C Hughes1, K Grundy, G Emerson, E Mocanu. 1. Human Assisted Reproduction Ireland, Rotunda Hospital, Dublin 1, Dublin. chughes@rcsi.ie
Abstract
BACKGROUND: The frequency for virology testing for couples undergoing assisted reproductive treatment (ART) in Europe is currently under debate, with little scientific data available to support the time-frame imposed by EU legislation. The aim of this study was to determine the incidence of blood-borne viruses (BBV) in this population and to assess the likelihood of seroconversion after an initial negative screen and the possible cost saving to couples. METHODS: We identified all cases where a BBV screen was performed on patients attending our tertiary referral unit for ART. We calculated the incidence of Hepatitis B surface antigen, Hepatitis C antibody and HIV infection in this population and the incidence of seroconversion in follow-up screening (which included Hepatitis B core antibody) following the implementation of the EU legislation. In all cases identified, we sought to assess the risk of seroconversion after an initial negative screen. RESULTS: Between 1998 and 2009, we identified a total of 79 291 tests performed in over 12 500 patients. The incidence in this population of Hepatitis B surface antigen was 0.28% (37/12,797), Hepatitis B core antibody 3.32% (96/2891), Hepatitis C antibody 0.33% (43/12,762) and HIV 0.007% (1/12,819). We were able to show that for over 6500 individuals who were tested and re-tested for all three viruses, no seroconversions were reported. CONCLUSIONS: Based on the above measured negligible risk of seroconversion after an initial negative screen in co-habitating couples participating in an ART programme, current legislation requiring screening of couples at each procurement of cells in the assisted reproductive setting is not clinically justified.
BACKGROUND: The frequency for virology testing for couples undergoing assisted reproductive treatment (ART) in Europe is currently under debate, with little scientific data available to support the time-frame imposed by EU legislation. The aim of this study was to determine the incidence of blood-borne viruses (BBV) in this population and to assess the likelihood of seroconversion after an initial negative screen and the possible cost saving to couples. METHODS: We identified all cases where a BBV screen was performed on patients attending our tertiary referral unit for ART. We calculated the incidence of Hepatitis B surface antigen, Hepatitis C antibody and HIV infection in this population and the incidence of seroconversion in follow-up screening (which included Hepatitis B core antibody) following the implementation of the EU legislation. In all cases identified, we sought to assess the risk of seroconversion after an initial negative screen. RESULTS: Between 1998 and 2009, we identified a total of 79 291 tests performed in over 12 500 patients. The incidence in this population of Hepatitis B surface antigen was 0.28% (37/12,797), Hepatitis B core antibody 3.32% (96/2891), Hepatitis C antibody 0.33% (43/12,762) and HIV 0.007% (1/12,819). We were able to show that for over 6500 individuals who were tested and re-tested for all three viruses, no seroconversions were reported. CONCLUSIONS: Based on the above measured negligible risk of seroconversion after an initial negative screen in co-habitating couples participating in an ART programme, current legislation requiring screening of couples at each procurement of cells in the assisted reproductive setting is not clinically justified.