Assisted Reproductive Services Research Articles

Handling techniques of frozen semen: storage, transfer, transport, and thawing

Enormous demand for assisted canine reproduction services in the last decade has increased the use of frozen semen in veterinary clinics. However, training and knowledge regarding frozen semen handling, as observed by the author, has been lagging. Therefore, this report focuses on simple steps to avoid damage to frozen semen prior to its use.

O-081 Navigating the crossroads: unraveling predictors for treatment discontinuation in couples pursuing assisted reproduction: findings from a 2-year prospective study

Abstract Study question What are the medical, individual, relationship, and clinic-related factors associated with fertility treatment discontinuation ? Summary answer Insurance status and medication use by the partner emerged as primary predictors for treatment discontinuation, while emotional burden and cost were the leading reasons cited. What is known already Despite advancements in assisted reproduction, the arduous nature of fertility treatments prompts 20 to 30% of couples to discontinue before pregnancy, even with a favorable prognosis and financial means. Whereas the World Health Organization deems treatment compliance critical for effectiveness, fundamental knowledge on fertility treatment compliance is lacking. Existing retrospective studies attribute discontinuation to the physical and psychological burdens of treatment and relationship strain. However, understanding the precise nature of psychological and relational issues influencing this decision remains limited. Additionally, previous research has overlooked patient and clinic factors related to discontinuation, hindering professionals in supporting couples through this process. Study design, size, duration A 2-year prospective study with a correlational design. The sample included 310 couples (35 same-gender/sex couples) pursuing assisted reproduction in Canada or the United States. Data were collected between December 2019 and November 2023. Participants/materials, setting, methods Couples seeking assisted reproductive services within six months of their initial visit to a fertility clinic were recruited through social media and affiliated fertility clinics. Both partners completed online questionnaires evaluating sociodemographics, medical and treatment history, psychological and relationship functioning, and their perception of patient-centered care at baseline. Follow-up assessments occurred at 6, 12, 18, and 24 months. Treatment status (ongoing, terminated due to pregnancy) and reasons for discontinuation were also recorded at each follow-up. Main results and the role of chance To identify the primary predictors of treatment discontinuation, we conducted survival analyses using sociodemographic variables (age, relationship duration, income, insurance coverage), medical and treatment history (infertility duration, medication side effects), psychological (depression, anxiety symptoms, quality of life, distress tolerance, attachment style), relationship (satisfaction, dyadic coping, commitment), and patient-centered care (communication, involvement in decisions, information accessibility) data at baseline for both partners (person to be carrying the pregnancy and their partner). Variables were initially tested separately (p < .05), and significant predictors were included in a multivariate model. In individual analyses, couples whereby the partner did not have insurance or was using anxiety/mood medication were more likely to discontinue at some point during the study. Couples in which the person to be carrying the pregnancy reported higher attachment avoidance, lower relationship commitment, or less dyadic coping were also more likely to discontinue during the study. In the comprehensive model, only the partner’s insurance and medication use predicted discontinuation. The most frequently cited reasons for discontinuation were the emotional burden of treatment (43.6%) and cost (43.7%), followed by physical discomfort (31.4%), loss of hope regarding treatment (33.3%), reasons related to services in clinics (28.6%), and personal circumstances impeding treatment (27.5%). Limitations, reasons for caution Given the correlational study design, causation cannot be inferred between identified predictors and treatment discontinuation. The 2-year study duration also limits capturing later discontinuations. Predictors were assessed at baseline only, potentially differing across treatment stages. Finally, 2SLGBTQ+ couples experiencing social infertility are underrepresented in the sample. Wider implications of the findings These findings underscore the importance of addressing insurance accessibility and psychological factors in fertility treatment support. Elevated emotional burden and cost as prominent discontinuation reasons highlight the need for comprehensive, affordable care and emotional support in fertility clinics to improve overall patient experience and outcomes. Trial registration number n/a

Coronavirus disease and assisted reproduction in South Africa: a qualitative study

