Human health risks are naturally of primary concern to those who may be affected. Responsibility for initial detection, investigation and reporting lies with clinicians. Procurement organisations, tissue, cell and ART processors play an essential role in quarantine, investigation and recall of potentially implicated allografts or techniques. Adverse outcomes that have been confirmed ultimately become the responsibility of competent authorities when they rise to the level of governmental attention. Global distribution of MPHO requires communications among national competent authorities to ensure effective risk mitigation. Legislative, regulatory and reporting requirements vary from country to country. In addition, a variety of professional associations have established registries and reporting systems to capture adverse occurrences.