SARS-CoV-2 testing in infertile patients: different recommendations in Europe and America

Journal of Assisted Reproduction and Genetics
Antonio La Marca, Scott M Nelson

Abstract

The incorporation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing into patient care algorithms has been proposed to mitigate risk. However, the two main professional societies for human reproduction (ESHRE and ASRM) appear divergent on their clinical utility and whether they should be adopted. In this opinion paper, we review the currently available tests and discuss the strengths and weaknesses of the proposed clinical care pathways. Nucleic acid amplification tests are the cornerstone of SARS-CoV-2 testing but test results are largely influenced by viral load, sample site, specimen collection method, and specimen shipment technique, such that a negative result in a symptomatic patient cannot be relied upon. Serological assays for SARS-CoV-2 antibodies exhibit a temporal increase in sensitivity and specificity after symptom onset irrespective of the assay used, with sensitivity estimates ranging from 0 to 50% with the first 3 days of symptoms, to 83 to 88% at 10 days, increasing to almost 100% at ≥ 14 days. These inherent constraints in diagnostics would suggest that at present there is inadequate evidence to utilize SARS-CoV-2 testing to stratify fertility patients and reliably inform clinical decision...Continue Reading

References

Feb 20, 2020·The New England Journal of Medicine·Lirong ZouJie Wu
Mar 30, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Juanjuan ZhaoZheng Zhang
Mar 31, 2020·Fertility and Sterility·Antonio La MarcaScott M Nelson
Apr 5, 2020·Journal of Clinical Microbiology·Yi-Wei TangCharles W Stratton
Apr 17, 2020·Nature Medicine·Xi HeGabriel M Leung
May 1, 2020·Nature Medicine·Quan-Xin LongAi-Long Huang
May 2, 2020·Reproductive Biomedicine Online·Alberto VaiarelliFilippo M Ubaldi
May 14, 2020·Clinical Chemistry·Mei San TangChristopher W Farnsworth
May 15, 2020·Reproductive Biology and Endocrinology : RB&E·Carlo AlviggiUNKNOWN POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) group
Jun 9, 2020·MedRxiv : the Preprint Server for Health Sciences·Fatima AmanatFlorian Krammer
Jun 26, 2020·The Cochrane Database of Systematic Reviews·Jonathan J DeeksUNKNOWN Cochrane COVID-19 Diagnostic Test Accuracy Group

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Citations

Jan 8, 2021·Journal of Assisted Reproduction and Genetics·Scott M Nelson, Antonio La Marca
Oct 23, 2020·Journal of Assisted Reproduction and Genetics·M Cristina Magli, Catherine Racowsky
Jul 19, 2021·Reproductive Biomedicine Online·Marine PoulainJean-Marc Ayoubi
Nov 24, 2020·Urologia Internationalis·Peng JinJayoung Kim

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Methods Mentioned

BETA
nucleic acid amplification
ELISA

Software Mentioned

ESHRE

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