Objective: Little has been written about the effects of the coronavirus disease 2019 (COVID-19) pandemic on assisted reproduction services in low and middle-income countries. The purpose of this study was to investigate the immediate and long-term effects of assisted reproductive technology services in South Africa after 27 months of various lockdowns and restrictions associated with the pandemic. Methods: This article draws on data collected in 2020–2023 as part of a qualitative study of assisted reproduction within sub-Saharan Africa. Twenty-nine infertility specialists and other clinical staff including embryologists, clinic coordinators, ova donor coordinators, and nurses were interviewed and asked about the effects of the pandemic on their clinics and patients. A semistructured in-depth interview technique was used to collect the data. The analysis was conducted using the thematic analysis method. Result: Findings revealed that the immediate effects of the pandemic included the cancellations and deferral of assisted reproductive technology cycles and decreased numbers of cross-border patients. Challenges experienced by clinics in making decisions included whether to treat COVID-positive patients, increased costs of testing, and economic losses. Longer-term effects included the reconsideration of life priorities by both specialists and patients, and improved remote consultations and networking opportunities facilitated by the widespread dissemination of online platforms. There was also increased acceptability of the shipping and use of frozen gametes, leading to a perceived growth of the South African frozen oocyte trade. There was also decreased demand for add-ons, associated with the economic downturn post-pandemic in the region. Conclusion: COVID-19 carried costs (cancellation of cycles, a decrease in international patients, decrease in some procedures with the post-COVID economic downturn) but also unanticipated benefits for the practices and provision of services within infertility clinics in South Africa (increased gamete and embryo shipping; virtual patient consultations; improved virtual networking; greater use of local in vitro fertilization services). Further comparisons postpandemic in other low and middle-income countries are needed to understand the long-term implications.

Access to assisted reproductive technologies in sub-Saharan Africa: fertility professionals’ views

Across sub-Saharan Africa, there remains disagreement among local expert providers over the best ways to improve access to assisted reproduction in low-income contexts. Semi-structured qualitative interviews were conducted between 2021 and 2023 with 19 fertility specialists and 11 embryologists and one clinic manager from South Africa, Zimbabwe, Namibia, Kenya, Ethiopia and Uganda to explore issues surrounding access and potential low-cost IVF options. Lack of access to ART was variously conceptualised as a problem of high cost of treatment; lack of public funding for medical services and medication; poor policy awareness and prioritisation of fertility problems; a shortage of ART clinics and well-trained expert staff; the need for patients to travel long distances; and over-servicing within the largely privatised sector. All fertility specialists agreed that government funding for public sector assisted reproduction services was necessary to address access in the region. Other suggestions included: reduced medication costs by using mild stimulation protocols and oocyte retrievals under sedation instead of general anaesthetics. Insufficient data on low-cost interventions was cited as a barrier to their implementation. The lack of skilled embryologists on the continent was considered a major limitation to expanding ART services and the success of low-cost IVF systems. Very few specialists suggested that profits of pharmaceutical companies or ART clinics might be reduced to lessen the costs of treatments.

A Qualitative Study on the Experience of Assisted Reproductive Technology in Women with Dyspareunia.

This study aims to investigate the phenomenon of sexual intercourse-related fear among women utilizing assisted reproductive technology due to dyspareunia. The primary objective is to offer insights that can inform the development of targeted nursing interventions. Employing a purposive sampling approach, a cohort of 23 female patients experiencing dyspareunia and undergoing treatment at the Reproductive Medicine Center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between July 2022 and December 2022, were selected as participants for this research. Semi-structured, in-depth interviews were conducted to gather qualitative data. The Colaizzi 7-step analysis method was subsequently applied to scrutinize the interview transcripts and identify emergent themes. The analysis yielded five prominent themes: psychological disturbances, incongruent cognitive perceptions, anticipations regarding conception, insufficient adaptive responses, and sexual expectations. It is imperative for medical practitioners to demonstrate reverence for patients' sexual beliefs and conditions, attune to their apprehensions, and offer efficacious emotional support. Tailored and multifaceted sexual health knowledge should be dispensed based on patients' individual requirements and their envisioned sexual experiences, thereby fostering spousal and familial harmony. By prioritizing patients' sexual well-being, cultivating a compassionate medical milieu, and augmenting the quality of assisted reproductive services, comprehensive improvements can be achieved.

