Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.
Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA.
Syst Biol Reprod Med. 2021 Apr;67(2):144-150. doi: 10.1080/19396368.2021.1884317. Epub 2021 Mar 16.
The SARS-CoV-2 pandemic peak around March 2020 led to temporary closures of most fertility clinics. Many clinics reopened but required universal SARS-CoV-2 screening. However, the rate of positive results and the necessity for such testing is unknown. We report here on early results from asingle-center academic NewYork fertility practice utilizing universal SARS-CoV-2 screening. This mixed prospective retrospective cohort included 164 patients who underwent at least one SARS-CoV-2 screening test for fertility treatment between May and July2020. Patients completed 1 to 3 nasopharyngeal SARS-CoV-2 tests per cycle and remained symptom-free to continue fertility treatments. SARS-CoV-2 test results, past results, history of Covid-19 infection, and patient/cycle characteristics were recorded and tabulated through October2020. Outcomes included positive SARS-CoV-2 RNA tests, rate of prior Covid-19 infections, and clinical courses of patients testing positive. Patients underwent 263 cycles entailing 460 total SARS-CoV-2 screening tests. Fifteen patients reported astrong prior clinical history of Covid-19. Six patients experienced apositive SARS-CoV-2 test (2.3% of all cycles). Among 77 cycles (n = 58 patients) entailing one SARS-CoV-2 test, 2 cases (2.6%) were noted. Among 173 cycles (n = 121 patients) entailing two SARS-CoV-2 tests, 4 cycles (2.3%) were noted. Zero (0%) of 13 cycles (n = 13 patients) entailing 3 SARS-CoV-2 tests were positive. All patients were cleared to resume treatment within one month. Overall, anew asymptomatic infection was identified in 2 cycles (0.8%), while 4 of the 6 positive SARS-CoV-2 tests were among patients with aprior history of Covid-19. 3 of 4 also had adocumented prior positive RNA test. Our data suggest that universal SARS-CoV-2 screening among fertility patients is feasible, with an approximately 2% positive rate per cycle among the patients of this study. Most positive patients had aprior remote infection, but their infectiousness while being screened remains unclear. REI: reproductive endocrinology and infertility; IUI: intrauterine insemination; IVF: fertilization; sono: sonography; cryo: cryopreservation; FET: frozen embryo transfer.
2020 年 3 月左右,SARS-CoV-2 大流行达到高峰,导致大多数生育诊所暂时关闭。许多诊所重新开放,但需要进行普遍的 SARS-CoV-2 筛查。然而,阳性结果的比率和进行此类检测的必要性尚不清楚。我们在此报告一家位于纽约的学术生育实践中心的早期结果,该中心利用普遍的 SARS-CoV-2 筛查。这项混合前瞻性回顾性队列研究包括 164 名患者,他们在 2020 年 5 月至 7 月期间接受了至少一次生育治疗的 SARS-CoV-2 筛查测试。患者每周期进行 1 到 3 次鼻咽 SARS-CoV-2 测试,并且无症状继续进行生育治疗。通过 2020 年 10 月记录并制表了 SARS-CoV-2 检测结果、既往结果、Covid-19 感染史以及患者/周期特征。结果包括 SARS-CoV-2 RNA 检测阳性、既往 Covid-19 感染率以及检测呈阳性的患者的临床过程。患者接受了 263 个周期,总共进行了 460 次 SARS-CoV-2 筛查测试。15 名患者报告了强烈的既往临床新冠病毒感染史。6 名患者 SARS-CoV-2 检测呈阳性(占所有周期的 2.3%)。在 77 个周期(n=58 名患者)中进行了一次 SARS-CoV-2 检测,发现 2 例(2.6%)。在 173 个周期(n=121 名患者)中进行了两次 SARS-CoV-2 检测,发现 4 个周期(2.3%)。在进行了 3 次 SARS-CoV-2 检测的 13 个周期(n=13 名患者)中,无一例呈阳性。所有患者均在一个月内获准恢复治疗。总的来说,在 2 个周期(0.8%)中发现了新的无症状感染,而在 6 例 SARS-CoV-2 检测阳性的患者中,有 4 例有新冠病毒感染史。其中 4 例的既往 RNA 检测也呈阳性。我们的数据表明,对生育患者进行普遍的 SARS-CoV-2 筛查是可行的,在本研究的患者中,每个周期的阳性率约为 2%。大多数阳性患者有既往的远程感染,但他们在筛查期间的传染性尚不清楚。REI:生殖内分泌与不孕;IUI:宫腔内人工授精;IVF:体外受精;sono:超声检查;cryo:冷冻保存;FET:冷冻胚胎移植。