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Lopes ÉPF, Tetaping GM, Novaes MAS, dos Santos RR, Rodrigues APR. Systematic review and meta-analysis on patented and non-patented vitrification processes to ovarian tissue reported between 2000 and 2021. Anim Reprod 2023; 20:e20230065. [PMID: 38026005 PMCID: PMC10681131 DOI: 10.1590/1984-3143-ar2023-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/17/2023] [Indexed: 12/01/2023] Open
Abstract
Due to the great interest in ovarian cryopreservation and, consequently conservation and restoration of female fertility in the last decades, different vitrification procedures (vitrification devices or solutions) have been developed, patented, and used both for academic research purposes and for clinical use. Therefore, the present study aimed to provide a systematic review and meta-analysis of data obtained from the application of different patented and non-patented vitrification devices and solutions in different countries. For this purpose, relevant observational studies published between the years 2000 to 2021 were selected to verify the efficiency of ovarian vitrification processes on parameters such as morphology, viability, and apoptosis in preantral ovarian follicles after transplantation or in vitro culture. Our research revealed that, although several countries were considered in the study, the United States and Japan were the countries that registered the most processes, and 22 and 16 vitrification devices and solutions out of a total of 51, respectively were patented. Sixty-two non-patented processes were also considered in the study in all countries. We also observed that transplantation and in vitro ovarian culture were the techniques predominantly used to evaluate the efficiency of the devices and vitrification solutions, respectively. In conclusion, this review showed that patented or non-patented protocols available in the literature are able to successfully preserve preantral follicles present in ovarian tissue. Despite the satisfactory results reported so far, adjustments in ovarian vitrification protocols in order to minimize cryoinjuries to the follicles remain one of the goals of cryopreservation and preservation of the female reproductive function. We found that vitrification alters the morphology and viability, and offers risks leading in some cases to follicular apoptosis. However, adjustments to current protocols to develop an optimal procedure can minimize damage by not compromising follicular development after vitrification/warming.
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Affiliation(s)
- Éverton Pimentel Ferreira Lopes
- Laboratório de Manipulação de Oócitos e Folículos Ovarianos Pré-Antrais (LAMOFOPA), Faculdade de Medicina Veterinária, Universidade Estadual do Ceará, Fortaleza, CE, Brasil
| | - Gildas Mbemya Tetaping
- Laboratório de Manipulação de Oócitos e Folículos Ovarianos Pré-Antrais (LAMOFOPA), Faculdade de Medicina Veterinária, Universidade Estadual do Ceará, Fortaleza, CE, Brasil
| | - Marco Aurélio Schiavo Novaes
- Laboratório de Manipulação de Oócitos e Folículos Ovarianos Pré-Antrais (LAMOFOPA), Faculdade de Medicina Veterinária, Universidade Estadual do Ceará, Fortaleza, CE, Brasil
| | | | - Ana Paula Ribeiro Rodrigues
- Laboratório de Manipulação de Oócitos e Folículos Ovarianos Pré-Antrais (LAMOFOPA), Faculdade de Medicina Veterinária, Universidade Estadual do Ceará, Fortaleza, CE, Brasil
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Chen S, Zhang S, Liu G, Wang X, Peng Y, Chen Y, Gong F, Yang Z, Lin G. Embryo development, pregnancy and live birth outcomes following IVF treatment were not compromised during the COVID-19 pandemic. J Assist Reprod Genet 2023:10.1007/s10815-023-02863-3. [PMID: 37428430 PMCID: PMC10371922 DOI: 10.1007/s10815-023-02863-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/14/2023] [Indexed: 07/11/2023] Open
Abstract
PURPOSE To evaluate whether outcomes of in vitro fertilization (IVF) are affected during the coronavirus disease-19 (COVID-19) pandemic. METHODS This was a single-center, retrospective study. Embryo development, pregnancy, and live birth outcomes were compared between COVID-19 and pre-COVID-19 groups. Blood samples from patients during the COVID-19 pandemic were tested for COVID-19. RESULTS After 1:1 random matching, 403 cycles for each group were included in the study. The rates of fertilization, normal fertilization, and blastocyst formation were higher in the COVID-19 group than in the pre-COVID-19 group. No difference was observed in the rates of day 3 good-quality embryos and good-quality blastocysts between the groups. A multivariate analysis showed that the live birth rate in the COVID-19 group was higher than that in the pre-COVID-19 group (51.4% vs. 41.4%, P = 0.010). In fresh cleavage-stage embryo and blastocyst transfer cycles, there were no differences between the groups in terms of pregnancy, obstetric, and perinatal outcomes. In the freeze-all cycles, the live birth rate was higher during the COVID-19 pandemic (58.0% vs. 34.5%, P = 0.006) than during the pre-COVID-19 period following frozen cleavage stage embryo transfer. The rate of gestational diabetes during the COVID-19 pandemic was higher than that during the pre-COVID-19 period (20.3% vs. 2.4%, P = 0.008) following frozen blastocyst transfer. All the serological results of the patients during the COVID-19 pandemic were negative. CONCLUSION Our results indicate that embryo development, pregnancy, and live birth outcomes in uninfected patients were not compromised during the COVID-19 pandemic at our center.
