Brisbane woman gives birth to stranger’s baby after embryo mix-up

ABC NEWS (Australia)

Let's get more now on that IVF mix up with reproductive specialist, associate professor, Alex Polyakov. He says it's a strange situation as there are a number of checks that occur during the IVF process.

Transcript

00:00The process of IVF takes place from the beginning of a cycle when stimulation is given, and

00:08then eggs are collected.

00:11Those eggs are placed in dishes which are clearly labelled with what we call three-point

00:16ID.

00:17So the patient's name, address, date of birth, and the clinic number are all on the dish

00:22where the eggs are stored.

00:24They go to the lab and they are fertilized with usually partner sperm but sometimes donor

00:32sperm and those ID badges are transferred from one dish to another.

00:37So when an embryo is moved, it can only be moved from one dish to another where those

00:42three points of ID are checked and the checks usually involve two embryologists who look

00:47at all those data points and confirm that the embryo actually belongs to that particular

00:53patient.

00:54So usually one embryo is transferred and the rest are frozen, which is what seems to have

00:58happened in this case.

01:00And then once they need to be used, they are pulled from a freezing tank and the straws in

01:07which they are frozen are also labelled in the same fashion.

01:11And every step of the way, there are two embryologists or two scientists who look at all those points

01:17of identification and confirm that the embryo belongs to that particular patient.

01:21So an embryo is thawed and transferred into a dish, which once again has all those points

01:26of identification and in some clinics there is also electronic tagging of those dishes.

01:32So there is an electronic record as to from which dish an embryo is taken.

01:38And then embryo is taken into the embryo transfer room and put into a pipel and transferred into

01:44a patient's uterus and hopefully produces a pregnancy.

01:47So there are redundancies upon redundancies.

01:50So this sort of situation doesn't happen.

01:52There are at least two embryologists involved at every step of the way confirming the identity

01:58of the embryo, sperm and eggs, and linking those to the identity of a particular patient.

02:04Yeah, so that key backup system that you mentioned there is the two embryologists.

02:10Does this case indicate that maybe that something needs to change, something else needs to be added

02:16to that process?

02:19Well, I think it's important to know that this is a unique situation.

02:23I mean, IVF has been around in Australia for about 40 years.

02:27At the moment, we will probably do about 120,000 to 150,000 embryo transfers a year.

02:34And this is the first instance where a child was born from a wrong embryo.

02:41And so I think the system is robust.

02:45There are always two people who are involved in the identification.

02:49And I am not entirely clear as to how this happened.

02:53I can't really comment on that because the details haven't been released.

02:56And I understand there are a number of investigations going on.

02:59But I would say that the current system actually works very well.

03:03Unfortunately, there are humans involved in this process.

03:07And very, very rarely, probably one in a million or so, there are mistakes that are made.

03:13And Monasheviev themselves put it down to human error, which I think that's what it was.

03:18But we have to wait for the results of the investigations to come out to determine what actually happened

03:24in this particular instance.

03:26Does the sector have a code where there are protocols set out of what's required through

03:32the system?

03:34Absolutely.

03:35I mean, IVF sector is probably the most regulated sector in medicine in Australia.

03:39We have a very robust regulatory framework.

03:43It's on the federal and state level.

03:45And each state has their own regulator.

03:47In Queensland, that has changed recently, I understand.

03:50But nevertheless, there are very robust protocols.

03:53And one of the key points to be made is that all of Australia, every clinic, must have two

04:01people identifying and checking the identity of the either gametes or embryos and matching

04:06them to the patient.

04:08Furthermore, when the embryo transfer actually takes place, the patient is involved in that

04:13process as well.

04:13So we take a dish which contains the embryo.

04:17We ask the patient, what's your name, address and date of birth?

04:20And then electronically, we check their patient number and it must match to the number on the

04:27dish.

04:28So, yes, there was some sort of an error that resulted in this very, very unfortunate incident.

04:35But I am not quite clear what else can be done to prevent those errors in the future.

04:42Doesn't the fact this was only discovered by chance after the birth parents asked to transfer

04:46their remaining eggs to another provider suggest that maybe this could have happened before

04:52without anyone realising?

04:55It's very difficult to answer that question.

04:57I think the processes, once again, that guide these technologies are extremely robust in

05:06Australia.

05:07We can't say whether this happened before or not.

05:10But to my knowledge, in Australia, this is the first instance where this has happened.

05:15And the baby was born from a wrong embryo.

05:18There were some reports in years gone by where there were similar instances in other countries

05:24like United States and Israel more recently.

05:26But this is, you know, it's world news.

05:30It happens so very rarely.

05:32And we transfer so many embryos that my feeling is that the chance of this happening is exceedingly

05:39low.

05:40This is obviously incredibly traumatic.

05:42Would you expect there'll have to be some substantial payment made as compensation to the

05:48couples involved?

05:50Well, I think that goes a little bit beyond my area of expertise.

05:55I'm not a lawyer.

05:58You would think that the lawyers would jump onto this one.

06:01But I don't know what the outcome will be.

06:04There are a lot of ethical and legal questions associated with this particular scenario, which

06:11you perhaps want to speak with an ethicist or a lawyer who specialises in this area.

06:17OK, and so broadly then, how should people feel about IVF standards here in Australia in

06:22the wake of this?

06:24I would have to say that the IVF standards in Australia are among the highest in the world,

06:28if not the highest.

06:30And so I would urge people not to panic.

06:36And I would say that this sort of scenario, what actually happened in this instance, is

06:42unique.

06:43I mean, it's not something that is a systemic problem within the industry or even that particular

06:48clinic.

06:49I think it's a very unfortunate confluence of events, which resulted in this outcome.

06:57But overall, I would like to reassure future patients and current patients and former patients

07:03of IVF clinics that this scenario is exceedingly unlikely.

07:07And it's unlikely that it's happening on a wider scale rather than, you know, just a unique

07:15occurrence that happened here.

Category

Transcript

Recommended