Gynecologic Care of Black Breast Cancer Survivors.

Black patients suffer from breast cancer-related racial health disparities, which could have implications on their gynecologic care. This review explores considerations in the gynecologic care of Black breast cancer survivors. Black people have a higher risk of leiomyoma and endometrial cancer, which could confound bleeding patterns such as in the setting of tamoxifen use. As Black people are more likely to have early-onset breast cancer, this may have implications on long-term bone and heart health. Black patients may be more likely to have menopausal symptoms at baseline and as a result of breast cancer treatment. Furthermore, Black patients are less likely to utilize assisted reproductive technology and genetic testing services. It is important for healthcare providers to be well-versed in the intersections of breast cancer and gynecologic care. Black breast cancer survivors may have unique considerations for which practitioners should be knowledgeable.

Medicine in the marketplace: clinician and patient views on commercial influences on assisted reproductive technology

Research questionWhat are the views and experiences of patient and expert stakeholders on the positive and negative impacts of commercial influences on the provision of assisted reproductive technology (ART) services, and what are their suggestions for governance reforms? DesignSemi-structured interviews were conducted with 31 ART industry experts from across Australia and New Zealand and 25 patients undergoing ART from metropolitan and regional Australia, between September 2020 and September 2021. Data were analysed using thematic analysis. ResultsExpert and patient participants considered that commercial forces influence the provision of ART in a number of positive ways – increasing sustainability, ensuring consistency in standards and providing patients with greater choice. Participants also considered commercial forces to have a number of negative impacts, including increased costs to government and patients; the excessive use of interventions that lack sufficient evidence to be considered part of standard care; inadequately informed consent (particularly with regard to financial information); and threats to patient–provider relationships and patient-centred care. Participants varied in whether they believed that professional self-regulation is sufficient. While recognizing the benefits of commercial investment in healthcare, many considered that regulatory reforms, as well as organizational cultural initiatives, are needed as means to ensure the primacy of patient well-being. ConclusionsThe views expressed in this study should be systematically and critically examined to derive insights into how best to govern ART. These insights may also inform the design and delivery of other types of healthcare that are provided in the private sector.

Intrauterine insemination: prognostic factors.

To evaluate the impact of possible maternal and paternal prognostic factors and ovarian stimulation protocols on clinical pregnancy and live birth rates in intrauterine insemination (IUI) cycles. Retrospective observational study of 341 IUI cycles performed from January 2016 to November 2020 at the Assisted Reproduction Service of the Clinics Hospital of the Ribeirão Preto Medical School, University of São Paulo. Clinical pregnancy and live birth rates and their potential prognostic factors were evaluated. Wilcoxon's non-parametric test was used to compare quantitative variables, and the chi-square test to compare qualitative variables, adopting a significance level of p<0.05. A logistic regression model was performed to verify which exploratory variables are predictive factors for pregnancy outcome. The ovulation induction protocol using gonadotropins plus letrozole (p=0.0097; OR 4.3286, CI 1.3040 - 14.3684) and post-capacitation progressive sperm ≥ 5million/mL (p=0.0253) showed a statistically significant correlation with the live birth rate. Female and male age, etiology of infertility, obesity, multifollicular growth, endometrial thickness ≥ 7 mm, and time between human chorionic gonadotropin administration and IUI performance were not associated with the primary outcomes. In the group of patients with ideal characteristics (women aged< 40 years, BMI < 30 kg/m2, antral follicle count ≥ 5, partner aged< 45 years, and post-capacitation semen with progressive spermatozoa ≥ 5 million/mL), the rate of clinical pregnancy was 14.8%, while that of live birth, 9.9%. In this study, the ovulation induction protocol with gonadotropins plus letrozole and post-capacitation progressive sperm ≥ 5 million/mL were the only variables that significantly correlated with intrauterine insemination success.

Attitudes toward Reproductive Tourism and Cross border reproductive care (CBRC): Legal, Economic, Ethical issues and dilemmas, possibilities and limitations

The goal of the present study is to discuss the issue of Cross-Border Reproductive Care known as CBRC and Reproductive Tourism. The subject is of great interest as this type of tourism has been flourishing in recent years, without, however, being thoroughly researched, regarding the very important, health, quality of medical care, financial, ethics, legality and transparency or illegality, aspects concerning the processes that are carried out for the desired result of human reproduction. In addition, one of the sharpest-increasing types of Cross-Border Reproductive Care is international surrogacy. Thousands of interested people travel abroad for IVF and ICSI treatment, or with the aim to employ the paid services of foreign surrogates. The search for solutions has made CBRC a global industry. It is a multibillion-euro international industry introducing unique legal, financial, ethical, and risk-management challenges and disputes.&#x0D; The current study addressed this gap by examining Greek citizens’ attitudes toward Reproductive Tourism and Cross border reproductive and their legal, financial, ethical, consequences. To test the research hypotheses, a survey was conducted on 652 Greek citizens, who answered a questionnaire, which was distributed electronically in the format of a Google form. For the data analysis the study used the multiple correspondence analysis – MCA of sphere of multivariate data analysis.&#x0D; The results discuss, as far as the legal dimensions are concerned, the restriction on specific reproductive treatments in the country of residence. IVF and ICSI are allowed in almost all countries but there are legal restrictions regarding the age of the woman or the couple, unmarried couples, single woman, gay, transgender and same-sex couples. As far as the financial dimension of the CBRC is concerned, the study discusses the lack of financial data that is a natural consequence of the lack of both national and global registers. The cost of infertility treatment seems to be one of the most basic reasons for those interested to seek assisted reproductive services outside the borders of their country of origin and residence, and the commercialization of health is an ethical issue that deserves further study in relation to the country of destination. In addition, the study discusses main ethical issues regarding donors and surrogate mothers, among others, which have to do with their exploitation, their moral and physical harm, possible child abuse, parental rights and the sale of babies which are considered of a major importance. Donor or surrogate mothers may suffer from serious and even life-threatening complications. Donor or surrogate mothers from low and economic backgrounds do not have the possibility of legal support and coverage and cannot claim parental rights. Additionally, the study debates the high cost of treatments, health and care benefits, the economic exploitation of women from countries with weak economies, the instrumentalization of women, the legal issues and rights of descendants born in destination countries and in terms of their repatriation, the correct information and informed consent for the medical procedures to be performed, as well as many others because the list is long.&#x0D; According to the study the need that is obvious, due to the great impact of the CBRC, concerns the creation of a universal protocol through the European Council and the College of Obstetrics and Gynaecology (EBCOG) as well as the American College of Obstetrics and Gynaecology (ACOG) to remove all the above mentioned issues , issues and moral dilemmas that above all will guarantee the good of health, justice, non-harm, the good of justice, autonomy and self-determination and finally, human rights.

Expectations for family building, assisted reproduction, and adoption among lesbians in the National Survey of Family Growth, 2017–2019

To characterize the family-building goals and experiences of lesbians compared with those of heterosexual females in the United States. Secondary analysis of nationally representative, cross-sectional survey data. National Survey of Family Growth 2017-2019. 159 reproductive-age lesbian respondents and 5,127 reproductive-age heterosexual respondents. We characterized family-building goals and the use of assisted reproduction and adoption among lesbians using nationally representative female respondent data from the 2017-2019 National Survey of Family Growth. We performed bivariate analyses examining variations in these outcomes between lesbian and heterosexual individuals. Wantedness of children, use of assisted reproductive technology, and pursuit of adoption among reproductive-age lesbian and heterosexual participants. We identified 159 reproductive-age lesbian respondents of the National Survey of Family Growth, representing 2.3% or approximately 1.75 million US individuals of reproductive age. The lesbian respondents were younger, less religious, and less likely to have children than heterosexual respondents. These groups did not differ significantly by race/ethnicity, education, or income. More than half of the individuals reported wanting a child in the future, with proportions similar between the lesbian and heterosexual individuals (48% vs. 51%, respectively; P = .52). Accordingly, 18% of both the lesbian and heterosexual individuals reported that they would be greatly bothered if they were unable to have children. Nevertheless, health care providers reportedly asked the lesbians about their desire to get pregnant less frequently than they asked the heterosexual individuals (21% vs. 32%, respectively; P = .04). Only 26% of the lesbians had ever been pregnant compared with 64% of the heterosexual individuals (P<.01). Approximately one third (31%) of lesbians with medical insurance were seeking reproductive services compared with 10% of heterosexual individuals (P = .05). Lesbians were significantly more likely to be seeking adoption than heterosexual individuals (7.0% vs. 1.3%, respectively; P = .01), although they were more likely to report being turned down (17% vs. 10%, respectively; P=.03), not knowing why they were unable to adopt (19% vs. 1%, respectively; P = .02), and quitting because of the adoption process (100% vs. 45%, respectively; P = .04). Approximately half of US females of reproductive age desire to have a child, a proportion that is not different between lesbian and heterosexual individuals. However, fewer lesbians are asked about their desires to get pregnant, and fewer ever become pregnant. Lesbians are significantly more likely to pursue assisted reproductive services when covered by insurance and more likely to seek adoption. Unfortunately, lesbians are more likely to face challenges with adoption.

Going the Distance

Qualitative studies on assisted reproductive technology commonly focus on the perspectives of participants living in major metropolises. In doing so, the experiences of those living outside major cities, and the unique way conditions of spatiality shape access to treatment, are elided. In this paper, we examine how location and regionality in Australia impact upon access and experience of reproductive services. We conducted twelve qualitative interviews with participants residing in regional areas across Australia. We asked participants to discuss their experience with assisted reproduction services and the impacts of location on access, service choice, and experience of care, and analysed the data using reflexive thematic analysis, as outlined by Braun and Clarke (2006, 2019). Participants in this study reported that their location impacted the services available to them, required considerable time in travel, and reduced continuity of care. We draw on these responses to examine the ethical implications of uneven distribution of reproductive services in commercial healthcare settings which rely on market-based mechanisms.

Cryopreservation as a strategy for prevention of ovarian hyperstimulation syndrome in a public assisted reproduction service in São Paulo - Brazil.

This study aimed to evaluate the prevalence of ovarian hyperstimulation syndrome (OHSS) and associated risk factors in patients undergoing fertilization cycles at risk of OHSS (≥15 antral follicles or ≥15 oocytes aspirated) and submitted to cryopreservation of all embryos in the Human Reproduction Service of the Pérola Byington Hospital (Referral Center for Women's Health) in São Paulo, SP, Brazil. This cross-sectional, institutional, descriptive study of secondary data from patients' charts enrolled in the Assisted Reproduction Service of the Pérola Byington Hospital at risk of OHSS after controlled ovarian stimulation and submitted to cryopreservation of all embryos was conducted between January 2015 and September 2017. OHSS occurred in 47.5% of cycles, all with mild severity, and there were no moderate or severe cases of OHSS. The cryopreservation of all embryos is associated with a reduction in moderate and severe forms of OHSS. Risk factors for OHSS should be evaluated prior to initiation of treatment, with less intense stimulation protocols accordingly.

New choreographies of inequalities in reproduction: an overview of assisted reproduction market.

Brazil follows the trend of countries that went from high fertility to below replacement level; in many countries, fertility rates continue to fall, often to levels well below population replacement, especially in Europe and Eastern Asia. Since 2006, Brazil has presented rates below the population replacement level, with regional variations. The shift to a pattern of late motherhood is central to understanding this phenomenon, as well as the increased use of reproductive technologies and the global market for assisted reproduction. Demand for services based on Assisted Reproductive Technologies (ART) has increased in European countries and the United States. Also, in Brazil, there is a growing demand for assisted reproduction services, which private clinics offer at a significantly high cost. This article provides an overview of these issues. It raises new questions and dimensions of analysis by problematizing the socio-demographic, legal, and ethical aspects of assisted reproduction, which need to be explored in future population studies.

Medically assisted procreation: A new legal framework to overcome infertility in Morocco in the context of energy optimization

After more than a quarter of a century of the practice of medically assisted procreation (MAP) in Morocco in the absence of a legal framework, the Moroccan legislator passed Law 47-14, in April 2019, to make up for the considerable delay in the field of medically assisted procreation. Through this research work, we aim to explore the field of application of this law and demonstrate its contributions to the lives of couples aspiring to motherhood and fatherhood in order to achieve their parenthood project within the couple. From a methodological point of view, this research is based on the qualitative analysis of semi-directive interviews conducted with infertile couples having recourse to (AMP) and practitioners of this medical technique. One of the key findings of this work is that there are major differences between the provision of medically assisted reproduction services in the public and private sectors, and between insured and uninsured couples.

Reviewing the Impact of SARS-Cov-2 Infection on Human Fertility

The Coronavirus Disease 2019 (COVID-19) pandemic brought a significant impact on medically assisted reproduction services. Besides its negative impact relative to non-urgent cycle cancelations, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is thought to affect the human reproductive system through Angiotensin-Converting Enzyme 2 (ACE2) receptor and consequently lead to infertility.

Review of the impact of COVID-19 on male reproduction, and its implications on assisted reproductive technology services.

The announcement in 2019 of a new coronavirus disease that quickly became a major pandemic, is an exceptional challenge to healthcare systems never seen before. Such a public health emergency can largely influence various aspects of people's health as well as reproductive outcome. IVF specialists should be vigilant, monitoring the situation whilst contributing by sharing novel evidence to counsel patients, both pregnant women and would-be mothers. Coronavirus infection might adversely affect pregnant women and their offspring. Consequently, this review paper aims to analyse its potential risks for reproductive health, as well as potential effects of the virus on gamete function and embryo development. In addition, reopening fertility clinics poses several concerns that need immediate addressing, such as the effect of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) on reproductive cells and also the potential risk of cross-contamination and viral transmission. Therefore, this manuscript summarizes what is currently known about the effect of the SARS-CoV-2 infection on medically assisted reproductive treatments and its effect on reproductive health and pregnancy.

Impact of satellite clinics on geographic access to assisted reproductive technology services in the United States

BackgroundMany assisted reproductive technology (ART) centers utilize satellite clinics to expand reach and access to clinical services, but their contribution to lowering geographic barriers in access to care has not been examined. This study’s purpose is to determine the extent to which satellite clinics impact geographic access to ART and estimate the percentage of reproductive-age women who have geographic access to ART services.MethodsA systematic web-search collected the locations of all main and satellite ART clinics in the United States (US). Driving times were calculated between satellite clinics and main clinics. The percentage of women with geographic access to care was characterized by clinic type using US Census Core Based Statistical Areas (CBSAs). Logistic regression was used to statistically model the presence of main and satellite clinics as a function of CBSA median income and female reproductive-age population.ResultsFour hundred sixty-nine main clinics with embryology labs and 583 satellite clinics were found in the US. Practices with satellite clinics tend to perform more ART cycles. Satellite clinics are located on average 66 minutes from their practice’s main clinic and 31 minutes from any main clinic. 22% of satellite clinics were in CBSAs without a main clinic. 46 M (72%) US reproductive-age women live in a CBSA with a main clinic, 5.1 M (8%) women live in a CBSA without a main clinic but at least one satellite clinic, and 13 M (20%) women live in an area with no ART clinic of either type. Female reproductive-age population was found to be a more important predictor of clinic presence than median income.ConclusionsThe majority of satellite clinics in the US are positioned in relative proximity to a main clinic. 85% of satellite clinics are located closer to the main clinic of other practices than to their own main clinic. Less than a quarter of ART satellite clinics expand geographic access to ART services by being located in areas without a main clinic, and the vast majority of practices with satellite clinics position their satellite clinics close to another practice’s main clinic.Trial registrationNot applicable.

