The chances of IVF malpractice

We have all seen the headlines of IVF malpractice and for everyone in the fertility industry, they are headlines we can all live without! Only last week, we were all horrified to read the story of 30-year-old Jessica Harvey from Ohio. Jessica took an Ancestry DNA test to celebrate her landmark birthday. Jessica had always been very proud of her Italian roots on her father’s side. Therefore, she was shocked to learn her DNA was from Wales, Ireland and Germany! She had no Italian roots at all. Jessica was conceived via IVF and 30 years ago the clinic had inadvertently used the wrong sperm at her conception.

Jessica said, “My entire life, I have always been so passionate, so proud of my heritage on both sides where I came from, how my ancestors got here, what makes me today.” The news has rocked her family. Her mother, Jeanine said, “I’m like, wait a minute, I carried a total stranger’s child, you know, for nine months, and who in the world does the other half of this child belong to?”

There is now a legal case underway, the clinic involved has not commented beyond offering an initial apology. This is standard practice in such cases, clinics are bound by their insurers to take the advice of the insurer’s lawyers. It happened three decades ago; it is doubtful if any of the original staff are still there. And, if they are, it’s doubtful they would be able to shed much light on a specific incident, which occurred during a routine procedure back then.

The family’s lawyer commented, “It shouldn’t be that the fertility clinic transferred some stranger’s sperm into Mrs. Harvey’s body. That is not OK. It’s not OK under the law. It’s not OK under any sense of medical ethics. And it shouldn’t happen ever.”

Well, yes. It shouldn’t happen ever. After all, it is in no one’s interest. But these kinds of incidents have happened in the past, and do happen now, even if very rarely.

The real risk

According to insurers and lawyers, malpractice within IVF clinics tends to fall into 6 categories

  1. Using the wrong sperm or egg: this can occur during the in vitro phase (i.e., in the lab, and outside of the woman’s body). This is probably what happened in Jessica Harvey’s case, where the wrong sperm was used to fertilise her mother’s egg.
  2. Implanting the wrong embryo: there are also cases when the wrong embryo is implanted. In this situation, a woman who is accidentally carrying the child of another family may be legally required to hand over the child to the biological parents after birth. It goes without saying that a situation like this can be dire.
  3. Improper storage of eggs or embryos: before being implanted in a woman who is undergoing an IVF procedure, the embryo and egg must be properly stored in a medical facility, or it could sustain serious damage or be destroyed.
  4. Failure to properly screen egg or sperm donors: If not properly screened, a sperm or egg donor may pass on a high probability of a genetic defect to offspring.
  5. Implantation of the embryo in the right place: an embryo that is accidentally implanted in the mother’s fallopian tube could result in a dangerous ectopic pregnancy.
  6. Prescribing the wrong drugs: a failure to properly prescribe or screen a patient before administering fertility drugs that are not appropriate for the patient may result in serious harm.

Issues are incredibly rare

These issues are incredibly rare. While there are no reliable statistics for some countries, the statistics for developed countries reveal a low probability that any kind of IVF procedure will result in an error or a mix-up.

A study published in 2020 found that, between 2009 and 2019, out of approximately 2.5 million IVF procedures in the US, 133 errors happened that resulted in lawsuits. 87 of these involved two alleged freezer tank failures in 2018 and 2019. This is a risk rate of 0.00005%, roughly the same risk as dying from a bee/wasp sting in any given year!

This is not to downplay the distress caused by this kind of issue, which can be devastating. But even if the true error rate in IVF is higher than studies suggest, it may be that DNA testing platforms like Ancestry may reveal quite a few more Jessica Harveys in future. It is likely to be much lower than error rates in medicine overall e.g., studies show 21% of US patients report having experienced a medical error at some point.

The exception, errors during IVF proves the rule that IVF is extremely safe and generally error-free.

Rather than risk and error being the story, perhaps the media should focus on the bigger issue, access to IVF for infertile women and the influence of cost/affordability and availability.