Avoiding Medical Errors with Infertility Treatment

Nothing strikes fear in the heart of infertility patients quite like the thought that the wrong embryo or sperm or egg was used during their procedure. We posted the switched embryo story on our In the News page right after it hit the news and quickly received several poignant comments.

“I’m going to have my transfer next week and now I’m terrified. I have waited so long for this, and the thought that I could end up carrying someone else’s baby is almost unbearable.”

and

“We did an IUI last week, and I can’t stop thinking now that it wasn’t my husband’s sperm.”

This screw up, and the resulting fears, hits at the heart of infertility—lack of control. Procreation isn’t supposed to be this way. Control is central to the way we are taught that babies should be made. We should be selective about a partner and use protection until we are ready to parent. Selecting and protecting requires control. Infertility strips away control and replaces it with fear, and this story of switched embryos plays to this fear.

Mistakes happen, it’s true, but it is important to keep things in perspective. This story of innocent babies and anguished parents is ready-made for the mass media, so of course we’re seeing a slew of coverage, both local and national.

What is not being reported is the frequency of these type mistakes. Remember that about 140,000 IVF cycles are being done each year. The number of errors being reported is very few. Also remember that you aren’t powerless. There are things you can do to help prevent these mistakes. You can’t take back all the control, but there are absolutely things you can do to increase the odds that these mistakes won’t happen to you.

I’ve listed the Top Ten Things to Do to Prevent Mistakes in Your Infertility Treatment at the bottom of this blog. Also, listen to our Creating a Family show on “Switched Embryos and Other IVF Errors and How to Avoid Them”. Our guests were Dr Jacob F Mayer, embryologist at the Jones Institute for Reproductive Medicine and Professor of Obstetrics and Gynecology; Dr. Elizabeth Ginsburg, President of the Society for Assisted Reproductive Technology, Associate Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard, and director of the IVF program at Brigham and Women’s Hospital; and Jessica Berg, Professor of Law and Biomedical Ethics at Case Western Reserve University School of Law and Associate Director of the Law-Medicine Center.

Top Ten Tips for Avoiding Medical Errors with Infertility Treatment

  1. Is your doctor a member of the American Medical Association and board certified in an area of specialty that relates to infertility.
  2. Is the embryology lab accredited by either the College of American Pathologists (CAP) or the Joint Commission, a voluntary accreditation program for hospitals and other health care organizations? You can find this information by asking the clinic, and it is also on the Center for Disease Control statistics table for each clinic.
  3. Is the clinic a member of the Society of Assisted Reproductive Technology? Membership is voluntary and SART has very limited enforcement authority, but membership is at least an indication that the clinic will follow the SART guidelines for practice. You can find this information by asking the clinic, and it is also on the Center for Disease Control statistics table for each clinic.
  4. Check the Center for Disease Control statistics on the clinic to see not only their pregnancy rate, but also their live birth rate, and multiple birth rate. Triplet and more pregnancies are another form of IVF mistake.
  5. Ask the clinic about their labeling protocol for sperm, eggs, and embryos? (They should use at least two, and preferably more, unique identifiers such as bar-coding, color-coding, name, number, etc.) Your clinic should welcome this question.
  6. Ask the clinic what safeguards are used to ensure that the correct eggs, sperm and embryos are used for each procedure? (For example, more than one person doing the identification of both the embryo or gamete and the patient, multiple times for comparing patients identification with the gamete or embryo, handing off sperm sample to the person in the lab who will be processing it rather than to a secretary or assistant, etc.) Again, your clinic should welcome these questions and provide specific answers not vague assurances.
  7. Check to see if there have been any complaints or disciplinary actions against your doctor. You have a couple of options:
    • Search “medical board” and the state name in your favorite search engine to find the Medical Board for your state.
    • Use a commercial service, such as HealthGrades, to provide a report on your doctor.
  8. Ask the clinic if a nurse is available to work with you individually if needed to make certain you understand how to administer the medication? Not all mistakes in infertility treatment are by the clinic itself. Infertility medications can be confusing to administer.
  9. Does the clinic have a specific policy of disclosing all mistakes or errors to a patient?
  10. During your procedure, ask questions. It’s OK to appear paranoid. Have you double checked to make sure these are my embryos? May I see the storage vial for the sperm before or after insemination?

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