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Affiliation(s)
- Su Chen
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Shuoping Zhang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Gang Liu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, Central South University, No. 88 Xiangya Road, Changsha, 410008, China
| | - Xiaojuan Wang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Yangqin Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Yongzhe Chen
- The First Affiliated Hospital of University of South China, Hengyang, China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, Central South University, No. 88 Xiangya Road, Changsha, 410008, China
| | - Zhihong Yang
- California Excellent Fertility, 1808 W Lincoln Ave, Anaheim, CA, 92801, USA.
| | - Ge Lin
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.
- Institute of Reproductive and Stem Cell Engineering, Central South University, No. 88 Xiangya Road, Changsha, 410008, China.
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McGough AM, Doody KA, Foy OB, Harris CA, Mandelbaum RS, Matsuo K, Paulson RJ. Seasonal fluctuation of in vitro fertilization encounters in the United States. J Assist Reprod Genet 2023; 40:1099-1107. [PMID: 36943573 PMCID: PMC10239406 DOI: 10.1007/s10815-023-02777-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
PURPOSE To examine patient and hospital characteristics related to seasonal fluctuation in in vitro fertilization (IVF). METHODS This retrospective cohort study examined 33,077 oocyte retrievals identified in the National Ambulatory Surgery Sample. Exposure assignment was monthly IVF encounters: low-volume months (<25%ile), mid-volume months (≥25/<75%ile), and high-volume months (>75%ile). Main outcomes were patient and hospital characteristics related to the exposure groups, assessed with a multinomial regression model. RESULTS The median IVF encounters were 977 per month, ranging from 657 to 1074 (absolute-difference 417). January, July, and December were the lowest-quartile volume months, ranging from 657 to 710 encounters per month (low-volume months). May, August, and November were the top-quartile volume months, ranging from 1049 to 1074 encounters per month (high-volume months). In a multivariable analysis, patients undergoing IVF in the low-volume months were younger and less likely to have infertility or comorbidities. Patients undergoing IVF in the high-volume months were more likely to have lower household income and receive IVF at urban teaching facilities. Northeastern residents were less likely to have IVF in the low-volume months but more likely to have IVF in the high-volume months. Sensitivity analyses showed that the lowest-to-highest variability in monthly IVF encounters was higher in Northeast region compared to other regions (320 vs 50-128); infertility patients compared to those without (317 vs 190); privately insured patients compared to self-pay (227 vs 156); and older patients compared to younger (234 vs 192). CONCLUSION This study suggests substantial seasonal fluctuation in IVF oocyte retrieval in the USA based on patient and hospital factors.
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Affiliation(s)
- Alexandra M McGough
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kaitlin A Doody
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Olivia B Foy
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chelsey A Harris
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
| | - Rachel S Mandelbaum
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA.
