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A few months after Dr. Michael Kamrava helped Nadya Suleman become pregnant with octuplets, he transferred at least seven embryos to another patient.

She was in her late 40s and wanted just one baby.

Now she's five months pregnant with quadruplets and hospitalized at Los Angeles County-USC Medical Center, according to several sources familiar with the situation.

The new case could add to concerns about Kamrava's practice and about whether the fertility industry needs more regulation.

In fertility medicine, any pregnancy greater than twins is considered a poor outcome because of the danger it poses to the mother and the babies. Quadruplet births are rare, with an average of 14 sets born in California each year, according to state records.

"Historically, we have been very hesitant to regulate anything close to procreation from parents making judgments about how many children they will have and when," said Kirk O. Hanson, ethics professor and executive director of the Markkula Center for Applied Ethics at Santa Clara University.

"However, that worked under a natural process of fertilization and incubation. There are serious questions...