Years before she became known as "Octomom," Nadya Suleman vowed to have 10 children, according to testimony from the fertility doctor whose in vitro treatments helped produce her octuplets.
In their first meeting in 1997, Dr. Michael Kamrava recalled Wednesday that the then-childless woman told him she had been trying to become pregnant for four years and had suffered a miscarriage.
"'I'm going to have 10 kids, I just want to have large family,'" Kamrava recounted Suleman saying. He testified on his treatment of the mother of 14 during his Medical Board of California's licensing hearing in downtown Los Angeles.
The state licensing agency alleges that Kamrava was negligent in the treatment of Suleman and two other patients, and is seeking to revoke or suspend his license. The Beverly Hills fertility doctor helped Suleman have octuplets and six other children through in vitro fertilization.
On Thursday, Kamrava is expected to detail the in vitro treatments that resulted in her octuplets.
His testimony Wednesday began tearfully, but Kamrava regained his composure once he delved into his educational background and the evolving science of fertility medicine through the course of his career.
Kamrava said Suleman was already taking hormones to increase her chances for becoming pregnant at the time of their first meeting.
In hearings this week, an expert witness for the state testified that Suleman's medical records show Kamrava implanted 12 embryos in the pregnancy that gave Suleman octuplets. National guidelines recommend no more than two embryos for a woman her age.
In less than eight years, Kamrava repeatedly performed in vitro fertilization for Suleman, implanting her with 60 fresh embryos that resulted in a total of 14 children.
Kamrava said Suleman's embryos were low quality, and though he routine implanted her with a number of embryos far in excess of the national average of 2.2, his goal was always to have single-baby pregnancies.
There are health risks associated with crowding in a mother's uterus that could endanger the mother and result in premature birth or other ailments for the babies.
Suleman is identified only as N.S. in the medical board's documents and hearings but has previously identified Kamrava as her doctor. The documents also identify N.S. as the mother of octuplets, and Suleman is the mother of the world's only living full set of octuplets.
The octuplets' birth in January 2009 was hailed by many as a miracle until details of Suleman's personal life became public, and concern grew for the safety of her 14 children. Before the octuplets were born, the unemployed and divorced Suleman and her children lived with her mother, relying on food stamps, school loans, workers compensation and disability payments for her two autistic children to get by.
More recently, Suleman has tried to make a living by selling pictures and gossip items about herself to the tabloid media, but she struggles to pay rent and is facing a $450,000 balloon payment on her La Habra home.
Kamrava is also accused of failing to refer Suleman for a mental health consultation when she repeatedly sought fertility treatment.