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
| | - Richard J Paulson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
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4
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Scaravelli G, Levi Setti PE, Gennarelli G, Mencaglia L, Ubaldi FM, De Luca R, Cimadomo D, Spoletini R, Vigiliano V, Sileri PP. The actual impact of SARS-CoV-2/COVID-19 pandemic on IVF activity: a survey across Italian ART centers. J Assist Reprod Genet 2022; 39:2373-2380. [PMID: 35997867 PMCID: PMC9395871 DOI: 10.1007/s10815-022-02600-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/18/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose Since the end of February 2020, SARS-CoV-2 dramatically spread in Italy. To ensure that most of National Health System (NHS) resources were employed to control the pandemic, non-urgent medical procedures (including IVF) were suspended in March 2020. Here, we aimed at assessing the impact of the restrictive measures on Italian IVF activity. Methods In May 2020, the Italian ART Register launched an online survey (multiple choices and open answers) across ART centers (89.0% response rate; N = 170/191) to investigate how they were facing the emergency and estimate the reduction in their activity. In February 2022, the official data of the whole 2020 were published and retrospectively analyzed. The ART cycles conducted in Italy in 2020 (67,928 by 57,423 patients) were then compared to those conducted in 2019 (82,476 by 67,633 patients). The estimates formulated through the survey were compared to the actual reduction. Results In 2020, 14,548 less IVF cycles were conducted with respect to 2019 (− 17.6% reduction). This led to 2539 fewer live births (− 19.8%) than 2019. If the reduction unveiled by the survey launched in May 2020 (i.e., − 35%) would have persisted throughout 2020, a significantly larger impact was expected (4200 less newborns). Instead, the activity was gradually recovered, and it compensated the months of greatest emergency, thus fulfilling the most optimistic scenario. Conclusions Italy suffers from the lowest birth rate in Europe, and COVID-19 impact on IVF-derived live births testified how key ART is for Italian demographics. The government should support access to these treatments with dedicated actions. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-022-02600-2.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy
| | - Paolo Emanuele Levi Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Gianluca Gennarelli
- Obstetrics and Gynecology 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant'Anna Hospital, University of Torino, Turin, Italy.,Livet, GeneraLife IVF, Turin, Italy
| | - Luca Mencaglia
- Physiopathology of Reproduction, Santa Margherita Hospital, Cortona, Italy
| | | | - Roberto De Luca
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy.
| | | | - Roberta Spoletini
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy
| | - Vincenzo Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy
| | - Pier Paolo Sileri
- Undersecretary for Health, Ministry of Health, Rome, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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Affiliation(s)
- Gábor Vajta
- RVT Australia, 20 Slate Close, Brinsmead, Cairns, QLD, Australia
- VitaVitro Biotech Co., Ltd, Shenzhen, China
| | - Catello Scarica
- European Hospital, Center for Reproductive Medicine, Rome, Italy
| | - Lodovico Parmegiani
- Next Fertility GynePro—NextClinics International, Bologna, Italy
- Correspondence address. Next Fertility GynePro—NextClinics International, Via T. Cremona 8, Bologna 40137, Italy. E-mail:
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Demeestere I, Van den Abbeel E, Delbaere A. Reply: Risk of contamination with SARS-CoV-2 in ART. Hum Reprod 2022; 37:1096. [PMID: 35262685 PMCID: PMC9383612 DOI: 10.1093/humrep/deac054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- I Demeestere
- CUB-ERASME Hospital, Department of Obstetrics and Gynecology, Fertility Clinic, Brussels, 1070, Belgium.,Université Libre de Bruxelles, Research Laboratory on Human Reproduction, Erasme Campus, Brussels, 1070, Belgium
| | - E Van den Abbeel
- CUB-ERASME Hospital, Fertility Clinic, IVF Laboratory, Brussels, 1070, Belgium
| | - A Delbaere
- CUB-ERASME Hospital, Department of Obstetrics and Gynecology, Fertility Clinic, Brussels, 1070, Belgium
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7
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Rizal DM, Septiyorini N. Adjustment of in vitro Fertilization Clinic Management during COVID-19 Pandemic: A Study among Laboratory Staff in Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and Objectives: The Ministry of Health as a national authority and several international organizations highly recommend that each IVF clinic conduct reviews for service regulations, and make adjustments for the patient's services according to the COVID-19 pandemic. A survey of IVF clinic management in Indonesia during the COVID-19 pandemic needs to be carried out so that the results of the survey can be used as evaluation material for the management to improve services safely.
