In-vitro fertilization laboratory safety: engineered through people, process, and planning

PURPOSE OF REVIEW: IVF laboratories operate in biologically constrained environments where strict timing and chain of custody govern patient safety. In the last decade, the field has undergone a seismic operational shift as the transition to the freeze-all model has exponentially increased specimen inventories, altering the risk profile from acute procedural errors to latent infrastructure and data management failures. This review examines the risks of relatively new field threats and outlines strategies necessary to mitigate them. RECENT FINDINGS: As frozen embryo transfers increasingly dominate the assisted reproductive technology field and social freezing becomes prevalent, the risk for the embryos and gametes concentrates in a long-term perspective. While procedural error rate in IVF labs remains rare, reviews of recent disasters highlight vulnerabilities in cryostorage monitoring, proper witnessing, and data transferring. SUMMARY: Modern IVF laboratories face tail-risk scenarios where rare equipment or data failures can affect hundreds of patients. Mitigating these threats requires a shift from relying on human alertness to preventive work resilience. Accreditation standards govern changes, while automated technologies such as weight-based cryostorage monitoring and electronic witnessing protect the identity, viability, and genetic integrity of patients' specimens.