SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services
SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services
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DOI：
10.1111/andr.12809
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发表时间：
2020-05-22
期刊：
影响因子：
4.5
通讯作者：
Agarwal, Ashok
中科院分区：
文献类型：
--
作者：
Esteves, Sandro C.;Lombardo, Francesco;Agarwal, Ashok
由于SARS-CoV-2大流行，许多生殖医学实体和监管机构目前建议长期封锁提供非紧急配子冷冻保存的卫生设施，这将对男性不育患者亚组有害。我们认为，现有的建议应该立即修改，并建议将给予癌症男性的精子库同样的许可方法扩展到其他弱势患者群体。这些群体包括接受药物或手术治疗以改善精子数量和质量的不孕症患者（例如，无精子症和隐精子症），以及受炎症和全身性自身免疫疾病影响的育龄男性，他们即将开始使用性腺毒性药物治疗或正在缓解。在这两种情况下，“生育窗口”可能是暂时的;推迟这些男性的诊断性精液分析和精子库可能会损害生物父母的前景。此外，我们还就如何以深思熟虑的方式和安全的环境继续提供男科服务提出了建议。鉴于目前大多数国家将生育服务列为低优先事项，我们的意见是及时和相关的。
The prolonged lockdown of health facilities providing non-urgent gamete cryopreservation-as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS-CoV-2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto-immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the "fertility window" may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries.