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Screening for blood born viruses in assisted reproduction: is annual testing necessary?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Screening for blood born viruses is routinely performed before fertility treatment in assisted reproduction technology (ART) clinics worldwide. It involves testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), among others. Identifying patients with positive viral screening allows to refer them and their partners for appropriate counseling and treatment. The need for repeat viral screening and its required frequency have never been clearly established. In Israel, viral screening is mandatory and is repeated annually. Our aim was to determine the prevalence of HBV, HCV, and HIV seroconversion in patients with negative screening upon initiation of ART treatment.

Methods

A retrospective analysis of viral screening tests of all fertility patients in a single assisted conception unit between 1997 and 2015.

Results

During the study period, 2844 patients were treated at our clinic, out of whom 1945 patients met the inclusion criteria. The average length of treatment was 1.61 ± 0.81 years, during which female patients underwent screening tests 2.6 ± 0.9 times, and male patients 2.3 ± 1.2 times. No case of seroconversion to any of the three viruses was noted during the entire study period, resulting a seroconversion rate of 0%.

Conclusions

Primary infection with HBV, HCV, or HIV is an extremely rare event among Israeli infertile patients, and the risk for seroconversion in this population is practically nil. Annual screening of both partners leads to substantial costs and appears to be futile. Our results question the current practice and support increasing the interval between screening tests in low-risk populations.

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References

  1. Gilling-Smith C, Vernazza P (2018) Viral disease and ART. In: Gardner DK, Weissman A, Howles CM, Shoham Z (eds) Assisted reproductive techniques: laboratory and clinical perspectives, vol 2, 5th edn. Informa Healthcare, London, pp 806–817

    Google Scholar 

  2. Practice Committee of American Society for Reproductive M (2013) Recommendations for reducing the risk of viral transmission during fertility treatment with the use of autologous gametes: a committee opinion. Fertil Steril 99(2):340–346. https://doi.org/10.1016/j.fertnstert.2012.08.028

    Article  Google Scholar 

  3. Wingfield M, Cottell E (2010) Viral screening of couples undergoing partner donation in assisted reproduction with regard to EU Directives 2004/23/EC, 2006/17/EC and 2006/86/EC: what is the evidence for repeated screening? Human Reprod (Oxford, England) 25(12):3058–3065. https://doi.org/10.1093/humrep/deq261

    Article  CAS  Google Scholar 

  4. Mocanu EV (2012) Facts and myths in serological screening of ART couples. Facts Views Vis Obgyn 4(3):198–202

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Hughes C, Grundy K, Emerson G, Mocanu E (2011) Viral screening at the time of each donation in ART patients: is it justified? Hum Reprod 26(11):3169–3172. https://doi.org/10.1093/humrep/der278

    Article  CAS  PubMed  Google Scholar 

  6. Pepas L, Macmahon E, El Toukhy T, Khalaf Y, Braude P (2011) Viral screening before each cycle of assisted conception treatment is expensive and unnecessary: a survey of results from a UK inner city clinic. Hum Fertil (Camb) 14(4):224–229. https://doi.org/10.3109/14647273.2011.627624

    Article  Google Scholar 

  7. Abusheikha N, Akagbosu F, Marcus S, Lass A, Cousins C, Brinsden P (1999) Viral screening and assisted conception treatment—the Bourn Hall experience. J Assist Reprod Genet 16(6):337–339

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hart R, Khalaf Y, Lawson R, Bickerstaff H, Taylor A, Braude P (2001) Screening for HIV, hepatitis B and C infection in a population seeking assisted reproduction in an inner London hospital. BJOG 108(6):654–656

    CAS  PubMed  Google Scholar 

  9. EU tissues and cells directive, 2006/17/EC, Annex III Section. 4.2 ESHRE position paper (2007). https://www.eshre.eu/-/media/sitecore-files/Guidelines/Guidelines/Position-Papers/Tissues-and-cellsdirective.pdf?la=en&hash=330CC230E81E5ABC073B655E30C5C5231B01F092. Accessed 21 Feb 2019

  10. ESHRE (2009). Statement of the European Society of Human Reproduction and Embryology (ESHRE) on the European Commission proposal of viral screening in assisted reproduction treatments. ESHRE Press Office, 16 November

  11. European Commission Evaluation and fitness check (FC) roadmap. Evaluation of Union legislation on blood, tissues and cells. 2017. http://ec.europa.eu/smart-regulation/roadmaps/docs/plan_2016_154_evaluation_eu_legislation_on_blood_en.pdf. Accessed 21 Feb 2019

  12. Israel Ministry of Health PHS, Division of Epidemiology, Department of Tuberculosis & AIDS (2017) HIV HIV/AIDS in Israel: periodic epidemiological report 1981–2016. https://www.health.gov.il/PublicationsFiles/AIDS_PeriodicReport2017e.pdf. Accessed 21 Feb 2019

  13. Weil C, Nwankwo C, Friedman M, Kenet G, Chodick G, Shalev V (2016) Epidemiology of hepatitis C virus infection in a large Israeli health maintenance organization. J Med Virol 88(6):1044–1050. https://doi.org/10.1002/jmv.24426

    Article  PubMed  Google Scholar 

  14. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ (2015) Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 386(10003):1546–1555. https://doi.org/10.1016/S0140-6736(15)61412-X

    Article  Google Scholar 

  15. CIA (2018) HIV/AIDS—adult prevalence rate. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2155rank.html. Accessed 21 Feb 2019

  16. Yakass MB, Woodward BJ, Otoo MA, Hiadzi EK (2016) Prevalence of blood borne viruses in IVF: an audit of a fertility Centre. JBRA Assist Reprod 20(3):132–136. https://doi.org/10.5935/1518-0557.20160030

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

Authors

Contributions

EG project development, data collection, and manuscript writing. YM data management, data analysis, and manuscript editing. AS project development and manuscript editing. JF project development and manuscript editing. EH project development and manuscript editing. AR project development and manuscript editing. SA project development and manuscript editing. DL project development and manuscript editing. AR project development and manuscript editing. AW project development, data management, and manuscript editing.

Corresponding author

Correspondence to Yossi Mizrachi.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gold, E., Mizrachi, Y., Shalev, A. et al. Screening for blood born viruses in assisted reproduction: is annual testing necessary?. Arch Gynecol Obstet 299, 1709–1713 (2019). https://doi.org/10.1007/s00404-019-05112-0

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  • DOI: https://doi.org/10.1007/s00404-019-05112-0

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