Laboratory safety and infection control in human assisted reproduction

Abstract

In the last years, there has been a substantial increase in the demand for assisted reproduction technology in patients with blood-borne viral (BBV) infections, such as human immunodeficiency virus (HIV). In fact, with the increase in HIV prevalence in the heterosexual population and the ready availability of effective antiretroviral medication, assisted conception became an important tool to achieve pregnancy in such patients. In addition, targeted antenatal and postnatal care has substantially reduced vertical transmission risk, from 25% to < 2%. Guidelines for assisted procreation impose a special responsibility upon physicians for the health of the expected child. Therefore, careful clinical diagnostics of both partners have to precede the use of these methods, considering all factors for a successful therapy. The treatment of patients with BBV in assisted reproduction clinics highlights questions over the safety of clinical and laboratory procedures. Until now, published guidelines on the subject are limited. In this paper we argue the current work practices within the ART laboratories for handling and storing high risk samples to ensure the safety of both infected and non-infected patients, as well as staff, in centres electing to treat patients with BBV.