The Agence de la biomédecine (French Biomedicine Agency) has published a new update of its recommendations on patient management in the context of SARS-CoV-2 circulation.

The Agence de la biomédecine is today issuing a further update to its recommendations on medically assisted procreation activities, to continue to support centers faced with the circulation of the virus responsible for Covid-19, and help them prepare for the possibility of an epidemic rebound.

These recommendations are the result of discussions held by a working group set up by the Agence de la biomédecine last March, bringing together learned societies, experts, a patient association, representatives of regional health agencies and the French Ministry of Health and Solidarity. This working group is continuing its reflections on how to support the practice of medically assisted procreation, taking into account the evolution of the health situation linked to the SARS-CoV-2 epidemic.

Please note The recommendations issued by the Agence de la biomédecine are intended to help healthcare professionals assess the situations they face. However, it is up to multi-disciplinary medical teams to implement them after examining each situation on a case-by-case basis, according to the health context and constraints specific to each center.

Increased cooperation between centers and continuation of sanitary measures

In the event of a resurgence of the Covid-19 epidemic, MPA medical teams and their establishments are asked to pay particular attention to women undergoing stimulation and people undergoing urgent fertility preservation (these people are given priority for care at their center, as far as possible within the establishment).

In order to ensure continuity of care, it is recommended that establishments should, wherever possible: either redirect patients to one or more other establishments authorized to carry out MPA or, conversely, offer the possibility, depending on local capacity, of receiving patients thus redirected.

In view of the uncertainty as to which centers will be affected by a reduction or cessation of activity, it is advisable to strengthen cooperation between approved and authorized MPA establishments. In addition to existing agreements, complementary agreements with at least one other establishment, including private establishments, drawn up in advance, are likely to reduce the risk of urgent care being interrupted. In addition, medically assisted procreation activities must continue to comply with specific procedures relating to the circulation of Covid-19: in particular, centers must comply with working conditions in healthcare establishments, barrier measures and social distancing for both healthcare professionals and patients, SARS-CoV-2 diagnosis and screening procedures, and surface decontamination procedures. The use of telemedicine should be encouraged wherever possible, in order to limit the number of patient movements within the units.

Screening for gamete donation, embryo reception and fertility preservation

In the case of oocyte donation, systematic testing for SARS-CoV-2 prior to ovulation induction in the donor is no longer recommended. However, this test is still recommended for sperm donations, 48 hours before the first collection. In addition, serology with total antibody assay is recommended 48 hours before each collection and one month after the last collection.

Embryos stored for donation between September 2019 and March 2020 can be used without the need for a serology test.

In the specific case of fertility preservation (for people with cancer whose treatment is toxic for their fertility), it is recommended that a virus test be carried out as soon as possible before the medical procedure, even in the absence of symptoms, and that the result be available on the day of preservation.

The Agence de la biomédecine recommends that patients keep in touch with the medical team at the MPA center that treated them. The medical teams will keep patients informed of any provisions and developments that may be implemented concerning their MPA pathway.

Link to the full version of the Agence de la biomédecine recommendations: https://www.agence-biomedecine.fr/Recommandations-sur-les-modalites-de-prise-en-charge-des-couples-dans-le

Association française d'urologie (AFU) Fédération nationale des biologistes des laboratoires d'étude de la fécondation et de la conservation de l'œuf (BLEFCO) Fédération nationale des centers d'étude et de conservation des œufs et du sperme humains (CECOS Federation) Collège national des gynécologues et obstétriciens de France (CNGOF) Fédération française d'étude de la reproduction (FFER) Fédération nationale des collèges de gynécologie médicale (FNCGM) Groupe d'étude pour le don d'ovocytes (GEDO) Groupe d'études sur la fécondation in vitro en France (GEFF) Groupe de recherche et d'études sur la cryoconservation ovarienne et testiculaire (GRECOT) Société d'andrologie de langue française (SALF) Société française de diagnostic préimplantatoire (SFDPI) Société française d'hygiène hospitalière (SF2H) Société française de virologie (SFV) Société de médecine de la reproduction (SMR) Société de pathologie infectieuse de langue française (SPILF) Institut national du cancer (INCa) Agence régionale de santé (ARS) Grand-Est Agence régionale de santé (ARS) Ile de France Collectif des centers privés en AMP français Collectif BAMP ! Direction générale de l'offre de soins (DGOS) Direction générale de la santé (DGS) Dr Jade Ghosn, infectious diseases department, Hôpital Bichat Dr Florence Damond, virology, Hôpital Bichat Dr Nadhira Fidouh, virology, Hôpital Bichat

About the Agence de la biomédecine The Agence de la biomédecine is a public body under the authority of the French Ministry of Health, created by the French Bioethics Act of 2004. Its missions cover four major areas of human biology and medicine: assisted reproduction, prenatal and genetic diagnosis, embryo and embryonic stem cell research, and organ, tissue and cell retrieval and transplantation. www.agence-biomedecine.fr Twitter : @ag_biomedecine

Press contacts: bcw | burson cohn & wolfe - Juliette Billaroch, juliette.billaroch@bcw-global.com, 06 26 28 40 11 Agence de la biomédecine - Hélène Duguet, 06 16 35 91 80 presse@biomedecine.fr