How Often Are There ART Mistakes?

One quick note to add to the whole wrong embryo discussion, one that also ties back to an earlier and more general post about ART mistakes.  This story reports that a single clinic in the New Orleans area mislabeled dozens of frozen embryos creating the potential for many mix-ups like that experienced by Carolyn and Sean Savage.   

Even in the best of all possible worlds, mistakes are bound to happen.  And in our particular world, we really don’t know how frequently they occur.   That’s one of the reasons why all the legal uncertainty I’ve detailed is so important.  While the Savages and the Morells appear to have agreed on an outcome in their case, that won’t always be the case.   Litigation is bound to occur.  This new story convices me that it may well be sooner rather than later.

The Wrong Embryo and Language

Just a quick coda to the recent case popularly referred to as “the wrong embryo case.”  (And yes, I’ve used that terminology, too.)  Thursday Carolyn Savage gave birth to a baby boy and the boy will be raises by the Morells, who are genetically related to him.

What’s most notable to me is the language the Morell’s used to describe Carolyn Savage.  In earlier discussions here I and some commenters touched on whether she would be considered a surrogate.   But the Morell’s chose to call her a “guardian angel” and the headline writer shortened that to “guardian.” 

A long time ago on this blog I struggled with word choice in various surrogacy situations.   Nothing like “guardian” ever crossed my mind. 

It’s an interesting choice.   I think, at least in this context, to be called a guardian is to given a certain amount of honor.   It’s a more favorable term than “surrogate.”  There is a way in which, particularly under these circumstances, it seems appropriate.   But there is a tinge of something there that makes me a trifle uneasy.  (Is it from the Handmaid’s Tale?)      

I wonder if the term has a future outside of this one instance?

The Wrong Embryo and the Patchwork Quilt

As more details are reported about the recent wrong embryo case I can see even more issues to discuss.  (I’ve done several recent posts about it and there’s been some interesting discussion there.)  

To recap quickly, Carolyn Savage and her husband Sean had donated their own genetic material to create some embryos in order to use IVF.  After the birth of one child, the remaining embryos were frozen.    Last winter they went back to the clinic to use some of those frozen embryos in the hopes of having another child.    

Carolyn Savage did get pregnant but it turned out that the clinic had mistakenly used embryos of another couple, Paul and Shannon Morell.   Now as it happens, this time it seems it will work out as well as it possibly could–the couples are in contact and the Savages have agreed to turn the baby over to the Morells once it is born.   The key thing, to me, is that the couples have come to an agreement. 

But here’s a thing that leapt out at me in today’s news. 

The Wrong Embryo: Variations on a Theme

I want to continue the wrong-embryo thread a bit longer, but before I do I want to make it clear that I am now fully in the realm of the hypothetical.   The discussion here takes off from the earlier posts, but I’m now changing facts freely just to make myself good questions. 

In the real world, the Carolyn Savage ended up pregnant after an embryo that belonged to someone else was transferred into her uterus.   Now we’ve assumed that the embryo was actually created with the other couples sperm and egg.  But suppose that is not the case.   Suppose the other couple had purchased one of the elements (let’s start with sperm) and then used it to create the embryos that were frozen. 

The Wrong Embryo, II: An Afterthought

This picks up from yesterday’s post–read that first.  

Consider the position of the hospital when Carolyn Savage gives birth.   The hospital is obliged to prepare a certificate of live birth.   Suppose there is a blank for “mother” on the birth certificate.  What name should go in that blank?    

I am fairly sure that the ordinary practice is to fill in the name of the woman who just gave birth.   If  the Savages want to put some other name on the certificate (like the name of the woman whose egg was used and who will parent the child), should the hospital let them do that?   Should it require them to produce some sort of document instructing it (the hospital) to do so or should it just take any name they offered?   

The Wrong Embryo, II

I just sat down to write this entry, inspired by this morning’s Today Show and lo, I found I had already used my title.  Six months ago I wrote about another wrong embryo case, but I guess I’d forgotten.   Just goes to show that, as I said in that earlier post, accidents will happen.  

