Stine Willum Adrian calls for better ways of dealing with mistakes made by fertility clinic laboratories.
What does one do when eggs, sperm, or embryos are mixed up in a fertility clinic lab? This is a difficult question, since mix-ups in the laboratory are not supposed to happen. Unfortunately, they sometimes do.
Marcus, a 19 year-old born and raised in Denmark, is the result of such an incident. In July he went public with his story in the Norwegian media in the hope of finding his genetic mother, a woman living in Iran.
Marcus’ parents had gone through fertility treatments at a private Danish clinic. As Marcus grew up, his parents suspected that a mix-up in the laboratory had taken place. With his dark complexion, brown eyes, and dark hair, Marcus looked different from his Scandinavian-looking, blonde-haired, blue-eyed family.
As it turned out, a cryopreserved embryo from an Iranian woman and a sperm donor had been mistakenly implanted into Marcus’ Danish mother. Marcus found out from the clinic that his genetic mother had a sister that lived or had lived in Norway. He hoped to find her and to get in touch with his other genetic relatives, and went to the Norwegian media for assistance.
Marcus’ story is unique in many ways. Since Marcus and his family have made a legal settlement with the clinic, they are restricted with regard to what they may say in public. Therefore, his story has been told in bits and pieces in the media.
From what has been reported, it seems that this mistake was poorly handled by the clinic responsible for it. According to some media reports, the clinic knew that a mistake had been made during Marcus’ mother’s pregnancy, but they never informed her. Instead, Marcus’ parents became suspicious after his birth that he was not genetically related to them, and confirmed their suspicion by a blood test they conducted when he was three years old.
Additionally, the woman in Iran—Marcus’ genetic mother—has been kept ignorant of what happened to the embryo she left cryopreserved in the Danish fertility clinic. Furthermore, Marcus’ Danish family has not received support to help them adjust to the news of the mistake.
Stories of mistakes in clinical practice are deeply troubling.
With an increase in the global movement of bodies and gametes across national borders, and a growing global private fertility industry, more stories like Marcus’ will come to light.
An estimated, 8-9% of Danish-born babies are conceived annually using assisted reproductive technologies. Considering the number of fertility treatments that have taken place in Denmark, it is surprising that Marcus’ story was the first to be reported in the media.
In 2007, Denmark implemented the European Union Tissue and Cells Directive as a means to ensure quality and safety regarding handling of cell and tissue. Yet, shortly after Marcus’ story broke, journalists reported that at least five other incidences of switched eggs, sperm, or embryos have taken place since 2007.
In the Danish media, stories of laboratory mistakes have been feeding a critical discussion about assisted reproductive technologies. There has been a call to strengthen clinical procedures to prevent future mistakes. In particular, there has been a call for improved documentation and practices that help to secure the traceability of everything from gametes to the tips of the pipettes.
Although clinical practices could be improved to help prevent future mistakes, the focus on prevention alone will not help Marcus, or any other people who have already been affected by laboratory mix-ups in assisted reproductive technology. Even in the best scenario, mistakes can still happen. During in vitro fertilization, eggs, sperm and embryos are manipulated outside the human body, and can be accidentally switched in a laboratory.
Where mistakes have already occurred, we need to address the identity issues and kinship troubles that are faced by these children and their families. This includes possible racism in the society where this occurs (as in the case of Marcus).
Marcus’ story teaches us that we cannot always prevent or undo laboratory mistakes. We are in urgent need of an ethical framework that can deal with these lab mix-ups. In other words, we need to switch from a mistaken ethics to an ethics of dealing with mistakes.