Embryo Development, Grading and Selection Copy —
Training activity: 7

Details

Dispose of unused fresh embryos

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• HFEA traceability and record keeping regulations
• Witnessing regulations
• Informed consent
• Informing patients of fate of individual embryos
• Local SOPs/protocol for embryo disposal

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

What does success look like?

• Identify what is expected of you in relation to disposing of unused fresh embryos accurately and according to stringent regulatory protocols.
• Consider how the learning outcomes apply, specifically in relation to interpreting/reporting results, communicating effectively, and practicing in accordance with regulatory and safety standards, including keeping accurate records of the fates of embryos.
• Discuss with your Training Officer to gain clarity of what is expected of you in relation to the procedure for disposal and the specific regulatory checks required for witnessing and documentation.

What is your prior experience of this activity?

• Think about what you already know about the ethical and legal requirements for embryo disposal, including the need for proper witnessing and documentation.
• Consider possible challenges you might face during the activity, such as ensuring accurate witnessing and double-checking documentation before disposal or handling the emotional sensitivity of the procedure.
• Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example, if the witnessing requirements cannot be strictly adhered to.
• Acknowledge how you feel about the procedure and the need for strict regulatory compliance.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as performing accurate documentation and witnessing procedures for disposal according to regulatory standards.
• Identify the specific insights you hope to gain into the critical importance of record-keeping in final embryo disposal.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of documentation or compliance activities.
• Identify important information you need to consider before embarking on the activity, such as the specific SOPs for disposal, witnessing logs, and correct disposal into clinical waste.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst performing the disposal of unused fresh embryos?
• Are you encountering situations such as:
  • A discrepancy is found between the number of embryos to be disposed of and the recorded documentation, halting the procedure.
  • A necessary witness is unavailable, jeopardising regulatory adherence.
  • The physical integrity of the embryo is surprisingly high, raising a momentary conflict about disposal versus cryopreservation criteria (if criteria were borderline).

How are you reacting to the unexpected development?

• How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to documentation checks or protocol adherence?
• Consider the steps you are taking in the moment, such as immediately suspending the disposal procedure to resolve the documentation discrepancy or seeking immediate guidance on alternative witnessing procedures.
• How are you feeling in that moment? For instance, are you finding it difficult to focus on the procedure? Is it affecting your confidence in meeting the strict documentation requirements?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully resolving the documentation discrepancy and proceeding with the witnessed disposal? Or are you needing support because regulatory non-compliance requires reporting and senior authorisation?
• What are you learning as a result of the unexpected development? For example, are you mastering a more rigorous technique for pre-disposal verification and adherence to statutory documentation?

On action

What happened?

• Begin by summarising the key steps you took when disposing of unused fresh embryos.
• Consider specific events, actions, or interactions which felt important, such as how you verified the embryos for disposal or how you ensured compliance with the required dual witnessing protocol.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately suspending the disposal when a discrepancy in the written documentation was noticed.
• How did you feel during this experience, e.g., focused on regulatory adherence and accurate witnessing or aware of the ethical gravity of the procedure?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding strict regulatory compliance and meticulous documentation for disposal. What strengths did you demonstrate, e.g., rigorous checking of intended embryo fate and adherence to the witnessing SOP?
• What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the specific logging requirements for disposal documentation?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in practicing in accordance with regulatory and safety standards?
• Identify any challenges you experienced, such as an unexpected delay due to a witnessing colleague’s unavailability, and how you reacted to this. This might include needing to seek advice or clarification on scope of practice regarding safe temporary handling of embryos awaiting disposal or documentation protocols, and how you reacted to this.

What will you take from the experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving regulatory documentation and compliance checks.
• What will you do differently next time you approach disposal of unused fresh embryos, for instance, by proactively ensuring a witness is available ahead of the scheduled time?
• Do you need to practise any aspect of the activity further, such as reviewing the criteria for disposal or key learning outcomes related to interpreting and reporting embryology results?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of disposal procedures since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, a subsequent instance requiring disposal under highly sensitive ethical scrutiny forced you to re-evaluate the depth of regulatory adherence and detailed documentation applied during your first attempt at this training activity.
• Considering what you understand about legal requirements for disposal witnessing, documentation security, and ethical sensitivity now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your procedural safety and record-keeping based on further learning and experiences? For example, how you proactively designed a stringent checklist for verifying patient identity and final embryo fate prior to disposal that requires cross-checks.
• Has discussing ethical sensitivity of disposal procedures or the impact of documentation failure on legal compliance with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about an audit that uncovered a disposal where a witnessing protocol was breached refined your understanding of the critical nature of procedural strictness.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent regulatory witnessing and strict procedural adherence experiences, contributed to your overall confidence and ability in safely and compliantly disposing of embryos, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated strict procedural adherence to witnessing protocols and documentation verification now enables you to confidently dispose of embryos using appropriate witnessing during a DOPS assessment.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to procedural compliance and ethical diligence during disposal? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer immediately when documentation discrepancies or unavailability of a required witness threaten compliance, recognising the need for senior authorisation before proceeding with a sensitive regulatory step.
• Looking holistically at your training journey, how has this initial embryo disposal experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to practicing in accordance with regulatory and safety standards? For example, how this foundational experience has supported your development in understanding the importance of accurate records of the fates of embryos.

Relevant learning outcomes

#	Outcome
# 3	Outcome Interpret and report embryology results.
# 4	Outcome Communicate embryo grade and clinical decisions effectively with patients and the multidisciplinary team to enhance the overall patient experience.
# 5	Outcome Practice in accordance with regulatory and safety standards, including keeping accurate records of the fates of embryos.