Monash IVF have announced a second IVF mix-up, two months after one of their clients gave birth to a genetically unrelated baby. In a statement to the ASX, the company said "a patient's own embryo was incorrectly transferred to that patient, contrary to the treatment plan which designated the transfer of an embryo of the patient's partner". The Chief Executive Officer of the company has since resigned.

Dr Evie Kendal, senior lecturer of health promotion at Swinburne University of Technology, told the AusSMC these mix-ups would likely weigh on the minds of those aiming to have children via assisted reproductive technology.

"The news that another woman in Australia has had the wrong embryo transferred in an IVF procedure is likely to cause a lot of discomfort among other clients of assisted reproductive services, both here and overseas. Many of us feel immediate sympathy for the individuals involved and the complicated feelings this incident may have caused," Dr Kendal said.

Bioethicist Hilary Bowman-Smart from the University of South Australia said the mistakes of one company could affect the whole industry.

"In reproductive care, trust is everything. Patients entrust clinics with embryos that may represent their only opportunity to have children," Dr Bowman-Smart said.

"This mix-up - the second reported incident at Monash IVF - risks shaking confidence not just in one provider, but across the entire fertility sector."

Associate Professor Alex Polyakov, Medical Director of Genea Fertility Melbourne, said these errors were "still extraordinarily uncommon" across the 40 years IVF has been used in Australia, however, the fact that it happened twice was worth reflecting on.

"IVF clinics operate within some of the most highly regulated and scrutinised environments in medicine. Multiple safeguards—including dual verification and electronic tracking—exist at every step to prevent precisely this kind of error. Australia’s assisted reproduction sector is internationally recognised for its rigorous oversight and quality control," A/Prof Polyakov said.

"Although human error can never be entirely eliminated, incidents like this are not indicative of widespread system failure. Instead, they highlight the need to review how even robust systems respond to rare but serious breaches."

Professor Jeremy Thompson, Chief Scientific Officer of Fertilis, said IVF was carried out in an often challenging work environment.

"Being an embryologist places high demands on skills and concentration and can be stressful, particularly in busy laboratories, where skill and time management are critical for the best outcome from applying the multiple procedures conducted in the laboratory," Prof Thompson said.

"Globally, there is a shortage of well-trained and experienced embryologists, and as such, levels of training and experience can vary. Australia’s reputation as a leader in embryology training and technique auditing is beyond question."

"Although there is not yet formal accreditation of embryologists in Australia, auditing is conducted through an arm of the Fertility Society of Australia and New Zealand, along with professional development programs conducted in states and nationally."

Dr Kendal said advances in reproductive technologies have come alongside changes in the way we look at the "genetic, gestational and social elements of motherhood."

"By introducing more areas of human intervention into reproduction, such technologies also introduce the potential for human error, as has been seen in these cases. Previous safeguards are clearly not up to the challenge of protecting clients against such incidents, and urgent ethical and policy guidance is needed to prevent such mistakes from occurring again," she said.

"As new technologies further expand and challenge our conception of the family, we need to stay focused on providing the circumstances for all children to be loved and cared for in society, including when things don't go to plan when using assisted reproduction."

You can read the full Expert Reaction here

This article originally appeared in Science Deadline, a weekly newsletter from the AusSMC. You are free to republish this story, in full, with appropriate credit.

Contact: Rachel McDonald

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Email: info@smc.org.au