Reproductive planning in times of Zika: getting pregnant or delaying plans? The opinion of the Brazilian Society of Assisted Reproduction Committee - a basis for a bioethical discussion

Carvalho, Bruno Ramalho de; Taitson, Paulo Franco; Brandão, Karina; Ferriani, Rui Alberto; Nakagawa, Hitomi; Silva, Adelino A.; Lopes, Joaquim Roberto Costa

doi:10.5935/1518-0557.20160034

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…There is no consensus about to postpone pregnancy, as there is no evidence about when will be the safest moment for that . However, the CDC suggests that infected woman wait until 8 weeks since the beginning of the symptoms to conceive, as well as those who have traveled to endemic areas, even if there are no symptoms.…”

Section: Preventionmentioning

confidence: 99%

Zika virus and pregnancy: An overview

Carvalho

Dóris

et al. 2017

American J Rep Immunol

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In May 2015, the first episodes of Zika virus infection of the Latin America were confirmed in Brazil, where currently 196 976 cases were reported. The main route of transmission occurs by Aedes mosquitoes, and the most common symptoms are maculopapular rash, fever, conjunctivitis, polyarthralgia, and periarticular edema. However, the infection is asymptomatic in 80% of the cases. The congenital infection is characterized when the transmission to the fetus occurs during pregnancy, but the mechanisms of how the virus infects the placenta remain unclear. Anatomopathological findings were described in first-and third-trimester human placentas; however, the major affected tissue of the baby is the neural. Several clinical situations were listed in these fetuses, such as neurological, ophthalmological, auditory, and articular alterations. The World Health Organization proposed a new congenital syndrome caused by Zika virus. The virus has an important neurotropism and the main manifestation observed in the syndrome is microcephaly, which is usually severe and associated with other neurological injuries. The appearance of sudden rash in pregnant women determines immediate investigation through RT-PCR and serological analysis. Moreover, the prevention consists in using repellents and avoiding endemic areas, considering that the vaccine is still under development. K E Y W O R D Scongenital malformations, microcephaly, obstetrician, pregnancy, Zika virus

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Section: Preventionmentioning

confidence: 99%

Zika virus and pregnancy: An overview

Carvalho

Dóris

et al. 2017

American J Rep Immunol

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“…Guidelines for assisted reproduction in patients and providers vary by country. Brazil's initial regulatory guidelines published March 2016 required negative Zika testing (serologic) within 5 days of gamete collection [91], which was reportedly found to be difficult, since serologic testing often took 7 days and RT-PCR was not always available [92]. The French guidelines were first published February 2016 and last updated in January 2017: they recommend waiting 2 months after potential ZIKV exposure or 2 months after a local epidemic is officially over before infertility treatment.…”

Section: Preconception Counseling Prevention Of Sexual Transmissionmentioning

confidence: 99%

Impact of Zika virus for infertility specialists: current literature, guidelines, and resources

Dubaut

Higuita

Quaas

2017

J Assist Reprod Genet

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In the past 2 years, Zika virus has emerged from obscurity onto the world stage-traversing and transcending clinical specialties, basic science disciplines, and public health efforts. The spread of Zika virus has serious implications for the specialty of reproductive endocrinology and infertility. Our patients, practices, and labs-worldwide and specifically in the USA-have been impacted by this teratogenic, sexually transmitted, largely asymptomatic virus. While the World Health Organization's Public Emergency of International Concern designation has lapsed as major epidemics have subsided and understanding of risks is in part clarified, the acute and long-term threat to pregnant patients is not over. The risk of wider spread in the USA is not insignificant, the subtler and long-ranging consequences beyond microcephaly are not fully known, large geographic areas of risk still contain naïve populations, and whether Zika will continue to be an intermittent risk in endemic areas is uncertain. Staying up to date with the burgeoning research on Zika virus is an important objective for the infertility specialist. Here, we review in detail the most relevant recent developments, discuss applicable guidelines, and propose strategies for contributing to a reduction in the risk and burden of Zika virus.

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“…Because of the risk of virus persistence in gametes, especially in sperm, and the danger of the Zika virus for the fetus, ANVISA declared that patients involved in fertility treatments must be tested for Zika prior to insemination, or embryo transfer. This position was also supported by the Brazilian Society of Assisted Reproduction (ANVISA, 2016;Carvalho et al, 2016). The decision whether to risk ART treatment during an epidemic of a sexually transmitted disease that affects the fetus was nevertheless left to the discretion of individual couples and their doctors.…”

mentioning

confidence: 99%