Methods: This cross-sectional survey was conducted among 49 IVF laboratory staff members of ISHE from 42 IVF clinics in Indonesia. We administered an online questionnaire containing several questions related to the management of IVF clinic services during the COVID-19 pandemic based on a search of scientific literature.
Results: Several services adjustments have been made by IVF clinic management in response to the COVID-19 pandemic to minimize transmission of the virus in the IVF clinic. The IVF clinic management revised the service regulations and the patient services procedure was also undergone several adjustments, to minimize the COVID-19 transmission.
Conclusions: Several adjustments were made by IVF clinic management in Indonesia as an early response to the COVID-19 pandemic. Clinic managements compile several adjustments to the service regulations during the COVID-19 pandemic as one of the readiness of IVF clinics in providing safe services for patients and staff
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8
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Wu Y, Zhang X, Wang Z, Xia X. Can We Cryopreserve the Sperm of COVID-19 Patients During the Pandemic? Front Endocrinol (Lausanne) 2022; 13:753267. [PMID: 35712235 PMCID: PMC9197193 DOI: 10.3389/fendo.2022.753267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
An extreme strain has been placed on healthcare facilities in the COVID-19 era. Initial stage of the pandemic, national and international societies for reproductive medicine suggested the suspension of new IVF treatments and non-essential cryopreservation of gametes. Accordingly, the demands of cryopreservation of semen with COVID-19 patients also was suspended by some of cryobanks to protect staff and patients from unnecessary viral exposure at the acute stage. However, the pandemic may stay with us longer than expected. In addition, there will be some male COVID-19 patients with cancer or critically illness who needs to cryopreserve their semen before medical treatments, otherwise they might loss the chance of getting their own offspring. In this document, we summarize available evidence to deepen and expand awareness of feasibility of sperm cryopreservation and propose some suggestions to help cryobanks carry out sperm preservation procedure for COVID-19 male patients.
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Affiliation(s)
- Yongming Wu
- Human sperm bank, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoxue Zhang
- COVID‐19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, Nanjing, China
| | - Zhiqiang Wang
- Human sperm bank, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinyi Xia
- COVID‐19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China
- *Correspondence: Xinyi Xia,
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Cutting E, Catt S, Vollenhoven B, Mol BW, Horta F. The impact of COVID-19 mitigation measures on fertility patients and clinics around the world. Reprod Biomed Online 2021; 44:755-763. [PMID: 35190253 PMCID: PMC8712431 DOI: 10.1016/j.rbmo.2021.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/02/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Elizabeth Cutting
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia.
| | - Sally Catt
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia
| | - Beverley Vollenhoven
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Womens and Newborn Program Monash Health, Clayton, Melbourne Victoria, Australia; Monash IVF, Clayton, Melbourne Victoria, Australia
| | - Ben W Mol
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Womens and Newborn Program Monash Health, Clayton, Melbourne Victoria, Australia
| | - Fabrizzio Horta
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Monash IVF, Clayton, Melbourne Victoria, Australia
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Anifandis G, Taylor TH, Messini CI, Chatzimeletiou K, Daponte A, Ioannou D, Tempest HG. The Impact of SARS-CoV-2 on Sperm Cryostorage, Theoretical or Real Risk? ACTA ACUST UNITED AC 2021; 57:medicina57090946. [PMID: 34577870 PMCID: PMC8467274 DOI: 10.3390/medicina57090946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 12/24/2022]
Abstract
Cryopreservation of human gametes and embryos as well as human reproductive tissues has been characterized as an essential process and aspect of assisted reproductive technology (ART). Notably, sperm cryopreservation is a fundamental aspect of cryopreservation in oncological patients or patients undergoing gonadotoxic treatment. Given that there is a risk of contamination or cross-contamination, either theoretical or real, during the procedures of cryopreservation and cryostorage, both the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) have provided updated guidelines for preventing or reducing the contamination risk of sexually transmitted viruses. Given the ongoing and worldwide COVID-19 pandemic, there is considerable interest in what measures should be taken to mitigate SARS-CoV-2 contamination during cryopreservation and cryostorage of semen samples. The SARS-CoV-2 virus is the virus that causes COVID-19, and whose transmission and infection is mainly aerosol-mediated. Several ART professional societies, including ESHRE and ASRM have proposed measures to mitigate the spread of the SARS-CoV-2 virus. Whether the proposed safety directives are enough to mitigate the possible SARS-CoV-2-contamination of sperm samples during cryopreservation or whether the policies should be re-evaluated will be discussed in this review. Additionally, insights regarding the possible impact of COVID-19 vaccination on the safety of sperm cryopreservation will be discussed.
