It is difficult to imagine a circumstance where a mix-up in a medical situation could have a more damaging effect than in an IVF laboratory. For this reason, we take this issue very seriously and devote considerable time and effort into designing a system in which a mistake cannot happen.

Staff

Assembling the right team is the most important and fundamental part of running a good laboratory and each and every one of our Embryologists is Board Certified and Licensed in their specialty. The State of California does not currently require licensure for Embryologists, but Pacific Fertility Center insists that all our staff are certified to the highest available standard. We are fortunate in having one of the most highly trained teams in the country and we pride ourselves on our honesty, diligence and thoroughness.

Preparing for a procedure

When a patient is scheduled for a procedure such as IVF or IUI, the laboratory receives at least 24 hours notice of the case. Notice is served in the form of a Requisition, a document submitted by a Physician detailing all procedures to be performed. Upon receipt of this document, an embryologist will begin the preparations for the case. This usually involves the preparation of test tubes and petri dishes containing a special fluid that will be used to incubate, sperm, eggs and/or embryos. Each item is carefully labeled with clear and unique identifying information that includes the patient's name, and the patient is also assigned a color to further code her tubes and dishes.

Once the preparation is complete, the labeled and colored tubes and dishes are assigned to an incubator where they will warm to body temperature and equilibrate until the patient reports for her procedure the following day. We are careful to avoid assigning 2 cases to a single incubator on the same day. Even though an incubator can accommodate up to 3 cases we never have a situation where the eggs from 2 patients are going into the same incubator on the same day. Also, each incubator has 2 doors and both doors are clearly labeled with your name and color code. This allows the embryologist to see your name twice, first on the main door and then on the inner door, before ever handling your specimen.

Performing a procedure - General

In general, we have 2 embryologists performing procedures for the simple reason that we always know that we did it correctly. We are not required to assign 2 people to procedures, but we accept that a little redundancy eliminates the possibility of an error. When sperm are being added to eggs for example, one embryologist actually performs the procedure and another simply observes. Both embryologists sign off that they checked the paperwork, labeling, color code and performance of the procedure.

Performing procedures- Specific Details

Accepting sperm samples: When a man collects a sperm sample and delivers it to our office, we require that the sample is labeled with unique identifying information, including name, SS #, partner's name and signature. We will also collect other information relating to the sample itself, but our first priority is in sample identity and in establishing a chain of custody that will ensure that the specimen is under the control of a member of our staff at all times. The embryologist receiving the sample will note the time and date of receipt and sign that they received it. If they pass the sample to another member of staff, that individual will sign for it, thus continuing the chain. If for example a nurse comes to pick up a processed sperm sample for intra uterine insemination, s/he will sign for it and thus take custody of the sample.

Collecting eggs: When you come for an egg retrieval procedure, an embryologist will ask you your name before you are given any sedating drugs. The embryologist does not rely on anybody except the patient herself to establish her identity. Also, the embryologist will not ask you if you are "Jane Smith", but will instead ask you to state your full name. This avoids any issue of you mishearing the embryologist or being distracted by your surroundings. As your procedure gets underway, 2 embryologists will take responsibility for collecting your eggs and placing them in your already prepared petri dishes.

Inseminating eggs: This is arguably the most important part of the IVF cycle and while it is a relatively simple procedure to perform, we are sensitive to the significance and consequences of the insemination. As a rule, and no matter what the circumstances, 2 embryologists perform the insemination. Even if there's only 1 egg to inseminate, or even if there is only 1 insemination on a given day, 2 people will do it.

Embryo transfer: As with the retrieval procedure, the embryologist will ask you your name and a second embryologist will witness and verify that the correct embryos are being used for transfer. As a final check after the embryos are loaded into the transfer catheter, the embryologist will state loudly to your physician, your full name and the number of embryos in the catheter.

Freezing and thawing of sperm or embryos: Frozen specimens are extensively labeled and catalogued to ensure that we know at any time what you have frozen and where it is located in our tanks. Thawing can only be performed under the direction of a Physician and as a general rule we have 2 embryologists check and double check the paperwork before even opening a tank to retrieve a specimen. Once a specimen is thawed, there's no going back, so we have to be sure we thaw the right specimen first time, every time. Again, 2 embryologists will retrieve the specimen from the freezer only when they agree that the paperwork is in order.

Regular staff meetings

We are always looking for new ways to improve the system and to eliminate the possibility of an error. To this end, we have weekly staff meetings and welcome suggestions on this topic. We discuss problems and try to anticipate situations that might cause conflict in the laboratory, such as having 2 patients with the same name. Good communication between laboratory and Medical staff leads to a simple and well defined system without the possibility of mix ups.