Cryopreservation and IVF in the time of Covid-19: what is the best good tissue practice (GTP)?
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COMMENTARY
Cryopreservation and IVF in the time of Covid-19: what is the best good tissue practice (GTP)? Kimball O. Pomeroy 1
&
Mitchel C. Schiewe 2
Received: 10 June 2020 / Accepted: 24 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Examine good tissue practices as relates to in vitro fertilization, biopsying, and vitrificationto compare current knowledge of ova, sperm, and embryos as vectors for disease transmission as it relates to our current knowledge regarding the SARS-CoV-2 virus. Unknown risks relating to the SARS-CoV-2 virus and sperm, ova, and embryos necessitate a reexamining of how human IVF is performed. Over the last decade, improvements in cryosurvival and live birth outcomes have been associated with zona pellucida breaching procedures (e.g., blastocyst collapsing and biopsying). In turn, today embryos are generally no longer protected by an intact zona pellucida when vitrified and in cryostorage. Additionally, high security storage containers have proven to be resilient to potential cross-contamination and reliable for routine human sperm freezing and embryo vitrification. Several options to current IVF practices are presented that can effectively mitigate the risks of cross-contamination and infection due to the current Covid-19 pandemic or other viral exposures. The question remains; is heightened security and change warranted where the risks of disease transmission likely remain negligible? Keywords SARS-CoV-2 . Covid-19 . IVF laboratories . Cross-contamination . Good tissue practices
Introduction The onset of Covid-19 global pandemic in 2020 has altered all of our lives. We have changed how we function as family units in society and have adapted a safer workplace environment for our staff and patients. Forced to apply preventative measures to potentially control and contain the highly infectious coronavirus specifically known as Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) in our laboratories, we are once again faced with the inevitable question “What is the risk of disease transmission to and between human embryos, gametes and reproductive tissue in production and cryostorage?" Though it is safe to conclude that the background review and guidance of Pomeroy and
* Kimball O. Pomeroy [email protected] Mitchel C. Schiewe [email protected] 1
The World Egg Bank, Phoenix, AZ 85020, USA
2
Ovation Fertility, Newport Beach, CA 92663, USA
colleagues [1] remains valid today, with the former risks of viral transmission being negligible, we must also take a fresh look at the current situation. What has been published or changed in our laboratory practices in the last decade and how do we best adhere to the principles of the Food and Drug Administration’s Good Tissue Practice (GTP) guidance? SARS-CoV-2 is a nasty, infectious airborne virus that is easily spread to any surface for susceptible touch transmission. Interestingly, it is classified as a “wimpy” virus because of its exposed, lipid-containing nuclear envelope (i.e., encasing
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