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Affiliation(s)
- George Anifandis
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41200 Larisa, Greece; (C.I.M.); (A.D.)
- Correspondence: ; Tel.: +30-6975865861
| | - Tyl H Taylor
- Reproductive Endocrinology Associates of Charlotte, Charlotte, NC 28207, USA;
| | - Christina I Messini
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41200 Larisa, Greece; (C.I.M.); (A.D.)
| | - Katerina Chatzimeletiou
- 1st Department of Obstetrics and Gynecology, Unit for Human Reproduction, School of Health Sciences, Faculty of Medicine, Aristotelian University of Thessaloniki, 56403 Thessaloniki, Greece;
| | - Alexandros Daponte
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41200 Larisa, Greece; (C.I.M.); (A.D.)
| | - Dimitrios Ioannou
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (D.I.); (H.G.T.)
| | - Helen G Tempest
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (D.I.); (H.G.T.)
- Biomolecular Sciences Institute, Florida International University, Miami, FL 33199, USA
- College of Medicine, Roseman University of Health Sciences, Las Vegas, NV 89135, USA
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11
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Wiweko B, Ho TM, Tanaka A, Raggio V, Lee JR, Patil M, Chan CCW, Wutayavanich T, Diao F, Nair S, Mendiola RF. COVID-19 Pandemic Impacts Decision-Making and Psychosocial Behavior in Women Seeking Fertility Treatment in APAC—an ASPIRE Patient Experience Report. FERTILITY & REPRODUCTION 2021. [DOI: 10.1142/s2661318221500080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: ASPIRE (Asia-Pacific Initiative on Reproduction) aims to develop a “patient-centered” guide to provide fertility treatment based on patient preferences, needs, and concerns during and beyond the SARS-Cov-2 pandemic. Methods: Women, aged 20–45 years old, trying to conceive for more than 6 months and contemplating for pregnancy including IVF treatment. A country wise analysis of patient behavior, attitudes and concerns, reasons for disruption of treatment and availability of assistance from fertility clinics during SARS-Cov-2 pandemic was performed. Six problem statements addressing patient concerns were identified and corresponding solutions to improve patient experience were formulated. A two-tier recommendation was developed. Tier 1 comprises recommendations in which the rate of “absolutely agree” responses were [Formula: see text]60%, whereas tier 2 refers to recommendations in which the rate of “absolutely agree” plus “agree” together was >60%. Results: Women in countries that have better infection control and are living a new normal were less worried about the pandemic influencing their lifestyle and finances. The proportion of women choosing not to continue IVF/IUI treatment during COVID-19 was similar across countries. Sixty-five percent of women in Group A intend to continue treatment during COVID-19 pandemic. Nine out of 10 patients are expected to resume or start treatment once fertility clinics are accessible. A patient-centered guide focusing on management of patient safety concerns, reduction in difficulty of access to hospitals, prioritization of patients, provision of emotional support, and improvement in patient education and acceptance of remote health services was developed. Conclusion: This ASPIRE patient experience report highlights a patient-centered guide on provision of safe fertility treatment across the Asia-Pacific region, which can be adapted to suit country-specific requirements depending on the stage of the pandemic, local restrictions, and availability of resources.