Anyway, here is the story from this AM:  Carolyn and Sean Savage had used IVF to conceive their third child.  They had left-over embryos which were frozen.   They decided they wanted to try to have a fourth child and so went to have the embryos thawed and transferred. 

A pregnancy resulted.   But it turned out the clinic had used the wrong embryos–embryos that had been prepared and stored for some other couple.   Somehow this came to light quite quickly (though obviously not quickly enough) and so the news of the error arrived along with the news that Carolyn was pregnant.   

Is Embryo Adoption Adoption?

(I’m both away for the Labor Day weekend and under the weather, so this will be short.) 

Last year I followed the progress of legislation in Georgia around some aspects of assisted reproduction.   (This is the end of the line, but the link there can take you to earlier posts.)  What began, at least ostensibly, as a legislative response to the birth of octuplets to Nadya Suleman ended with a law the promotes what is called “embryo adoption.”  

The idea here is that there are said to be many embryos left over from IVF attempts that are essentially in storage.  

The Wrong Sperm

A month or so ago I wrote about a wrong embryo case in Japan.   Here’s news of a case in the same general genre (ART mistakes) from the UK.    The story is pretty simple and I’m not sure how much there is to say about it.   The reporting seems a tad more interesting.

Three couples were using IVF at the same London hospital.   It appears that these were different sex couples and for each couple the plan was to use sperm from the man and an egg from the woman, to create an embryo, and then to transfer the embryo into the woman’s uterus.   The problem, for each of these three couples, was that they used the wrong sperm.

Now in this instance the mistake was caught within hours–it’s not clear to me that fertilization had even occurred.   This is quite a bit different from the case in Japan where the embryo was transferred and pregnancy resulted.   As soon as the mistakes were discovered, the sperm and eggs were discarded.   

Georgia Update–Embryo Adoption Legislation Enacted

For some time now I’ve been following legislation in Georgia.   You can read through the older posts by following that link.   This all seemed to begin with the octuplets born in California.   (I’ve written quite a bit about that circus.  You could use the tag “octuplets” or start here and poke around a bit.)   The uproar around the octuplets (who you may recall were conceived via ART) lead to calls for regulation of ART.   At the time I wrote that this rush to regulation worried me and might go off in all sorts of unexpected (and to my mind undesirable) directions.

The Georgia legislation is actually a pretty good example of how the legislative process, once set in motion by public concern over one particular topic, can develop a life of its own.  Or perhaps more accurately, can serve as a vehicle for other interests.

I won’t retrace the whole history here–it’s there in the past posts on Georgia’s legislation.   But this is the end of the story, at least for this year.   The Georgia legislature has enacted a bill--HB388--that ostensibly provides for the adoption of embryos.  (It’s called the Option for Adoption Act.)    If you do not want to read the actual bill, you can read news coverage here.

The Wrong Embryo

No matter how careful they are, people make mistakes.   And mistakes create situations that no one ever intended, sometimes that no one ever imagined .    One thing this means is that you can learn a great deal by examining what happens when mistakes are made.

There’s a law professor whose written about this and her work is very thought-provoking.   Her name is Leslie Bender and you can find her work at her author page at SSRN (That’s one of those sites you must register for, although registration is free.   You can find my published work there, too.)   It’s worth your time.

Anyway, it is with her work in mind that I approach this next story.    There’s a longer account of the same incident here, one that raises some good points but also omits some details and is frustratingly sloppy in part.

A woman in Japan was undergoing IVF.  Embryos were created using her eggs and were then to be transferred into her uterus.   (One thing I wonder here is where the sperm came from, but let that go for now.)  Three embryos were transferred, two of which were ones created using her eggs.  By mistake, the clinic transferred a third embryo, one created with an egg of another woman who was also undergoing IVF.  The embryos were transferred on September 18 and September 20.

By October 7 it was clear that the woman was pregnant and somehow, around October 16 the doctor began to suspect that growing embryo was the one that had not been created with her eggs.  (I’m weak on the science, but I’d really like to know what would make the doctor suspect this.)   The thing is, there was apparently no way of being certain about this without doing amniocentesis, which could not be done for some time.