Will Embryo Mix-up Ultimately Make IVF Clinics Safer?

Intended parents everywhere are wincing this week, as they imagine themselves in the shoes of at least two heartbroken couples whose lives were turned upside down by an IVF clinic’s mistake, their tragedy broadcast to the world in sensational headlines.

As reported originally by the New York Post, a married Queens couple, identified only as YZ and AP, after struggling with infertility for years, turned in 2018 to Los Angeles-based CHA Fertility Center for help. Following a months-long regimen of medicines, vitamins, tests and procedures and some $100,000 in cash outlays, the couple produced eight embryos. A first attempt at implantation in July 2018 failed; a second procedure, in which two female embryos reputedly were implanted, was successful, and by September 2018, AP was pregnant.

Back home in Queens, the couple soon began to feel something was wrong. Ultrasound scans indicated that AP was pregnant with twin boys, rather than the girls they had been told AP was carrying. When they called CHA to ask about the discrepancy, they were assured the ultrasound was wrong and that AP was carrying twin daughters.

In March 2019, AP gave birth via Caesarean section to two boys, and not the twin girls the couple had been expecting. To inflame the situation even more, the boys did not appear to share their parents’ Asian ethnicity. Genetic testing quickly revealed the disturbing truth—the two boys AP carried and gave birth to were not genetically related to her or her husband—and were not even related to one another. In other words, AP, believing herself to be pregnant with her own twin daughters, had instead unknowingly served as a surrogate for the sons of two other couples.

The babies were the genetic offspring of two other CHA client couples, and AP and YZ gave the boys to their biologically related parents. What happened to their own twin female embryos, they still don’t know to this day.

Meanwhile, on the West Coast, as reported by The Daily Beast, CHA clients Anni and Ashot Manukyan received the surprising news that they were biological parents of a son, one of the boys carried to term by AP back in New York.

As a CHA client in 2018, Anni was implanted with two embryos the couple believed had been created using her eggs and Ashot’s sperm. That procedure failed, and Anni did not become pregnant at that time.

In hindsight, the Manukyans now realize the embryos Anni received could not have been their own genetic material, since one of their embryos had ended up with AP in New York. While they eventually gained custody of their son born to AP, they did not even know of his existence until he was two weeks old, and he was six weeks old before Anni was able to hold him for the first time. AP and YZ remain bereft, too embarrassed and sad to try to explain their situation to family and friends.

Both couples are suing CHA; both are struggling to recover from the heartbreaking and traumatic chain of events.

This indeed is a truly terrible story, and one that opponents of surrogacy and other forms of reproductive technology will try to use as ammunition. The fact that such mistakes are exceedingly rare does nothing to relieve the pain and suffering of intended parents whose dreams of parenthood are destroyed. But while risk exists, there are steps intended parents can to help minimize it.

Even within a highly regulated health care system such as that in the United States, patients are well advised to serve as their own advocates and do the homework to ensure they receive the best care possible. The truth is, as ever-improving outcomes encourage more people to turn to surrogacy as a path to parenthood, intended parents—in the role of patients—also must accept part of the responsibility for conducting due diligence.

The U.S. Centers for Disease Control and Prevention (CDC) maintains a database of fertility clinics and outcomes statistics, which is a good starting point. When vetting potential providers, consider your unique situation, including age and medical condition, in deciding whether a clinic a good match for you. Ask about the clinic’s policies, including any age limitations on treatment, who decides how many embryos to implant, and whether the providers are up-to-speed on the most advanced technologies. If the clinic staff can’t or won’t answer your questions, move on to a provider who understands the importance of ensuring its patients are fully informed and knowledgeable.

Don’t be afraid to address your concerns. Ask what measures the clinic takes to prevent cryopreservation tank failures, another IVF “scandal” that made headlines recently. Ask what safety procedures are currently in place to avoid mixing up or mismatching of embryos and parents or surrogates.

Most clinics have redundancy procedures in place, such as having one embryologist watching another one perform the embryo transfer, including literally going through a checklist when the embryos are retrieved from the tank to make sure the correct ones are pulled, all the way through to the implantation procedure to make sure the correct embryos are transferred. 

Some clinics will even allow intended parents who can’t be there in person to Skype in to the embryo transfer and watch the procedure.

Compared to the tens of thousands of successful IVF procedures, instances of human error or mechanical failure resulting in embryo loss are rare. Of course, that fact doesn’t mitigate the trauma and heartbreak suffered by intended parents who have lost embryos or given birth unwittingly to someone else’s child. My years of experience working with care providers, surrogacy and donor agencies and my fellow attorneys have convinced me that most of the professionals working in this field are passionately committed to achieving the best possible outcomes for their clients and patients. Painful and scandalous as the current embryo mix-up story is, there is no doubt it serves as a cautionary tale and a motivator for clinics to redouble quality assurance and safety efforts. The best possible outcome of this unspeakable tragedy will be heightened vigilance and safer, more accountable IVF clinics.

 

Rich Vaughn
Richard Vaughn
rich@iflg.net

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
PEIYA WANG(王培娅)
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya received her bachelor’s degree from Beijing Technologies and Business University, where she majored in Marketing. She moved to the United States in 2012 to attend Northeast University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015 and received her paralegal certification from UCLA Extension. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa
LUIS SOSA
Paralegal

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes
TONI HUGES
Paralegal

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”

Miesha Cowart
MIESHA COWART
Financial Coordinator

Miesha Cowart joined IFLG as a financial specialist in 2014 following a successful career in development and business finance. Miesha previously worked for 10 years in the construction industry as a controller and for 13 years as Development Coordinator for the non-profit U.S. Fund for UNICEF. In her free time, Miesha works with “Next Generation” at her church. “They are my heartbeats!” she says of the youth in her community.

Kim
KIM DEVEREAUX
Paralegal

Kim has over 25 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager of surrogacy and egg donation cases, and is also responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn
RICHARD B. VAUGHN
Founder

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo
ELIZABETH TAMAYO
Paralegal

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien
SUNNY CHIEN
Paralegal

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

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