A Day in the Life of an Embryologist
The Questions you should be asking about the laboratory process in handling eggs and sperm. by Karen Synesiou
Most patients spend considerable time researching IVF success rates, physician experience, and treatment costs. Few spend time asking about the laboratory where their eggs, sperm, and embryos will actually be handled.
Yet some of the most important questions in fertility treatment have nothing to do with pregnancy rates and everything to do with safety, identification, tracking, and accountability.
Every day, thousands of eggs, sperm samples, and embryos are handled in fertility laboratories around the world. Behind each embryo is a highly trained team of embryologists working with extraordinary precision. Eggs are retrieved, identified, fertilized, cultured, graded, frozen, thawed, and transferred. Every step requires attention to detail. Every decision matters.
Most patients never see this process. They meet their physician, discuss treatment options, review success rates, and place enormous trust in the IVF doctor they have chosen. Yet the laboratory is where much of the most critical work actually occurs.
On a busy day, an embryologist may be handling dozens of eggs and embryos belonging to multiple patients. Procedures are performed under strict protocols and quality control systems. However, as recent lawsuits and highly publicized laboratory errors have demonstrated, mistakes can still occur. While such events remain rare, the consequences can be devastating for the families involved.
In the United Kingdom, fertility clinics are required to report laboratory incidents, near misses, and errors. According to the Human Fertilization and Embryology Authority (HFEA), 517 incidents were reported in 2022/23, 581 incidents in 2023/24, and 792 incidents in 2024/25. More than 99% of treatment cycles were completed without any reported incidents.
Unfortunately, no comparable national reporting database exists in the United States. Instead, the industry primarily tracks pregnancy rates, live births, and treatment outcomes. While these statistics are important, they provide little insight into laboratory errors and near misses.
Court cases and public reports demonstrate that incidents do occur.
Recent years have seen a number of laboratory error reports such as:
- Embryos being transferred to the wrong patient.
- A Florida couple gave birth to a baby and immediately knew the child was not biologically related to them.
- In AP v. CHA Health Systems, a woman gave birth to twins. DNA testing later revealed that neither baby was biologically related to the intended parents, and the twins were not genetically related to one another.
- A woman in Georgia recognized immediately after delivery that the child she had given birth to was not genetically related to her. She later described walking into court as a mother with a child she loved and leaving with an empty stroller.
- Incorrect sperm being used to fertilize eggs.
- A Utah couple reached a settlement after learning that their child was genetically related to the mother but not to the intended father.
- Embryos being lost during storage.
- One woman was informed that no embryos remained from her IVF treatment. After her husband’s death and years later, the clinic unexpectedly billed her for the storage of embryos she had been told no longer existed.
- Embryos being mistakenly discarded.
- A lawsuit filed in Los Angeles alleges that embryos were improperly labeled before incubation and were later removed and discarded.
- Incubator failures resulting in the destruction of embryos.
- Multiple lawsuits have been filed against a California fertility facility after an incubator-related error allegedly destroyed all embryos being stored within the affected equipment.
- Cryogenic storage tank failures.
- In 2018, two major storage tank failures resulted in the destruction of thousands of frozen eggs, sperm, and embryos.
These events remain rare. The overwhelming majority of IVF cycles, (99%), proceed without incident. However, when mistakes occur, the consequences can be life-changing for the families involved. For this reason, patients should feel comfortable asking difficult questions before beginning treatment.
As an informed patient, you should ask:
- How are eggs, sperm, and embryos identified throughout the IVF process?
- Does the laboratory use an electronic witnessing system?
- Are barcodes, RFID technology, or other automated verification tools used?
- How many manual verification steps are required during fertilization, freezing, thawing, and transfer?
- How are frozen embryos tracked and monitored?
- What safeguards are in place to prevent mix-ups?
- What happens if an error occurs?
Many patients hesitate to ask these questions because they assume every clinic uses the same technology and procedures. That is not necessarily the case.
Laboratories vary in their protocols, staffing, equipment, and investments in technology. Some clinics have implemented advanced electronic witnessing systems that require multiple automated verifications before critical procedures can proceed. Others continue to rely more heavily on manual witnessing performed by laboratory staff.
Technology has advanced significantly over the past decade. Modern witnessing systems can electronically verify patient identity at multiple stages of the IVF process, helping reduce the risk of human error. Some systems use barcode scanning. Others use RFID technology. These systems create permanent digital records of every verification event and provide an additional layer of protection beyond traditional manual checks.
While no system can eliminate risk entirely, technology can reduce opportunities for error and improve accountability.
Patients should also consider asking about embryo storage and monitoring. Embryos may remain frozen for many years before being used. Understanding how old the cryogenic storage tanks are, how they are monitored, what alarm systems are in place, whether backup systems exist, and how clinics respond to equipment failures can provide valuable insight into a clinic’s commitment to safety.
None of this should be interpreted as criticism of embryologists.
On the contrary, embryologists perform some of the most demanding and consequential work in modern medicine. They operate under intense time pressures and carry enormous responsibility. Most spend their careers helping create families while maintaining exceptional standards of care.
But because they are human, mistakes can happen.
As technology continues to evolve, additional safeguards are becoming available. One example is early DNA testing during pregnancy. By analyzing fetal DNA found in the blood of the pregnant woman or surrogate, laboratories can compare the baby’s DNA with that of the intended parents. Alternatively, DNA testing can be performed after giving birth. While DNA testing is not a substitute for robust laboratory protocols and tracking systems, it does provide an additional layer of reassurance for families created through IVF and third-party reproduction.
As the fertility industry continues to evaluate ways to improve transparency and patient confidence, these technologies deserve thoughtful consideration.
Perhaps the larger question is this: why are more patients not already asking these questions?
IVF patients are placing their future children into the hands of a laboratory they may never see and professionals they may never meet. Understanding how embryos are identified, tracked, stored, and protected should be just as important as understanding success rates and treatment costs.
After all, these are not simply laboratory specimens. They are future sons and daughters. And every patient deserves to understand the safeguards that stand between hope and heartbreak.
Editor’s Note: In both her personal life and professional career, Karen Synesiou championed the belief that creating a family is a universal right transcending societal barriers. As Karent puts it, “Witnessing the joy of families coming together has always been a source of inspiration for me, deeply influencing my ethos and professional path.”