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THE MEDICAL PRACTICE OF MARK EVANS IS LOCATED ON THE GROUND FLOOR OF A MANHATTAN TOWNHOUSE, nestled discreetly among the restaurants and nail salons of the Upper East Side. To be admitted, patients must ring a buzzer and wait for the door to open before taking a seat inside the crowded waiting room.

Down the hall in a tiny examining room one morning, a sonographer named Rachel Greenbaum was sitting on a high stool next to an ultrasound machine. "Do you want to see the screen?" she asked one of Evans's patients, who was lying unhappily on an examining table. The woman, pale-skinned, fine-featured, tall, in her 30s, was wearing a hospital gown. Beside the woman was her husband, sitting in a chair, holding his wife's hand. He too was pale, and, like his wife, he looked miserable. "Yes, I'd like to see them," the woman on the table said firmly.

"I'll just take a few pictures, and I'll show them to you," Greenbaum said.

"Them" referred to the three fetuses in the woman's belly, a long sought pregnancy achieved...