In Vitro Fertilization – Just Be Careful
July 19, 2019

I read with horror the recent story about the Asian American couple who gave birth to twins only to be told that due to a “mix up” at the California fertility clinic, the twins were not their biological children and would have to be relinquished to their “real” parents. The couple had tried for years to get pregnant before spending more than $100,000 on IVF (in vitro fertilization).  They were no doubt delighted when they were advised that they were pregnant with twin girls. When they gave birth to twin Caucasian boys, it was clear that something had gone wrong.  As it turned out the implanted eggs belonged to two other couples who had used the same clinic.  Not only did the couple have to give up the children but it is reported that they may never know what happened to their embryos nor do they have any way of knowing that the currently preserved (with the same Clinic) embryos are genetically matched to them.

How could this happen?  Surely, I thought, this was a rare mistake – a one in a million occurrence.  So I googled “in vitro mix-ups” and was surprised to learn that mistakes like this are not at all uncommon in the world of IVF.  In fact, one IVF expert, Jake Anderson, questioned (during a CBS interview where the issue of these “mistakes” was being discussed) whether we have “become reckless and too careless with peoples’ most important genetic material and their future happiness?”.

Assisted reproduction is nothing new.  The first IVF was completed in the United States in 1981.  Today, there are over 500 fertility centers in the United States.  In 2012 more than 65,000 assisted reproductive technology births occurred in the United States.  So given the long history and extensive use of IVF, one would expect that extensive regulation should exist that would protect against these mishaps.  Quite the contrary.  Research shows that states oversee medical licensing and physician misconduct and there are Federal regulations that require the reporting of some data to the Centers for Disease Control and Prevention and the Food and Drug Administration.  But the existing regulation deals mostly with topics like the release of full medical information; the number of donor’s sperm or eggs used to conceive a child; and the pregnancy success rates of individual clinics.  But Dov Fox, a professor of law at the University of San Diego points out in an NBC interview that “there’s no federal law, no state law, no enforced professional guideline that enforces requirements, that licenses these facilities in the way that they label or diagnose or handle sperm, eggs, and embryos…But there is no single government agency empowered to crack down on mistakes made by fertility clinics and no single government entity oversees the fertility industry as a whole.”

What then can a couple do to assure that they do not fall victim to one of these mishaps?  Nothing is full proof but there are steps that can be taken to assure that the best results possible are attained.  First and most important – do your homework.  Research the Clinics that you are considering.  This is a big step and an expensive one so exhaust all avenues available to you.  Review the Clinic’s website and, if possible, talk to current and former patients.  Check the federal database kept by the Center for Disease Control, a good tool to help evaluate the success rates of fertility clinics throughout the United States.  (Be careful to assure that you are reviewing the most current information available on the site.)  Check the Clinic websites.

Be sure to meet and interview the doctors that you are considering. Do they take time to answer your questions?  Is he/she board-certified reproductive endocrinologists?  How long have they been working with infertility patients and how long have they been at the Clinic that you are considering?

With regard to the Clinic itself, ask if the Clinic has made any mistakes in the past.  Demand full information and transparency with all procedures.  Ask the Clinic to detail for you the steps they take and the procedures that they have in place to assure that mistakes do not occur.  How are embryos monitored?  Do they keep an embryology file that outlines the steps, the steps that the embryos have been taken from freezing to fertilization?  Ask to review the file and ask for a copy of the file.  If they do not keep such a file, how do they track the embryo?  Is double checking paperwork part of their protocol?

IVF is an expensive process.  It takes a lot of time and patience.  The results can be wonderful.  Just be careful and good luck.

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