Although the worst of SARS-CoV-2 seems to be behind us in Spain, there are many doubts as to its effects, transmission, and consequences in a post-COVID society. One of the main concerns in the field of Assisted Reproduction is the handling of gamete donation and the possible vertical transmission from parents to their offspring.
To date, the possibility of transmitting SARS-CoV-2 through human substances, that is, organs, tissues, cells, or blood, is still unknown.
Until more conclusive data is known regarding gamete donation, the Spanish Fertility Society has produced a document entitled SARS-CoV-2 screening in gamete donors . This report establishes the guidelines that must be followed when assessing and dealing with the donors. It is centered on “precautionary measures while taking into account the associated risks of all involved parties in these procedures.”
The document examines the perspectives of all the different situations involved: the patients and their offspring, the professionals, and the donors. Safety is of utmost importance for everyone.
Gamete donation and the risk of SARS-CoV-2 for patients and their offspring
“Based on current knowledge and studies, various conclusions have been reached. In cases involving asymptomatic donors whose clinical assessment results came back negative, the risks of their processed and cryopreserved sperm and oocytes being infected by SARS-CoV-2 is minimal. Based on this information, we consider that the risk of contagion from the recipient and transfer to the fetus is extremely reduced and almost non-existent,” explains Dr. Pilar Alamá, IVI gynecologist and member of the Gamete and Embryo Donation Working Group that wrote this document.
Gamete donation and the risk of SARS-CoV-2 for professionals.
The professionals who perform the reproductive treatments are at a greater risk for contracting SARS-CoV-2. This document offers various solutions for this situation, and one of them is to conduct a more specific screening, particularly in the case of oocyte donors. The procedure itself implies a greater risk for the professionals due to the level of contact that they must have during the extraction process.
Gamete donation and the risk of SARS-CoV-2 for egg donors
In regard to donors, the working group states, “the medical risks related to follicular stimulation and puncture in an asymptomatic donor infected with SARS-CoV-2 are similar to the risks when dealing with uninfected donors. However, given the current situation, we recommend that everyone take extreme measures to prevent complications that are often associated with donation, such as ovarian hyperstimulation syndrome, post-puncture bleeding, etc”.
When dealing with a donor infected with SARS-CoV-2 (either due to symptoms or to the results of a laboratory test) the guideline is clear: the puncture must be canceled to protect the safety of the donors and of the professionals. “But, in the rare cases where performing the puncture is more beneficial for the donor, it can be conducted while following the SEF-ASEBIR Recommendations,” suggests the document.
PCR test for donors to ensure a safe procedure.
In order to rule out a Coronavirus infection when they provide the sample, all semen donors must undergo a PCR test between the first and fifth day before their donation. Oocyte donors will follow the same procedure immediately before performing the follicular puncture. Negative results will notify asymptomatic conditions and give the green light to beginning the donation process.
The document suggests holding an interview 21 days after the donation, in the case of men, to find out if the donor has experienced any symptoms or discomfort. If there is any doubt at all, a new test is recommended to rule out infection and to assess continuing the treatment.
In the case of an oocyte donor whose results are positive, the document advises assessment and application of the following SEF-ASEBIR Recommendations guideline: “When fresh, the obtained oocytes can be fertilized or vitrified. In the exceptional case of a follicular puncture in a PCR positive donor, the oocytes should not be vitrified nor used until they have been proven safe to use,” concludes the document.