Recommendations for reducing the risk of viral transmission during fertility treatment with the use of autologous gametes: a committee opinion

Capsule:
This document provides strategies, based on scientific principles and clinical experience, to reduce the risk of viral transmission in couples seeking treatment for infertility using their own gametes.

Author:
The Practice Committee of the American Society for Reproductive Medicine

Volume 99, Issue 2, Pages 340-346, February 2013

Abstract:

This document provides strategies, based on scientific principles and clinical experience, to reduce the risk of viral transmission in couples seeking treatment for infertility using their own gametes. This document replaces the ASRM Practice Committee document, “Guidelines for reducing the risk of viral transmission during fertility treatment,” last published in Fertil Steril 2008;90(5 Suppl):S156-62.

  • Juan Giles

    First of all, I´d like to congratulate The Practice Committee of the American Society for Reproductive Medicine for this excellent manuscript which reviews the recommendations for reducing the risk of viral transmission during fertility treatment.

    In our opinion, chronic viral diseases impose a special responsibility for healthcare workers devoted to human reproduction to avoid the risk of infection for their partner or the expected child, and the article covers all the different aspects of this topic.
    However, we have different points of view in the following situations:

    – Our clinical group observed no benefits in administering ARV before washing (Garrido N, 2004). Nicopoullos et al showed in a recent review their experience after 10 years of sperm washing that there was no significant difference in any parameter between the samples in which viral load (VL) was detectable and in those where it was undetectable (Nicopoullos JD, 2010).

    – The use of “double bagging” or sealing tecniches to prevent the direct contact of
    cryocontainers with liquid nitrogen.
    In a recent publication, we have not detected viral sequences after culture and vitrification of oocytes/embryos from HIV-, HBV-, and HCV-seropositive patients. These findings represent good evidence of the lack of risk of cross-contamination among seropositive patients, even using an open device for vitrification (Cobo A. 2012).

    Although in case of hepatitis B you could have mentioned two interesting aspects:

    – The sperm washing technique will be carried out to reduce the viral load of HBV in this fluid when the female partner has not achieved immunity after precise vaccination.

    – The combined use of passive (HBIG) and active immunisation is 85% to 95% effective in preventing neonatal HBV infection.

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