26 Απρ Επανεκκίνηση θεραπειών σύμφωνα με ESHRE
Επαναλειτουργία ιατρείων γονιμότητας και θεραπειών Υποβοηθούμενης Αναπαραγωγής.
Η ESHRE European Society of Human Reproduction and Embryology ανακοίνωσε στις 23/4/2020 κατευθυντήριες οδηγίες για την επανέναρξη θεραπειών με συγκεκριμένη προετοιμασία και προφυλάξεις.
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Procedure for staff
a. Triage information regarding health status, symptoms and lifestyle of the clinic team members and of individual(s) living in the same household should start at least two weeks before the beginning of clinical activities at the centre.
b. Staff, suspected of infection after triage, should undergo regular SARS-CoV-2 IgM/IgG testing or equivalent tests. Additional and/or more frequent testing can be considered in line with national recommendations and/or availability of tests.
c. All staff members who test positive, either for SARS-CoV-2 IgM or IgG, irrespective of symptoms, should receive occupational health advice and go into self quarantine
d. Staff who are symptomatic should be referred for medical advice and testing and should not re-attend work until the infection is cleared and documented by negative RT-PCR test or equivalent.
e. Contact tracing and testing should be routine if a staff member is diagnosed with COVID-19 infection.
f. Depending on the size of the unit, staff should be subdivided in “mini-teams” with minimum interactions among them. Teams should work according to a rotating schedule, similar to the one adopted for weekend work.
Procedure for patients
a. All patients planning to start treatment should have a triage questionnaire (paper, email or phone) two weeks before commencing treatment.
b. A preliminary triage of both partners should be performed two weeks before starting the ART treatment.
c. A further triage of both partners should be performed during ovarian stimulation.
d. Triage should be performed according to the same procedures used for staff members. Both partners should undergo triage. Patients, suspected of infection after triage should get regular SARS-CoV-2 IgM/IgG testing or equivalent tests. Additional testing can be considered in line with national recommendations and/or availability of tests.
e. All patients with a previous confirmed COVID-19 infection should present medical evidence of clearance in order to be eligible for treatment. If patients have been on respiratory support during the COVID-19 infection episode, they should additionally provide evidence of assessment and a medical specialist report.
Ovarian stimulation monitoring
During this phase the following specific precautions should be taken:
• Minimal exposure for both staff and patients.
• Isolation of staff showing symptoms of infection
• Use of personal protective equipment (PPE) by staff
• Minimal number of visits and optimised number of blood tests
• Vaginal probe and tissue hygiene
• Re-triage and action depending on pre-triage results or new non-specific symptoms.
a. Routine good laboratory practice should be followed and laboratory staff should wear masks and gloves.
b. Staff should be organised in mini-teams.
c. Extra care should be taken to reduce exposure to native follicular fluid and sperm by dilution and safe disposal of fluids in individual closed containers, as quickly as possible.
d. Published guidelines and good laboratory practice principles should be followed at all times (www.eshre.eu/guidelines).
e. Should a patient become suspect or positive for COVID-19 during embryo culture, a freeze-all policy should be adopted.
a. Limit the number of staff members in the transfer room
b. Restrict access for accompanying person(s)
c. Perform transfer only in cases of low risk/asymptomatic patients and partners
d. Apply a freeze-all policy for all patients and/or partners who became symptomatic after the oocyte retrieval.