BLUNDERS THAT CAN MAR ASSISTED BABYMAKING
Accidentally switched embryos. Wrong sperm. As assisted baby-making’s popularity grows, experts warn that the science can involve serious blunders, including “misdirected” embryos — embryos that end up in the wrong woman’s body.
The American Society of Reproductive Medicine, in a newly published article, says fertility clinics have an ethical obligation to immediately disclose medical errors that could result in babies born with a “different genetic parentage than intended.”
That could include inseminating a woman with the wrong sperm, combining the wrong sperm with the wrong eggs or transferring the wrong embryos to the wrong uterus — devastating errors that can result in babies being born to couples that were intended for someone else, the society’s ethics committee writes in the latest edition of the journal, Fertility and Sterility.
Such calamities, experts insist, are rare, and while the body representing Canada’s largely for-profit fertility industry says it is unaware of any cases of “misdirected” embryos here, there has been a smattering of reports of IVF mix-ups in the U.S. and elsewhere that have led to emotionally wrought battles to determine legal parentage and custody.
In 1999, a New York State woman of Italian descent gave birth to twin boys — one white, the other black. The woman had undergone an embryo transfer at a Manhattan fertility clinic the same day a black couple were also undergoing IVF. But an embryo from the black woman ended up in the white woman, reportedly because the pipette hadn’t been properly flushed between transfers. Only the white woman became pregnant.
“The couples initially agreed to a shared custody agreement, but ended up in a custody dispute,” said Toronto fertility lawyer Sherry Levitan. “The genetic parents won.”
Levitan was involved in a case about 15 years ago involving a Toronto-area couple. An embryo was created using a donor egg and what was supposed to be sperm from the male partner. A surrogate carried the embryo. As part of a court application to obtain a Declaration of Parentage, DNA testing was performed. “The DNA testing came back, and nobody was related to the child,” Levitan said. “They ran (the test) again. It wasn’t a DNA mistake; it was clearly a laboratory mix-up.”
The parents chose not to sue for negligence, because they didn’t want to risk losing the child.
No one knows how often semen or embryo mishaps occur in Canada. Levitan said that while DNA tests are always done in surrogacy cases, they aren’t typically performed for routine IVF.
“In other words, most people never check to make sure that the baby they deliver is the baby that they expect.”
In the U.K., the Human Fertilisation and Embryology Authority, a government watchdog, reports on adverse incidents in fertility clinics. More than 1,600 incidents were reported between 2010 and 2012. While most were classed as “less serious,” errors ranged from incorrectly labelled pots and tubes to dishes containing the embryos of 11 patients contaminated with “cellular debris that may have contained sperm.”
A Canadian agency that was struck to license clinics, establish a registry and otherwise be a model of the British fertility oversight body was shuttered in 2012.
In Canada, private fertility clinics accredited by Accreditation Canada (a voluntary program) have disclosure policies mirroring those required of hospitals, said Mark Evans, of the Canadian Fertility and Andrology Society (CFAS). Those policies state all “critical incidents” must be reported and errors investigated and tracked, he said.
Labs as well follow a “rigid process of validating patient identity at every interaction with the patient and every time gametes (sperm, eggs or embryos) are manipulated or moved,” Evans said.
Levitan said patients should verify samples themselves. “Before sperm is used for an IUI (intrauterine insemination), before embryos are transferred for an IVF, they should be looking at the samples and making sure it’s their name on the label,” she said.
“Don’t just let a nurse read it out to you — look at it.”