Failsafes & Oversight
Building Safer, More Accountable IVF Systems
In vitro fertilization is a highly technical medical process involving the creation, storage, handling, and transfer of human embryos. The emotional and lifelong significance of this care is profound.
While IVF clinics operate within various reporting, accreditation, and laboratory frameworks, there is currently no single, enforceable system that establishes universal safety and chain-of-custody standards across all practices. Professional guidance emphasizes rigorous procedures and transparency when errors occur, yet minimum safeguards and oversight mechanisms vary widely between clinics.
Hope Without Harm advocates for practical, evidence-based safeguards that reduce preventable risk, support clinicians, and protect families.
Why Oversight and Safeguards Matter
In other areas of high-risk medicine, such as organ transplantation, blood banking, and pharmaceutical manufacturing, standardized chain-of-custody rules, redundancy, and independent oversight are required.
IVF has advanced rapidly as a technology, but safety systems and oversight have not advanced at the same pace. Most clinics are committed to good practice, yet reliance on voluntary guidelines and inconsistent standards leaves room for avoidable failures.
Even rare errors can have irreversible consequences for families. Reducing risk is not about blame; it is about designing systems that support accuracy, accountability, and trust.
Common Points of Vulnerability in IVF Systems
Reviews of reported incidents and clinical guidance show that errors tend to arise from predictable system weaknesses, including:
Manual labeling and identification steps
Reliance on visual confirmation alone
Inconsistent witnessing practices
Fragmented or outdated record-keeping
Human fatigue, distraction, or communication breakdowns
Limited independent review or accountability mechanisms
These vulnerabilities are well understood across healthcare and can be mitigated through thoughtful system design.
Safeguards That Can Reduce Preventable Risk
Hope Without Harm supports a layered approach to safety. No single tool prevents errors on its own. Strong systems combine verification, process controls, and accountability.
1. Verification and Identification Systems
Clear, reliable identification is foundational to safety.
Effective practices may include:
Electronic witnessing systems using barcodes or RFID to confirm identity at critical steps
Automated alerts when mismatches or discrepancies occur
Secure, time-stamped logs documenting handling and verification
Electronic witnessing systems are already in use in some clinics and have been shown to reduce identification errors compared to manual witnessing alone.
2. Chain-of-Custody Tracking
Every embryo should be traceable throughout its lifecycle.
Chain-of-custody practices include:
Documented verification at each handling step
Clear tracking of storage location and movement
Records of who accessed embryos and when
Chain-of-custody standards are widely used in other medical fields and provide clarity for both patients and clinics.
3. Redundancy and Process Controls
High-reliability systems are designed so that no single error leads to irreversible harm.
Key principles include:
Multiple independent verification steps
Standardized workflows that limit simultaneous access to multiple samples
Required pause-and-review moments before critical actions
Redundancy supports staff, reduces cognitive load, and improves consistency.
4. Identity Confirmation Enhancements
Paperwork and verbal confirmation alone may not be sufficient in complex clinical environments.
Additional verification methods, including biometric confirmation, may provide another layer of certainty when used responsibly and with appropriate privacy safeguards. These tools are widely used in other healthcare and secure settings.
Identity confirmation should be one component of a broader verification strategy, not a standalone solution.
5. Emerging Technologies
Emerging tools, such as AI-assisted cross-checks or advanced automation, may offer future benefits in identifying inconsistencies or process deviations.
When adopted, these tools should:
Be evidence-based and transparent
Support, not replace, human judgment
Be implemented with clear accountability
Innovation should strengthen safety without introducing new, opaque risks.
6. Independent Audits and Meaningful Accountability
Accreditation and inspections are most effective when they include:
Independent, third-party review
Evaluation of real laboratory practices, not just documentation
Clear expectations and consequences when standards are not met
Oversight builds trust when it is consistent, transparent, and focused on improvement.
7. Error Reporting and Disclosure
Currently, there is no comprehensive public system for reporting IVF errors or near-misses.
Clear reporting and disclosure practices can:
Identify systemic risks
Improve safety across clinics
Support informed patient decision-making
Uphold ethical obligations to patients
Transparency helps prevent repeat mistakes and strengthens public confidence.
8. Patient Transparency and Empowerment
Patients benefit when systems are designed with visibility and clarity in mind.
Optional measures that may enhance transparency include:
Independent witnessing options
Secure patient portals that show key verification steps
Clear explanations of safety protocols and consent processes
Empowered patients are partners in safety, not adversaries.
Our Position
Hope Without Harm supports fertility medicine and the clinicians who provide it.
Support also means encouraging systems to evolve.
IVF technology has advanced rapidly. Safety practices and oversight must advance with it.
Families deserve unified systems designed for safety, transparency, and accountability.
Sources & Further Reading
American Society for Reproductive Medicine (ASRM): Oversight of IVF in the United States
https://www.asrm.org/advocacy-and-policy/fact-sheets-and-one-pagers/oversight-of-IVF-in-the-US/ASRM Ethics Committee Opinion (2024): Disclosure of medical errors involving gametes and embryos
https://www.asrm.org/practice-guidance/ethics-opinions/European Society of Human Reproduction and Embryology (ESHRE): Good practice in IVF laboratories
https://www.eshre.euNational Academy of Medicine: To Err Is Human
https://nap.nationalacademies.orgKato et al. (2018). Electronic witnessing systems reduce risk of human error in IVF laboratories. Reproductive BioMedicine Online.
https://doi.org/10.1016/j.rbmo.2018.02.007