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Affiliation(s)
- Budi Wiweko
- Department Obstetric Gynecology Faculty of Medicine Universitas Indonesia — Dr. Cipto Mangunkusumo General Hospital, Indonesia Medical Education Research Institute (IMERI) Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Tuong M. Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | | | | | - Jung-Ryeol Lee
- Seoul National University, Bundang Hospital, Seongnam, South Korea
| | - Milind Patil
- Shobha Test-Tube Baby Centre, Maharashtra, India
| | | | | | - Feiyang Diao
- Clinical Center of Reproductive Medicine, Key State Laboratory of Reproductive Medicine, The First Affiliated Hospital with Nanjing Medical University, China
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12
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Chandi A, Jain N. State of ART in the COVID-19 era and consequences on human reproductive system. Biol Reprod 2021; 105:808-821. [PMID: 34159367 DOI: 10.1093/biolre/ioab122] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
The outbreak of the COVID-19 virus has created havoc on the socio-economic aspect of the world. With billions of lives affected by this wrecking pandemic, global fertility services were also not left untouched by its impact. The possibility of sexual transmission of SARS-CoV-2 virus, its impact on male and female fertility, pregnancy, its potential teratogenic effect, and handling of gametes in the clinical laboratories were major concerns among reproductive medicine specialists which led down all the reproductive health services including IUI, IVF/ICSI in most of the countries. Even the people did not intend to conceive during the pandemic crisis and were hesitant to avail such services. Discrete evidence regarding the pathophysiology of COVID-19 infection and its impact on the human reproductive system is not very clear. In this review article, we intend to incorporate all the evidence related to the COVID-19 infection and its impact on human reproduction available to date. It's our responsibility to provide rightful information and to keep our patients familiar with the existing lack of clear evidence. In this COVID-19 era, it's important that the fertility management be prioritized in sub-fertile couples with diminished fertility reserve, and high-risk conditions like malignancies, that may affect their long-term fertility prospects.
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Affiliation(s)
- Anadeep Chandi
- PGIMER, Chandigarh, H No 957, Sector 25, Panchkula, Haryana, India
| | - Neelam Jain
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Sector 32, Chandigarh, India
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Anifandis G, Messini CI, Simopoulou M, Sveronis G, Garas A, Daponte A, Messinis IE. SARS-CoV-2 vs. human gametes, embryos and cryopreservation. Syst Biol Reprod Med 2021; 67:260-269. [PMID: 34060390 DOI: 10.1080/19396368.2021.1922537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is an unprecedented global situation, and all countries have adopted their own measurements to mitigate the spread of the virus in the first as well as in the subsequent waves of infection. All measures, especially in the first wave of the pandemic, were in combination with recommendations provided by professional and scientific organizations. Similar measures were applied to specific procedures, such as the management of infertility, including in vitro fertilization-embryo transfer (IVF-ET) treatments. Although there is no clear scientific evidence yet that the SARS-CoV-2 may exert negative effects on IVF outcome, especially at the early stages, several clinical reports indicate that the virus may impact male fertility through specific receptors presented at the somatic cells of the testis and used by the virus in order to gain entry to the respective cells. Nevertheless, it is not unreasonable to suspect that the virus may affect sperm function as well as oocyte performance directly through specific receptors or indirectly through other signaling pathways. Despite the good practice of IVF laboratory techniques, culture media may also be contaminated during equilibration when airborne virus's particles can contaminate culture media from an already infected embryology area or staff. Furthermore, although there is no clinical evidence, liquid nitrogen could be a route of infection for gametes and embryos when it has been contaminated during production or transportation. Therefore, cryopreservation of gametes and embryos must be virus-free. This communication aims to provide some aspects of the possible impact of the virus on gametes and embryos and how it may affect the cryopreservation procedures.Abbreviations: ACE2: angiotensin- converting enzyme 2; ART: assisted reproductive technology; ASRM: American Society for Reproductive Medicine; CDC: Centers for Disease Control and Prevention; COVID-19: coronavirus disease 2019; ESHRE: European Society of Human Reproduction and Embryology; ET: embryo transfer; FSH: follicle stimulating hormone; IFFS: International Federation of Fertility Societies; IVF: in vitro fertilization; LH: luteinizing hormone; LN: liquid nitrogen; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; T: testosterone; WHO: World Health Organization.
