COVID-19: A review and considerations for the resumption of activities in an IVF laboratory and clinic in Brazil.

COVID-19 has caused radical effects on the daily lives of millions of people. The causal agent of the current pandemic is SARS-CoV-2, a virus that causes symptoms related to the respiratory system, leading to severe complications. In the in vitro fertilization (IVF) universe, there are several protocols for infection control and laboratory safety. Some professional associations have issued guidelines recommending measures involving patient flow and IVF practices. This study presents a review and considerations for the resumption of activities in IVF laboratories and clinics in Brazil during the COVID-19 pandemic, according to the guidelines and statements from professional organizations and societies in reproductive medicine.

Assessment and management of the risk of SARS-CoV-2 infection in an IVF laboratory.

RESEARCH QUESTION: The study set out to identify corrective measures aimed at reducing the risk of aerosol-mediated viral infection within an IVF laboratory. DESIGN: A failure modes and effect analysis (FMEA) was conducted by a multidisciplinary IVF team. A schematic representation of new protocols and procedures adopted during COVID-19 emergency has been defined, including directives about the behaviour to adopt when entering the clinic and the laboratory, in case of face-to-face contact with patients and between staff members. In addition, the risk of cross-contamination between samples belonging to different patients during cell handling and manipulation has been evaluated. Potential failure modes for each phase of the emergency have been analysed, focusing on possible sources of error. Risk priority numbers have been calculated as products of Occurrence × Severity × Detection scores. RESULTS: Except for cell-cell contamination, which was considered highly unlikely, failure modes during patient-staff, staff-staff and staff-cell interactions were estimated as carrrying a moderate to high risk of infection. The main corrective measures entailed precautionary logistic measures, the implementation of additional personal protective equipment and changes in the IVF laboratory procedures and scheduling of the daily routine. Some procedures were also revised, aiming to increase staff's awareness and caution. CONCLUSIONS: Standard laboratory protocols are insufficient to face a virus whose transmission is aerosol mediated. The measures outlined in this FMEA should thus be considered not only for facing this pandemic, but also for the future to promptly manage any aerosol-mediated virus infection, whose impact on the management of an IVF laboratory might be less severe than COVID-19 although not completely negligible.

COVID-19: New adaptation for IVF laboratory protocols.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) widely known as COVID-19 was first reported in late December 2019, in China. Since then this novel coronavirus has spread throughout the world. Our return to normal life will not take long, for we are in a phase where the COVID-19 curve is stabilizing. ART services must return to operation, since infertility is also a disease and treatment has to start. Before resuming ART treatments, it is very important to consider local and national regulations. Change is mandatory, to set us back to successful ART treatment without compromising on quality, and to minimize the spread of COVID-19 among staff and patients; and for this we need to take measured and vigilant steps.