Risk and Safety in the IVF Clinic

Abstract

Prioritising 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. For example, our knowledge of long-term risks of IVF is limited because human IVF has not been practised long enough for data to accumulate on this issue. 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.