A Practical Evaluation of Ivf Electronic Witnessing and Labeling Systems Within the Fertility Clinic Setting

Objective: Because of the complexity of IVF procedures, the IVF lab operates under significant stress and faces a risk of mismatches during the handling of gametes or embryos. Electronic witnessing systems (EWSs) are being promoted for use within the IVF clinic to prevent human error. This study is to determine how EWS identify and potentially prevent misidentification of patients and their gametes. Design: Retrospective and survey study at an academic IVF center Materials and Methods: Matcher, a barcode-based IVF EWS, was used for this study. The mismatch records from October 2022 - December 2024 of an EWS utilized at our clinic were analyzed to distinguish the origin of error using a photo and/or a lab reported note. The records were categorized as either a false positive (device system error) or a true mismatch (patient ID mismatch). In addition, clinical and lab staff were provided an anonymous survey to determine nursing, physician, lab, and patient perspectives on EWS implementation and efficacy. Results: A total of 113 mismatches occurred within the observed time frame of which 88 (77.88%) were categorized as false positives and 25 (22.12%) were categorized as true mismatches. Of true mismatches, 10 (8.85%) were labeled as patient data transcription errors and 15 (13.27%) were labeled as incorrect patient sample. Notably, all true mismatches were identified before opening any dish or tube that might have been missed without EWS. There was a noted decrease in mismatches approximately 6 months after the initial setup of the EWS. Survey results showed that 100% (n=4) of laboratory staff saw an increase in workload with an EWS and 75% agreed that it prevented misidentifying specimen. 100% (n=11) of all clinical staff surveyed agreed that an EWS gave patients more confidence in our clinic, with over 81% feeling very to extremely confident that all samples within our labs were identified correctly. Conclusions: The electronic witnessing system (EWS) reduced misidentification risks in our IVF lab, with most mismatches being false positives early after implementation. All true mismatches occurred before gamete handling. Despite increased workload, staff acknowledge its effectiveness in improving safety and patient confidence, especially when only one embryologist works in the lab.