title: Viral screening before each cycle of assisted conception treatment is expensive and unnecessary: a survey of results from a UK inner city clinic.
abstract: The European Union Tissues and Cells Directive requires screening of tissue and cell donors for infective organisms to prevent inter-patient transmission. The Directive includes the unique term partner donation, which refers to "donation of reproductive cells between a man and a woman who declare that they have an intimate physical relationship". In line with the Directive, partners undergoing Assisted Reproductive Technology (ART) now require screening before each treatment, regardless of the time interval between consecutive cycles. Evidence to support this recommendation is lacking. Therefore, we conducted a retrospective study of all virology screening tests undertaken over a three year period for individuals attending an assisted conception unit serving a high risk inner city population. We ascertained prevalence and seroconversion rates for HIV, hepatitis B and C and estimated the additional cost of implementing the Directive fully in our unit. With more than 3910 ART individuals screened between January 2007 and December 2009, the prevalence of HIV, hepatitis B and C was 0.6, 1.7 and 0.4%, respectively. A total of 422 individuals had a second screening test during the three year period and none seroconverted. This study suggests that increasing the frequency of screening individuals undergoing ART to less than 12 months would not confer added benefit and has significant cost implications.
authors.affiliation: Guy's Assisted Conception Unit, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, UK. lithapepas@hotmail.com
authors.forename: Litha
authors.initials: L
authors.lastname: Pepas
authors.forename: Eithne
authors.initials: E
authors.lastname: Macmahon
authors.forename: Tarek
authors.initials: T
authors.lastname: El Toukhy
authors.forename: Yacoub
authors.initials: Y
authors.lastname: Khalaf
authors.forename: Peter
authors.initials: P
authors.lastname: Braude
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology; D015497:HIV-1 / Q000302:isolation & purification*; D016174:Hepacivirus / Q000302:isolation & purification*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population