COVID-19 risk assessment and safety management operational guidelines for IVF center reopening

Abstract

Purpose To promote nationwide dissemination and implementation of COVID-19 Risk Assessment and Safety Management Operational Guidelines, drawn up by SAMeR Task Force in ART centers in Argentina. Our objective is to prevent and mitigate the transmission of SARS-CoV-2 at an institutional level, while reducing the risk of infection among both physicians and patients in the context of a critical scenario in the local and Latin American healthcare system. Methods SAMeR Executive Committee set up a crisis committee which was made up of specialists in reproductive medicine, embryology, and healthcare management. A critical and updated review of the advances in science, documents, and recommendations released by other societies (ASRM, ESHRE, IFFS, Red LARA, societies of anesthesiologists, infectious diseases, and Occupational Safety and Health Administration-OSHA) was carried out. Likewise, there were joint meetings with the Ministry of Health of Argentina in order to draw up the guidelines. Simultaneously, ongoing medical training was carried out, thus providing added value to them, including two status surveys of the activities of the monovalent and polyvalent centers according to the country's epidemiological mapping. Four additional recommendations were made, and online training was given to healthcare workers. The aforementioned regulations were first analyzed by the healthcare providers and their practical suggestions were then added to the guidelines. Results The one-off collaborative work and the actions coordinated with the National ART Program of the Ministry of Health of Argentina resulted in the development and implementation of the present COVID-19 Risk Assessment and Safety Management Operational Guidelines at a national level. SAMeR gave recommendations for the implementation of the Management Guidelines for the center reopening, providing new safety criteria against the threat of viral contagion. A new organizational culture was promoted through the awareness of all the healthcare workers and teaching responsibility. We continue working on the compliance with a new "Code of Conduct and Commitment in Healthcare" and with workplace safety measures. We helped with transforming the theoretical knowledge into practical measures for the healthcare workers in different services, with the aim to prevent, mitigate, and/or handle contingencies at the centers/services and gamete banks, in line with the actions agreed upon with the Ministry of Health. Conclusions As an extraordinary and uncertain event, the SARS-CoV-2 pandemic helped consolidate a volunteer-based and collaborative panel of SAMeR experts who developed the COVID-19 Risk Assessment and Safety Management Operational Guidelines as a new and readily available tool for physicians, patients, and gamete banks care. Their implementation has provided specific guidelines to minimize risk for professionals in ART clinics, as well as guaranteeing patient safety.

Can We Cryopreserve the Sperm of COVID-19 Patients During the Pandemic?

“…Managers of the cryobanks should be very prudent, and invite health authorities, including reproductive ethics committees, to evaluate their own conditions and facilities while providing regulatory standards ( 53 ).…”

“…Face-to-face interactions should be minimized with COVID-19 patients. Video conferencing, telephone and other online consultations can be used to collect the patient’s epidemiological history and assess the possible hidden risks ( 53 ). Meeting COVID-19 patients who want to fertility preservation, andrologists should give corresponding suggestions based on the decision path for sperm crypreservation of COVID-19 patients by managers of the cryobanks ( Figure 1 ).…”

IVF laboratory management in COVID-19 pandemic

“…Alaluf et al [20] Although the chances of cross-contamination are very low in ART laboratories due to antibiotics in media and continuous washing of gametes repeatedly, every laboratory should properly follow its standard operating protocols.…”

SARS-CoV-2 persistence at subzero temperatures

“…As the Italian Society of Embryology, Reproduction and Research (SIERR), we released recommendations on precautions to adopt in the IVF laboratory in response to the COVID-19 pandemic [ 15 ]. Likewise, Alaluf et al elaborated recommendations on re-opening of ART centers following a close-down, aiming at minimizing the risk of viral contagion and ensuring patient safety [ 16 ]. However, uncertainties and concerns raised by the pandemic demand more specific risk assessment focused on cryopreservation procedures.…”

“…For example, the ZIKA virus results more resistant to UV-rays than the Dengue virus [12]. Reassuringly, SARS-CoV-1 is completely [16]. However, uncertainties and concerns raised by the pandemic demand more specific risk assessment focused on cryopreservation procedures.…”