COVID-19 screening during fertility treatment: how do guidelines compare against each other?
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COMMENTARY
COVID-19 screening during fertility treatment: how do guidelines compare against each other? Athanasios Papathanasiou 1 Received: 20 May 2020 / Accepted: 8 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Various fertility scientific societies have published pathways and recommendations for COVID-19 screening during fertility treatments. As there is currently very limited research evidence on how to best deliver this screening, it is not surprising that there are noticeable differences between their recommendations. This paper compares the screening pathways recommended by these guidelines, in the light of the emerging evidence. It proposes the more liberal use of viral testing for improving detection of asymptomatic or mildly symptomatic fertility patients. It also argues that a negative test result on symptomatic individuals should not be over-relied upon for allowing the treatment to proceed. In these cases, a low threshold for cancellation may still need to be maintained. Keywords Covid-19 . Sars . Fertility . IVF . Guideline
Introduction Developing risk assessment strategies against COVID-19 for the fertility services presents with unique challenges. The very nature of fertility treatment involves a number of necessary face-to-face interactions which extend over a timeframe of weeks. This requires continual reaffirming of good health, not just a single assessment. It also demands prompt investigation of the potential risk, followed by decisions—to conclude or cancel the treatment—which are often backed by limited evidence. Ideally, a reliable and sensitive point-of-care diagnostic tool for COVID-19 could address most of these challenges effectively. However, at the time of writing this paper, no such tool is readily available for use in the reproductive medicine field [1]. As a result, fertility scientific societies currently suggest combining tools for assessing the risk of exposure to the virus, with some noticeable differences among their recommendations. The aim of this paper is to discuss the guidance on COVID19 screening that is specific to the delivery of fertility treatment. Differences within the existing guidelines will help highlight gaps and limitations in current knowledge, which * Athanasios Papathanasiou [email protected] 1
Bourn Hall Clinic, Farrier Close, Wymondham Norwich NR18 0WF UK
future guidance should try to address. Moreover, studying these differences will increase preparedness among clinicians, in anticipation of challenging, yet unexplored, clinical scenarios that may be encountered in everyday fertility practice.
Search for COVID-19 fertility guidelines COVID-19-related fertility guidance was expected to be available online within the dedicated scientific societies’ websites, as this would facilitate instant publication and dissemination, as well as regular updating of the guidance. Therefore, an online search was conducted using relevant keywords (‘covid-19′, ‘sars’, ‘fertility’, ‘reproductive’, ‘society’, ‘association’,
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