Use of reproductive technology for sex selection for nonmedical reasons: an Ethics Committee opinion

Because the practice of preimplantation sex selection is ethically controversial, clinics are encouraged to develop and make available their policies regarding its use. Practitioners offering assisted reproductive services are under no ethical obligation to provide or refuse to provide nonmedically-indicated methods of sex selection. This document replaces the document of the same name, last published in2015.

Fertility care expectations: what do PLHIV and health care providers in Jamaica know about assisted reproduction services for safe conception?

ABSTRACT Increased life expectancy among persons living with HIV (PLHIV) has increased the desire for parenthood. It is therefore important that PLHIV and health care providers (HCPs) are aware of the available assisted reproduction services (ARS) for PLHIV facing infertility or unsuppressed viremia. Through secondary data analysis we identified PLHIV who were actively trying to conceive and their knowledge of ARS. As specialized fertility care for PLHIV is managed by Obstetrician/Gynecologists (Ob/Gyns), they were surveyed regarding their attitudes towards working with PLHIV and their awareness and knowledge of ARS with a self-administered questionnaire. In this cross-sectional study, 251 PLHIV and 102 Ob/Gyns were recruited and interviewed using a semi-structured questionnaire. Although most Ob/Gyns (81%) reported being supportive of PLHIV having children, 85% counseled against pregnancy, particularly persons in HIV serodifferent relationships. Significantly more PLHIV under 40 years compared to those over 40 years had heard about ARS (59% vs. 43%, p = .007). Ob/Gyns were more knowledgeable of expensive ARS, while PLHIV’s knowledge was more restricted to cheaper more accessible ones. In conclusion Ob/Gyns knowledge gaps and underlying stereotypes may present barriers to PLHIV’s uptake of ARS. Additionally, virologically unsuppresed persons in HIV serodifferent relationships may be vulnerable as Ob/Gyns were less supportive of them.

Prevalence of asymptomatic SARS-CoV-2 Infection in couples seeking in vitro fertilization treatment in Riyadh, July–November, 2020

Background: After the start of the coronavirus disease (COVID-19) pandemic, assisted reproductive services were suspended and restarted in in vitro fertilization (IVF) clinics worldwide. In our center we implemented screening of all couples for COVID-19 the day before starting the ovulation cycle and before the ovum pick-up (OPU) procedure. Objectives: Assess the prevalence of asymptomatic COVID-19 among couples undergoing in vitro fertilization (IVF). Design: Cross-sectional and retrospective cohort study. Setting: An IVF unit in Riyadh from July to November 2020. Patients and methods: Patients and their partners were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 24-48 hours before their initial visit to initiate the fertility cycle and again prior to the ovum pick-up visit. Main outcome measures: Prevalence of asymptomatic SARS-CoV-2 infection. Sample size: 508 couples. Results: A total of 508 couples were tested. Of the 508 cycles of therapy, 24 (4.7%) were cancelled, 16 (3.14%) before the start of the cycle, and 8 (1.66%) before ovum pick-up, because one or both partners in the couple tested SARS-CoV-2 positive. Before the start of the cycle, 3 patients and their partners both tested positive; 7 patients tested positive and their partners tested negative; and 6 partners tested positive and the patient testing negative. In addition, on retesting 481 couples before OPU 3 patients and their partners both tested positive; 3 patients tested positive, and their partners tested negative; and 2 partners tested positive and the patients tested negative. Conclusion: The prevalence of asymptomatic SARS-CoV-2 infection in couples seeking IVF was higher than that in the general population. Implementing a policy of screening couples for SARS-CoV-2 prior to IVF treatment, minimized the possibility of transmission of SARS-CoV-2 from patients to healthcare workers.