Her publicist has resigned after death threats. She has been reviled as unhinged, irresponsible and parasitic. Her doctor has been criticised for being unprofessional. But are there other forces behind the octuplets born to Nadya Suleman (aka OctoMum and Madame Ovary) last month?

According to Stephen Latham, of Yale University, multiple pregnancies are a problem in the US because there is almost no government funding or private insurance for IVF treatment. In fact, in 2005, 53% of all IVF embryo transfers involved 3 or more embyros.

In the UK, Australia, Belgium, and Scandinavia, the government covers much of the cost. But in the US a single IVF cycle costs between US$10,000 and $15,000. This means that American couples will not make a risky business riskier still. One transfer of two or more embryos is cheaper and has a higher chance of success than two transfers of one embyro each.

"Without insurance coverage," writes Dr Latham in Bioethics Forum, "strict regulations capping the number of embryos transferred in a cycle will severely limit the reproductive options of couples who can’t afford multiple attempts at pregnancy. With insurance coverage, such regulations would not be nearly so burdensome. And that’s why the octuplets story is another classic insurance story." ~ Bioethics Forum, Feb 13