COVID-19: the perspective of Italian embryologists managing the IVF laboratory in pandemic emergency

Santis, Lucia De; Anastasi, Attilio; Cimadomo, Danilo; Klinger, Francesca Gioia; Licata, Emanuele; Pisaturo, Valerio; Fernandez, Laura Sosa; Scarica, Catello

doi:10.1093/humrep/deaa074

Cited by 29 publications

(30 citation statements)

References 3 publications

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“…Studies show that fully modified protocols and codes of conduct are developed to provide a safe practice [3,5,35] abided by both practitioners and patients. Recommendations and guidelines from highly esteemed reproductive societies are in place, and so it appears that we are well prepared and may be in the clear-albeit all recommendations may be subject to future reconsiderations and modifications [36]. Nonetheless, we cannot help but ponder whether perhaps restarting while still in the pandemic may have been premature.…”

Section: Resultsmentioning

confidence: 99%

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Simopoulou

Sfakianoudis²,

Giannelou

et al. 2020

J Assist Reprod Genet

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The COVID-19 pandemic has fueled numerous debates in the field of assisted reproductive technology (ART) as the effect of SARS-CoV-2 on pregnancy and infancy is still considered uncharted territory. Various theses and recommendations on what optimal practice is have emerged, as evidenced by surveys, webinars, and recent publications. ART specialists are faced with dilemmas in light of the lack of concrete scientific evidence required to pave the way towards future safe practice. Meanwhile, infertile couples were similarly left in limbo unable to exercise their reproductive autonomy unlike fertile couples-where achieving a pregnancy via natural conception is a matter of decision. ART treatment being classified as non-essential has only recently restarted , facing new challenges while enabling pregnancy at a time of uncertainty. This article highlights matters of bioethical nature to be considered in the ART world at the time of COVID-19 while presenting an all-inclusive critique of the current status. When pursuing pregnancy through IVF treatment during the pandemic, distancing and caution have the lead role in an effort to defend the health of the intended parents and future children. To promote patient autonomy along with our ethical, moral, and legal duty towards our patients, emphasis should be given on ascertaining shared decision-making, and ensuring that an appropriate all-inclusive informed consent is signed prior to initiating any IVF treatment.

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Section: Resultsmentioning

confidence: 99%

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Simopoulou

Sfakianoudis²,

Giannelou

et al. 2020

J Assist Reprod Genet

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“…Current restrictions in Italy have led reproductive centers to drastically limit their activities, accepting only asymptomatic patients about to undergo potentially gonadotoxic treatments. For sperm banks like ours, this means above all cancer patients who urgently need to begin radio-and/or chemotherapy [17]. However, apart from safety issues for the sperm bank personnel, this novel pandemic forced us to consider three major issues: (1) does the SARS-CoV-2 virus reach the testis and the seminal fluid?…”

Section: Discussionmentioning

confidence: 99%

“…The presence of ACE2 and TMPRSS2 may make the testis and male genital tract a viable site for the virus, but the cellular type that might function as reservoir has yet to be determined. It is therefore imperative to establish whether, when and how SARS-CoV-2 reaches the seminal fluid and how long it persists there, to assess the risks and establish strict procedures [17] for the use of gametes in assisted reproduction (transmission of infection, infection of embryos, congenital diseases, spontaneous abortions, etc.). Solving this uncertainty is even more important when we consider cryopreserved semen samples.…”

Section: Discussionmentioning

confidence: 99%

Sperm cryopreservation during the SARS-CoV-2 pandemic

Paoli

Pallotti

Nigro

et al. 2020

J Endocrinol Invest

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Purpose Sperm cryopreservation is fundamental in the management of patients undergoing gonadotoxic treatments. Concerns have risen in relation to SARS-CoV-2 and its potential for testicular involvement, since SARS-CoV-2-positive cryopreserved samples may have unknown effects on fertilization and embryo safety. This study therefore aimed to analyze the safety of sperm cryopreservation for cancer patients after the onset of the pandemic in Italy, through assessment of the risk of SARS-CoV-2 exposure and viral RNA testing of semen samples. Methods We recruited 10 cancer patients (mean age 30.5 ± 9.6 years) referred to our Sperm Bank during the Italian lockdown (from March 11th to May 4th 2020) who had not undergone a nasopharyngeal swab for SARS-CoV-2 testing. Patients were administered a questionnaire on their exposure to COVID-19, and semen samples were taken. Before cryopreservation, SARS-CoV-2 RNA was extracted from a 150 µl aliquot of seminal fluid in toto using QIAamp viral RNA kit (Qiagen) and amplified by a real time RT PCR system (RealStar SARS-CoV2 RT PCR, Altona Diagnostics) targeting the E and S genes. Results The questionnaire and medical interview revealed that all patients were asymptomatic and had had no previous contact with COVID-19 infected patients. All semen samples were negative for SARS-CoV-2 RNA. Conclusion This preliminary assessment suggests that a thorough evaluation (especially in the setting of a multidisciplinary team) and molecular confirmation of the absence of SARS-CoV-2 in seminal fluid from asymptomatic cancer patients may assist in ensuring the safety of sperm cryopreservation.

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“…Oosafe) and cleaned with sterile water after each procedure. It is recommended that these precautions take place during oocyte/embryo culture: 24 • Use personal protective equipment (laboratory coat that covers wrists, hair cover, shoe cover, mask, gloves) 21 • Use micropipette tips with filter • Turn on laminar hood air flow minimum 10 min before work • Disinfect the laminar hood working area (e.g.…”

Section: In Vitro Fertilization Technique Cell Culture and Covid-19mentioning

confidence: 99%

Croatian Society of Clinical Embryologists – guidelines on the epidemiological framework for the implementation of medically assisted reproduction (MAR) procedures during the COVID-19 pandemic regarding the safety of patients and medical health workers

Zivkovic¹,

Baričević

Cavlovic

et al. 2020

Mol. exp. biol. med.

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Due to the high virulence of the SARS-CoV-2 virus, the infection rate in the community has led to a state of pandemic, leading to the introduction of new emergency measures all over the world. With the aim of controlling and preventing the SARS-CoV-2 viral epidemic, the health institutions performing medically assisted reproduction (MAR) suspended any new MAR treatments in order to reduce the burden on the health care system and implement current social distancing recommendations. Considering the favorable epidemiological situation in Croatia, our perspective is that it is time to conceive, plan and bring forth guidelines for restarting work in MAR centres, taking into account the selection of patients and organization of good laboratory and clinical practices with emphasis on the safety of patients and health workers. In regard to epidemiological knowledge, it is important to establish the reorganization of work in MAR centres including epidemiological measures of reducing unnecessary stays in closed spaces, the usage of protective gear by patients and health workers and disinfection of the working spaces and equipment.

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COVID-19: the perspective of Italian embryologists managing the IVF laboratory in pandemic emergency

Cited by 29 publications

References 3 publications

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Sperm cryopreservation during the SARS-CoV-2 pandemic

Croatian Society of Clinical Embryologists – guidelines on the epidemiological framework for the implementation of medically assisted reproduction (MAR) procedures during the COVID-19 pandemic regarding the safety of patients and medical health workers

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