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Affiliation(s)
- George Anifandis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Christina I Messini
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Mara Simopoulou
- Department of Physiology, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - George Sveronis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.,Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Antonios Garas
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Alexandros Daponte
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Ioannis E Messinis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Rajput SK, Logsdon DM, Kile B, Engelhorn HJ, Goheen B, Khan S, Swain J, McCormick S, Schoolcraft WB, Yuan Y, Krisher RL. Human eggs, zygotes, and embryos express the receptor angiotensin 1-converting enzyme 2 and transmembrane serine protease 2 protein necessary for severe acute respiratory syndrome coronavirus 2 infection. F&S SCIENCE 2021; 2:33-42. [PMID: 33521687 PMCID: PMC7831752 DOI: 10.1016/j.xfss.2020.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To study messenger ribonucleic acid (mRNA) and protein expressions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptors (angiotensin 1-converting enzyme 2 [ACE2] and CD147) and proteases (transmembrane serine protease 2 [TMPRSS2] and cathepsin L [CTSL]) in human oocytes, embryos, and cumulus (CCs) and granulosa cells (GCs). DESIGN Research study. SETTING Clinical in vitro fertilization (IVF) treatment center. PATIENTS Patients undergoing IVF were treated at the Colorado Center for Reproductive Medicine. INTERVENTIONS Oocytes (germinal vesicle and metaphase II [MII]) and embryos (1-cell [1C] and blastocyst [BL]) were donated for research at the disposition by the patients undergoing IVF. Follicular cells (CC and GC) were collected from women undergoing egg retrieval after ovarian stimulation without an ovulatory trigger for in vitro maturation/IVF treatment cycles. MAIN OUTCOME MEASURES Presence or absence of ACE2, CD147, TMPRSS2, and CTSL mRNAs detected using quantitative reverse transcription polymerase chain reaction and proteins detected using capillary Western blotting in human oocytes, embryos, and ovarian follicular cells. RESULTS The quantitative reverse transcription polymerase chain reaction analysis revealed high abundance of ACE2 gene transcripts in germinal vesicle and MII oocytes than in CC, GC, and BL. ACE2 protein was present only in the MII oocytes, and 1C and BL embryos, but other ACE2 protein variants were observed in all the samples. TMPRSS2 protein was present in all the samples, whereas mRNA was observed only in the BL stage. All the samples were positive for CD147 and CTSL mRNA expressions. However, CCs and GCs were the only samples that showed coexpression of both CD147 and CTSL proteins in low abundance. CONCLUSIONS CCs and GCs are the least susceptible to SARS-CoV-2 infection because of lack of the required combination of receptors and proteases (ACE2/TMPRSS2 or CD147/CTSL) in high abundance. The coexpression of ACE2 and TMPRSS2 proteins in the MII oocytes, zygotes, and BLs demonstrated that these gametes and embryos have the cellular machinery required and, thus, are potentially susceptible to SARS-CoV-2 infection if exposed to the virus. However, we do not know whether the infection occurs in vivo or in vitro in an assisted reproductive technology setting yet.
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Affiliation(s)
| | | | - Becca Kile
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | | | - Ben Goheen
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Shaihla Khan
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Jason Swain
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Sue McCormick
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | | | - Ye Yuan
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Rebecca L Krisher
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
- Genus PLC, DeForest, Wisconsin
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Infection precautions for severe acute respiratory syndrome coronavirus 2 in assisted reproduction centers: dodging an invisible bullet. Fertil Steril 2021; 115:831-839. [PMID: 33750621 PMCID: PMC7834468 DOI: 10.1016/j.fertnstert.2021.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 01/05/2023]
Abstract
The coronavirus disease 2019 pandemic has resulted in many changes in how we interact in society, requiring that we protect ourselves and others from an invisible, airborne enemy called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Until a vaccine is developed, and it reaches high levels of distribution, everyone must continue to be diligent to limit the viral spread. The practice of assisted reproduction during this pandemic presents unique challenges in addition to the risks identified in general clinical care. The established good tissue practices employed in laboratories are not designed to protect gametes and embryos from an airborne virus, particularly one that may be shed by an asymptomatic staff member. Armed with theoretical risks but lacking direct evidence, assisted-reproduction teams must examine every aspect of their practice, identify areas at a risk of exposure to SARS-CoV-2, and develop a mitigation plan. Several professional fertility societies have created guidelines for the best practices in patient care during the coronavirus disease 2019 pandemic. As we learn more about SARS-CoV-2, updates have been issued to help adapt infection-control and -prevention protocols. This review discusses what is currently known about SARS-CoV-2 infection risks in assisted reproductive centers and recommends the implementation of specific mitigation strategies.
