Cryopreservation in reproductive medicine during the COVID-19 pandemic: rethinking policies and European safety regulations

Abstract

Cryopreservation of reproductive cells and tissues represents an essential aspect of ART practices that might be particularly strategic and helpful during SARS-CoV-2 emergency. However, recommendations on how and when to preserve reproductive tissues and cells during a novel severe pandemic are scanty. This paper uses a SWOT (strengths, weaknesses, opportunities and threats) analysis to identify favorable and unfavorable factors and to recognize challenges and obstacles related to the use of cryopreservation procedures during the spreading of a new virus. One of the strengths associated with the cryopreservation is represented by the availability of robust European guidelines on storage safety to prevent sample contamination or cross-contamination by pathogens. These recommendations should be deep-rooted in all ART laboratories. Weaknesses include uncertainties regarding the management of COVID-19 affected asymptomatic patients, the suboptimal accuracy of diagnostic tests for the disease, the nebulous prospective regarding the duration of the pandemic and the additional costs. The application of the strategy represents an opportunity to postpone pregnancy in order to avoid a severe infectious disease during gestation while concomitantly counteracting the possible detrimental effect of time. Critical threats, at present still undefined, are represented by potential adverse events for the mother and offspring due to infected gametes or embryos after thawing and, subsequently, the re-spreading of the virus.

COVID-19 risk assessment and safety management operational guidelines for IVF center reopening

“…Deferred transfer: It is recommended to implement a freeze-all policy for all patients and/or partners, especially when they have become symptomatic after oocyte retrieval as an alternative to avoid risk of COVID-19 disease. However, the lack of strong evidence this recommendation should be taken with caution [23].…”

Development of Optimized Vitrification Procedures Using Closed Carrier System to Improve the Survival and Developmental Competence of Vitrified Mouse Oocytes

“…Although a few reports suggest that the risk of cross-contamination is negligible [ 14 , 22 ], vitrification using OC remains forbidden in a few countries (e.g., France, Belgium, Ireland, and Czech Republic) [ 16 ]. The European Society of Human Reproduction and Embryology (ESHRE) and the American Society of Reproductive Medicine (ASRM) highlighted that using a high-security closed device is the safest fertility preservation procedure [ 23 , 24 ]. However, the advantages of both carrier systems are still debatable.…”

Aspectos gerais do Sars-CoV-2 na saúde reprodutiva feminina: uma revisão narrativa

“…Revisión bibliográfica: SARS-CoV-2 apareció en diciembre de 2019 y se extendió rápidamente por todo el mundo. El virus entra en la célula diana uniéndose a la enzima convertidora de angiotensina (ECA) 2, la serina proteasa transmembrana 2 1 Universidade CEUMA (UNICEUMA), Imperatriz -MA. *E-mail: ana57claudia@gmail.com (TMPRSS2) y 4 (TMPRSS4) y la proteína transmembrana Basigin (BSG) en las células huésped, que están presentes en las células del sistema reproductor femenino y pueden impactar el desempeño reproductivo de los pacientes afectados por el SARS-CoV-2.…”