This lawsuit concerned a woman who sought in vitro fertilization services and subsequently sued the fertilization clinic for an allegedly negligent procedure that left her with no available options to continue IVF. Two harvests of the patient’s eggs were conducted, but two days into the incubation period of the second harvest the carbon dioxide tube was discovered to be disconnected from the incubator. Of the seven eggs undergoing incubation, six died and one was found to have genetic abnormalities that rendered it unstable. An expert in fertilization was required to determine the role that the disconnected carbon dioxide tube, which was used to control the acidity level inside the incubator, may have played in the death of the six eggs.
Question(s) For Expert Witness
- 1. What is your familiarity with the In Vitro Fertilization process?
- 2. What effect might the removal of the CO2 tube from the incubator have had on 1-2 day old eggs in incubation?
Expert Witness Response E-124847
Carbon dioxide is used to maintain the pH around a level of 7.3 during the period when embryos are cultured in vitro. Most commercial incubations provide this pH within a narrow range of 7.25-7.35, depending on the altitude of the incubator itself. Deviation in pH may cause the embryos to not grow as well or steadily as they might in a more optimal environment. The harm caused to the embryos by lack of CO2 will depend on the duration of deprivation. Early stage embryos, which have only developed between one to eight cells, may exhibit slow embryonic cleavage. We have not experienced any such issue in our laboratory, and most IVF laboratories are equipped with alarms that alert the laboratory personnel if any deviation in temperature or gas parameters are encountered.
Expert Witness Response E-124919
Incubators are the most critical pieces of equipment in an IVF laboratory. Carbon dioxide helps maintain the pH of the culture medium. Lack of this carbon dioxide will have an effect on the pH and any increase in the pH will decrease embryonic development. This is why a stable pH environment is crucial in avoiding potential stress to the embryos which can impair embryo metabolism, alter organelle localization, and even retard resulting fetus. In my research work, the effectiveness of different media, incubators and appropriate quality control measures have been evaluated.