How does the embryologist prevent your eggs and sperm from being mixed up with someone else's in the IVF lab ?

What do we do to prevent Lab Mix-ups.
Dr. Sai, Head Embryologist, Malpani Infertility Clinic Pvt. Ltd.

The biggest worry in every IVF patient's mind is the possibility that the staff may screw up and mix up their eggs and sperms with someone else's. We've all read enough horror stories to know that this sometime still happens - and this is the worst nightmare for both patients and doctors. What's worse is that this may happen inadvertently, and you may never find out at all !

Its important that patients pose questions

Patients sometimes don't like to ask these questions, because they worry that their doctor will think they don't trust them and won't like them anymore. But you have a right to ask these questions and see if the answers make you more or less comfortable with the care you are receiving. A good IVF clinic won't mind sharing the details with you to reassure you that you are in good hands.

How do we make sure we don't mix up your eggs, sperms and embryos with another patient's ?

Eggs and embryos don't come labeled. Your eggs and embryos look just like everybody else's - the same size, same color, no matter what your ethnicity or race. It's only the container in which they are in which tells us who they belong to. This is why correct labelling is everything in the IVF clinic !

• Labeling samples correctly is critical
• Labeling is a pre-requisite for biological Quality Assurance
• We label paperwork, dishes, test tubes, pipettes. Everything we use for your case has your identity on it.
• We label your culture dishes. Culture dishes have a lid, so we label both lid and bottom.
• Three identifiers are used for labelling. First name, Husband's name and Last Name.
• Extra Care is taken for similar name or similar sounding names. Fourth identifier is used in such cases to avoid confusion.
• Regardless of labeling method, we still have to be sure to put the right embryo in the right dish. That's the reason only one patient's dishes are handled at one time.

Colour coding

Colour coding will act as an additional identifier. In fact it makes one's life much easier.

• Different colours are used for different patients.
• Every patient will have a unique colour tags.

There are 4 things we need to colour code:

• Semen collection container (you will be collecting your sperms in these containers)

• Centrifuge tubes (your sperm sample will be processed in these tubes)

• Culture dishes (your eggs and embryos will be kept in these dishes)

• Incubator shelves (your culture dishes will be kept in these shelves of CO2 Incubator)

Documenting information on the patient's file for every procedure is compulsory.

• When the husband collects semen sample in the container labelled and coloured coded with his name, it is brought to the lab along with the file.
• When culture dishes are prepared (a day prior to the pick-up, Fertilisation check or Embryo transfer), the name is properly cross checked with that on the file.

Having a witness for every procedure.

• When the patient is taken into the OT for Egg collection or embryo Transfer, one of the nurses informs both the doctor and me by calling out your name. This helps to increase your confidence levels as well !
• When I load embryos into ET catheter, a nurse cross checks that I am loading right embryos.
• When I hand over the loaded ET catheter to the doctor in the OT, I call out your name, to confirm that I am giving right embryos to the doctor.

Future

A new device called IVF witness has been launched worldwide that takes the IVF process to a much higher level of safety. Patients feel far more relaxed and confident about the procedure because they have an ID card which puts them in control and secondly embryologists are reassured by having an extra safety net. It tightens up the whole IVF process and makes it far more secure

IVF Witness

IVF Witness uses Radio Frequency Identification (RFID) technology to monitor all critical work carried out in the laboratory, creating a complete record of each stage of a patient's cycle.

IVF Witness is electronically tracking and recording all the time and locks the patient's identity to the sperm, eggs and embryos at every stage of the treatment. The system also actively prevents patient samples coming into proximity with those of other patients.