Concise practice recommendations for the provision of andrological services and assisted reproductive technology for male infertility patients during the SARS-CoV-2 in Brazil

Abstract

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the disease so-called COVID-19, represents the most exceptional health, social, economic, and humanitarian crisis known to humankind since the H1N1 flu of 1918. So far, it affected 213 countries, infecting over 100,000 people daily worldwide, with hundreds of thousands of deaths (2, 3). Restrictions to personal freedom and partial or complete lockdowns have been implemented to safeguard public health, with a noticeable impact on urological practice. Currently, diagnostic semen analysis, sperm banking in non-oncological patients, elective surgical sperm retrieval (SR), and related fertility procedures are rated as of low priority in most countries due to the COVID-19 pandemic (4). Based on expert best judgment, regulatory authorities, urological, and reproductive medicine societies have considered that postponing care in the above scenarios for six months or longer will have an unlikely risk of clinical harm. However, it has been argued that the pandemic may last many months, even years, and experts believe of second and third waves in the months to come. It is therefore evident that in the absence of a vaccine or broad herd immunity, not only urgent short-term responses but also long-term measures are essential in this most uncertain time.