By Glen Adaniya
Have you heard about Sean and Carolyn Savage? This Ohio couple had thawed frozen embryos transferred to Carolyn’s uterus in 2009. A few weeks later they got a phone call from their fertility clinic. The good news? Carolyn was pregnant. But there was bad news and a huge mistake had been made. Carolyn was pregnant with someone else’s child. The clinic had thawed and transferred the wrong embryos.
When going through in vitro fertilization (IVF) here at Midwest Fertility Specialists, patients frequently ask us two important questions, “How do you keep track of whose embryos are whose? And what safeguards are in place to make sure the embryos are not mixed up?”
Maintaining proper identification starts the day prior to the egg retrieval. It starts when we prepare the petri dishes used to grow the embryos. All petri dishes are labeled with the patient’s name and Social Security number. They also have a unique color code. The dishes are then placed on a shelf in an incubator overnight. A label is placed on the outside of the incubator. This label contains the patient’s name, Social Security number, a unique color code, and other information pertaining to the cycle.
The procedure for maintaining patient identification throughout an IVF cycle is based on a double verification system. A second biologist, a nurse, a surgical technician, or a physician – in addition to the primary biologist – always verifies the patient identity at key steps in the process. Here is how the double verification process works:
1. When a patient is brought to the Procedure Room for egg retrieval, the surgical technician verifies the patient’s identity.
2. The tech places a label with the patient’s first and last name, Social Security number, and date of birth on the Patient Verification Sheet.
3. The technician signs the Verification Sheet.
4. A biologist confirms the patient’s identity and labels on the culture dishes, and signs the Verification Sheet.
5. This process is followed for semen samples used for insemination, intracytoplasmic sperm injection (ICSI), and when freezing and thawing embryos.
When a patient is brought in for embryo transfer here at Midwest, both a biologist and a nurse or physician will verify the patient’s identity and sign the Verification Sheet. As an added measure of security, just prior to the embryo transfer, the biologist will have the patient confirm the label on one of the dishes in which the embryos were grown. In cycles involving thawed embryos, the patient will be asked to verify the labeled vial or straw in which the embryos were frozen. Finally, when the embryos are removed from the incubator, just prior to loading them into the transfer catheter, two biologists confirm the correct identity of the embryos and sign the Verification Sheet.
Even with over 400 IVF clinics in the United States, embryo mix-ups have been extremely rare. Still, the case of Sean and Carolyn Savage emphasizes the point that you can never be too careful when handling the eggs, sperm, and embryos of patients undergoing ART procedures. Patients should feel free to question their physicians about the protocols in place to prevent mix-ups from occurring in their laboratory.
In case you’re wondering what happened with Carolyn Savage, she went on to carry and deliver the other couple’s child, and then gave the child up for adoption to the biological parents.
Glen Adaniya, Ph.D. is the Lab Director at Midwest Fertility Specialists in Indiana. He oversees all aspects of ART, andrology, and endocrine laboratory services for patients at Midwest Fertility. He has authored many academic publications, journals, and articles, and regularly gives lectures to students, staff, and faculty on various topics related to ART and the lab services he oversees at MFS. To learn more about Midwest Fertility Specialists or to schedule an appointment, call (317) 456-5260 or visit www.midwestfertility.com.
