Risk and Safety in the IVF Clinic

  • Julius Hreinsson
  • Kia Borg


Prioritizing is an important part of risk management as it helps us to allocate resources to where they are of most utility. This requires us to quantify the different risks. All severe risks must be addressed as they can threaten the continued existence of the clinic or the life of a patient. However, also insignificant events that are highly likely to occur should be addressed, as they will drain the resources of the clinic. This process only indicates the priorities but does not suggest how to address the risk issue. In assessing risk, we are often hampered by the lack of knowledge of the exact nature of the risks, and quantifying the risk of rare events is problematic. Also, when assessing outcomes, one must know what to look for, and in many cases, we have a limited knowledge of the processes in human development and their vulnerabilities to our in vitro systems and the endocrine environment we create in ART. In principle, there are three ways of managing risk: elimination, reduction, and transfer.


Risk management in the IVF clinic Safety in the IVF clinic Risk identification Long-term risks of IVF Ergonomics in the IVF laboratory 



A previous version of this chapter was written in collaboration with the late Dr. Peter Sjöblom. We owe a debt of gratitude to him for his knowledge and his generous input from years of experience in the field of assisted reproduction.


  1. 1.
    ESHRE position paper 2008. Good clinical treatment in assisted reproduction. Accessed 14 Oct 2016.
  2. 2.
    Gleicher N, Barad D. Twin pregnancy, contrary to consensus, is a desirable outcome in infertility. Fertil Steril. 2009;91(6):2426–31.CrossRefGoogle Scholar
  3. 3.
    Sauer MV. Italian law 40/2004: a view from the ‘wild west’. Reprod Biomed Online. 2006;12(1):8–10.CrossRefGoogle Scholar
  4. 4.
    Braat DD, Schutte JM, Bernardus RE, Mooij TM, van Leeuwen FE. Maternal death related to IVF in the Netherlands 1984-2008. Hum Reprod. 2010;25:1782–6.CrossRefGoogle Scholar
  5. 5.
    Adams S, Carthey J. IVF witnessing and electronic systems—final report 2006. Accessed 14 Dec 2016.
  6. 6.
    Kupka MS, D’Hooghe T, Ferraretti AP, de Mouzon J, Erb K, Castilla JA, Calhaz-Jorge C, De Geyter C, Goossens V. Assisted reproductive technology in Europe, 2011: results generated from European registers by ESHRE. European IVF-monitoring consortium (EIM).; European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod. 2016;31(2):233–48.PubMedGoogle Scholar
  7. 7.
    Gozlan I, Dor A, Farber B, Meirow D, Feinstein S, Levron J. Comparing intracytoplasmic sperm injection and in vitro fertilization in patients with single oocyte retrieval. Fertil Steril. 2007;87(3):515–8.CrossRefGoogle Scholar
  8. 8.
    Kim HH, Bundorf MK, Behr B, McCallum SW. Use and outcomes of intracytoplasmic sperm injection for non-male factor infertility. Fertil Steril. 2007;88(3):622–8.CrossRefGoogle Scholar
  9. 9.
    Luna M, Bigelow C, Duke M, Ruman J, Sandler B, Grunfeld L, Copperman AB. Should ICSI be recommended routinely in patients with four or fewer oocytes retrieved? J Assist Reprod Genet. 2011;28(10):911–5.CrossRefGoogle Scholar
  10. 10.
    Tomás C, Orava M, Tuomivaara L, Martikainen H. Low pregnancy rate is achieved in patients treated with intracytoplasmic sperm injection due to previous low or failed fertilization in in-vitro fertilization. Hum Reprod. 1998;13(1):65–70.CrossRefGoogle Scholar
  11. 11.
    U.S. Chemical Safety and Hazard Investigation Board. Hazards of nitrogen asphyxiation. Safety Bulletin No. 2003-10-B: June 2003. Accessed 27 Oct 2010.
  12. 12.
    Tomlinson M. Risk management in cryopreservation associated with assisted reproduction. Cryo Lett. 2008;29:165–74.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Julius Hreinsson
    • 1
  • Kia Borg
    • 2
  1. 1.Mount Sinai FertilityTorontoCanada
  2. 2.Livio Fertilitetscentrum GöteborgGöteborgSweden

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