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Jirge PR, Patwardhan S, Jirge SN, Bhomkar DA, Chougule SM, Salpekar A, Modi D. Resuming Assisted Reproduction Services during COVID-19 Pandemic: An Initial Indian Experience. J Hum Reprod Sci 2020; 13:323-332. [PMID: 33627983 PMCID: PMC7879848 DOI: 10.4103/jhrs.jhrs_211_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The pandemic of COVID-19 has affected many countries and medical services including assisted reproductive treatment (ART) have been hampered. AIM The study was conducted to assess the preparedness of ART clinics and staff to resume services; patients' reasons to initiate treatment; and key performance indicators (KPIs) of ART laboratories during the pandemic. SETTING AND DESIGN This was a semidescriptive, prospective study in two private in vitro fertilization (IVF) clinics in Maharashtra, India, when COVID-19 testing for asymptomatic people was unavailable. MATERIALS AND METHODS Time required for replenishing consumables and clinic preparedness to function under "new norms" of pandemic was documented. Infection mitigation measures and triaging strategy were evaluated. KPIs following resumption were analyzed. The Student's t-test was performed for comparing parameters. RESULTS Thirty percent of the patients consulted through telemedicine accepted or were eligible to initiate treatment on clinic resumption. Lack of safe transport and financial constraints prevented majority from undergoing IVF, and 9% delayed treatment due to fear of pandemic. With adequate training, staff compliance to meet new demands was achieved within a week, but procuring consumables and injections was time-consuming. Fifty-two cycles of IVF were performed including fresh and frozen embryo transfers with satisfactory KPIs even during pandemic. Conscious sedation and analgesia during oocyte retrieval were associated with reduced procedure time and no intervention for airway maintenance compared to general anesthesia. Self-reported pain scores by patients ranged from nil to mild on a graphic rating scale. CONCLUSIONS This study provides practical insight for the resumption of IVF services during the COVID-19 pandemic.
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Affiliation(s)
- Padma Rekha Jirge
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Sadhana Patwardhan
- Department of Reproductive Medicine, Nagpur Test Tube Baby Centre, Nagpur, India
| | - Shishir Narendra Jirge
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Deepali A. Bhomkar
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Shruti M. Chougule
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Anita Salpekar
- Department of Reproductive Medicine, Nagpur Test Tube Baby Centre, Nagpur, India
| | - Deepak Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Rproductive Health, Mumbai, Maharashtra, India
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Assessment and management of the risk of SARS-CoV-2 infection in an IVF laboratory. Reprod Biomed Online 2020; 41:385-394. [PMID: 32693991 PMCID: PMC7320666 DOI: 10.1016/j.rbmo.2020.06.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022]
Abstract
Research question The study set out to identify corrective measures aimed at reducing the risk of aerosol-mediated viral infection within an IVF laboratory. Design A failure modes and effect analysis (FMEA) was conducted by a multidisciplinary IVF team. A schematic representation of new protocols and procedures adopted during COVID-19 emergency has been defined, including directives about the behaviour to adopt when entering the clinic and the laboratory, in case of face-to-face contact with patients and between staff members. In addition, the risk of cross-contamination between samples belonging to different patients during cell handling and manipulation has been evaluated. Potential failure modes for each phase of the emergency have been analysed, focusing on possible sources of error. Risk priority numbers have been calculated as products of Occurrence × Severity × Detection scores. Results Except for cell–cell contamination, which was considered highly unlikely, failure modes during patient–staff, staff–staff and staff–cell interactions were estimated as carrrying a moderate to high risk of infection. The main corrective measures entailed precautionary logistic measures, the implementation of additional personal protective equipment and changes in the IVF laboratory procedures and scheduling of the daily routine. Some procedures were also revised, aiming to increase staff's awareness and caution. Conclusions Standard laboratory protocols are insufficient to face a virus whose transmission is aerosol mediated. The measures outlined in this FMEA should thus be considered not only for facing this pandemic, but also for the future to promptly manage any aerosol-mediated virus infection, whose impact on the management of an IVF laboratory might be less severe than COVID-19 although not completely negligible.
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