Many thanks to Dr. Kapfhamer and Dr. Van Voorhis for addressing this very important and concerning issue. As mental health professionals who counsel and evaluate the women who may become gestational carriers, we have become deeply disturbed by the proliferation of broker programs and of intended parents unaware or unconcerned about multiple pregnancies. Helping potential surrogates and intended parents understand that a multiple pregnancy has never been considered a positive outcome of IVF must be a team effort. Original risk management counseling from the physicians should be emphasized by the mental health professionals whose job is to educate everyone about the risks and benefits of surrogacy. What we see all too often is a situation where that one, "not so good looking," "C-quality embryo" is transferred, with the parties being told it is highly unlikely to implant. Then, of course, all too often it does. And as stated in this article, the risks one is willing to take for oneself in the pursuit of family building are or should be very different from the risks asked of women becoming pregnant for others. We would love to see additional collaboration between our disciplines, teaming together for the ultimate well being of the babies being brought into the world and the women who make it possible. Carole LieberWilkins Marriage and Family Therapist Los Angeles, CA