the Challenders were contacted by a reporter for the Orange County Register newspaper who presented them with their medical records from the center. Spreading the documents across the Challenders' coffee table, the reporter broke the news to the couple: without their consent, three of their frozen embryos had been implanted in an Orange County woman. She gave birth to twins, a boy and a girl, who are the Challenders' biological offspring. (So far, the woman has not been identified.)
"When we saw the records, we just sat there and wept," says John. "It was the loss of three of our children, children that had yet to be born. We felt betrayed."
It's a feeling that others now share. On June 2, the university shut down Asch's clinic and filed suit against Asch and partners Dr. José Balmaceda and Dr. Sergio Stone, charging them with breach of ethics and contract. Then, on July 5, university investigators publicly alleged that the doctors, in some 30 cases, took eggs or embryos from patients without their consent and gave them to others—actions that resulted in the births of perhaps as many as seven children. The three fertility specialists are also accused of prescribing a non-FDA-approved fertility drug, performing research on harvested eggs without the donor's consent and failing to report $967,000 paid-in-cash patient fees, some of which the doctors allegedly stuffed in envelopes and carried home.
"Some of what they did was definitely well beyond the ethical standard," says Dr. Stanley Korenman, one of the three physicians investigating the doctors for the university. "Doctors who do this sort of work can start to feel godlike. Their patients are desperate for children, and they adore doctors who can do what others can't."
Indeed, as word of the UCI scandal spread, federal, state and local authorities all launched investigations into the doctors' activities. And although no criminal or civil charges have yet been filed against them, the three physicians have been booted from their practices at two other fertility centers in Southern California.
Asch, Balmaceda and Stone aren't discussing the controversy, but their lawyers say they never knowingly violated patients' wishes—and that any unauthorized transfer of eggs or embryos was the result of staff bungling. "The only time Dr. Asch saw the eggs or embryos was when he was harvesting or implanting them," says his attorney Ronald Brower. "Otherwise he trusted the employees—hired and paid by the university—to do their jobs correctly."
University officials concede they should have investigated rumors circulating about the clinic and monitored the center's activities more closely. "In retrospect, it's clear we should have had a higher level of oversight," Executive Vice Chancellor Sidney Golub said. "But there is a usual level of trust that faculty will behave according to the rules and will act in a responsible manner."
Particularly when the faculty in question are three of the world's best-known fertility experts. Asch, a native of Argentina, and Balmaceda, a native of Chile, found fame in the mid-80s for pioneering an in-vitro fertilization technique called GIFT (gamete intrafallopian transfer), in which mixed eggs and sperm are implanted into the fallopian tubes. In 1986, after much courting, UCI lured the pair away from the University of Texas Health Science Center at San Antonio to join Stone in creating the university's on-campus fertility clinic. (Stone, also a native of Chile, had previously headed UCI's reproductive-endocrinology department.) After the clinic opened its doors in 1990, the doctors saw hundreds of patients a year, published scores of research papers and generated millions of dollars in fees—of which UCI got a 13 percent cut.
With a success rate of around 25 percent (about twice the national average) and satellite practices at the UC campus in La Jolla and Saddleback Memorial Medical Center in Laguna Hills, the trio's prospects looked boundless—and increasingly lucrative. Asch, for example, drove a Ferrari, bred racehorses and split his time between a $1.1 million Newport Beach home and a $2.2 million oceanfront condo in Del Mar.
As early as 1992, though, some began to question procedures at the clinic. Marilyn Killane, who joined the staff as office manager in October of that year, recalls seeing the doctors carrying home envelopes stuffed with as much as $12,000 in cash and dispensing HMG Massone, a fertility drug Asch had obtained from Argentina that is not approved for use in the U.S. Killane took her concerns to Debra Krahel, the senior associate director at the center, who tried unsuccessfully to force an investigation. "I was told the doctors had a special arrangement with the university and that this was all hands-off," says Krahel. "I was told I should leave them alone."
Then, in June 1994, Krahel's senior administrative analyst, Carol Chatham, reported that the doctors might be implanting embryos without patient consent. Krahel phoned one of the patients involved and, pretending to be simply updating records, asked her if she had agreed to donate her embryos. She hadn't. That same day, Krahel and Chatham were placed on administrative leave for alleged poor job performance. (Killane had already been fired, with the same reason given.) Incensed, the women told their stories to the National Institutes of Health, university personnel and the Register. "It wasn't the financial stuff or the drugs, it was the egg issue," says Chatham, 44. "To think there was someone out there with your child, a child you know nothing about. That was the final straw. It was giving away babies. You just can't do that."
Despite the testimony of the three women, who split a whistle-blower settlement of nearly $1 million from the university, some of Asch's patients refuse to believe the charges. "When I heard them, it was like somebody had told me the pope was a serial killer," says Ginger Canfield, who, with Asch's help, gave birth to a daughter in 1988. "I love Dr. Asch."
As for Asch, he has stopped practicing medicine altogether. "He's depressed and overwhelmed," says Brower, Asch's attorney. But then so too are many of his patients, who have been calling a UCI hot line seeking reassurance about the conception of their own kids or the location of embryos and eggs they had frozen. (They are being stored at California Cryobank Inc. in Los Angeles.) And some, like the Challenders, have spent recent weeks coming to terms with the knowledge that they have children they may never meet. Both Debbie and John—who also have an adopted son, John Robert, 8—have struggled with insomnia and crying spells since they learned of their twins. "I don't want to take them away from the only family they've known," says Debbie. "I just want to hug them."
But both say that meeting the children they conceived might only bring more anguish. Says John: "I want to know their fate. I want to know they're in a good, stable home. But I'm afraid of what will happen when I walk away."
SCOTT LAFEE in Orange County