Infectious Disease Screen
During the diagnostic work-up of both male and female infertility, various blood tests have to be conducted prior to assisted reproduction attempts in order to verify the presence or absence of various infectious diseases. Having one of these infections could be a contributing factor to a couple’s infertility issues thereby affecting the outcome of an assisted reproduction attempt. Another important reason for this testing is the fact that many of these infections can be passed along to the baby, potentially jeopardizing their health and the pregnancy.
Infectious Disease Fertility Tests
Blood Grouping and Rh Typing:
Group and typing of expectant mothers and newborns may indicate potential for ABO hemolytic disease of the newborn (maternal antibodies cross the placental barrier to the fetal circulation system causing the destruction of fetal red blood cells). Rh (D) typing is used to determinate Rh immune globulin candidacy for prenatal and postpartum patient. During pregnancy a small amount of the fetal blood can enter the maternal circulation system. If the mother and the fetus are different Rh factors, the mother can develop an immune response against the fetal red blood cells. This can result in another form of ABO hemolytic disease.
Chlamydia:
This commonly found bacteria can cause infections in the male or female genital tract. It is important to screen for because of its potential to cause conjunctivitis and pneumonia (infections to the eyes or lungs) in a newborn. It also may present a fertility problem for some couples. These bacteria may be present without any symptoms. In some women, presence of the bacteria may result in tubal scarring. In order to screen for the presence of this bacteria, a culture is done of the woman’s cervical mucus, or the man’s semen. Chlamydia is an organism that can cause infection in the male or female genital tract. Different strains of Chlamydia can also cause infection of the eye or lung. (Open Chlamydia Fact Sheet)
Cytomegalovirus (CMV):
A blood test is most commonly ordered to detect the presence or absence of antibodies to CMV. The blood test is useful in determining whether a patient is currently infected or has antibodies form a previous infection. CMV is the most common intrauterine infection affecting 1% of live-borns in the US. It is a herpes virus. Infants infected before birth are usually asymptomatic after they are born, however some can develop hearing, vision, neurological, and developmental problems over time. In a few cases symptoms do occur at birth. These can include: premature delivery, being small for gestational age, jaundice, enlarged liver and spleen, microcephaly (small head), seizures, rash, and feeding difficulties. These infants are also at high risk for developing hearing, vision, neurological, and developmental problems.
Gonorrhea:
A sexually transmitted disease than can cause tubal disease and infertility. If identified early gonorrhea is easily treated with antibiotics. In addition, t reating a pregnant woman who has a gonorrhea infection can prevent an infection in her newborn. For these reasons, Gonorrhea needs to be identified and treated prior to the start of an IVF cycle.
Hepatitis B:
A viral disease primarily involving the liver, which may be transmitted by contact with virally infected blood or bodily fluids. Once infected with the virus, individuals may carry the virus and infect others, through exposure to blood, bodily fluids, or at childbirth . A simple blood test is available to screen individuals for the presence of Hepatitis B surface antigen. If a woman is known to be Hepatitis B antigen positive, her child should receive special medication at the time of childbirth to prevent infection with the Hepatitis virus.
HIV:
The virus responsible for Acquired Immunodeficiency Syndrome (AIDS); it compromises the bodies immune system and its ability to protect against infection. This test screens for the presence of antibodies to HIV. Women who are antibody positive to HIV have a significant chance of transmitting this virus to their newborns.
Human T-cell Lymphotropic Virus (HTLV):
A retrovirus that is in the same class of virus as AIDS and can be passed from infected mother to her child. HTLV infects T cells (a type of white blood cell) causing Adult T-cell leukemia/lymphoma (ATLL), or inflammation of the nerves of the spinal cord (causing stiffness and weakness of legs, backache, weak bladder and constipation. HTLV may also cause inflammation of the eye, joints, muscles, lung and skin.
RPR (Rapid Plasma Reagin):
A blood test for syphilis that looks for an antibody that is present in the bloodstream. Syphilis usually results in a rash, sore throat, swollen glands and sometimes sores. When left untreated syphilis can lead to infertility as well as other serious health problems including psychological impairment.
Rubella (German measles):
Used to confirm the presence of adequate protection against the rubella virus and to detect a recent or past infection. It can also be used to identify those who have never been exposed to the virus, or have not been vaccinated. This test is ordered on all pregnant women and those planning to become pregnant to verify that they have a sufficient amount (titer) of rubella antibodies to protect them from infection. If contracted during pregnancy, this disease may have severe effects on the developing fetus, including: blindness, heart defects, hearing defects, musculoskeletal defects, and mental retardation.
T. palladium (FTA) Antibody:
A blood test used to detect antibodies to the bacteria Treponema pallidum, which causes syphilis. It is used as a confirmatory test for syphilis after a reactive RPR is found to determine if there truly is an infection. It is also useful in confirming the diagnosis in late stage syphilis in which the RPR is often negative.
Varicella (chicken pox):
Used to determine if a woman has antibodies to the virus because it can cause birth defects of illness to a baby depending on when during the pregnancy the infection occurs. Most pregnant women have already been exposed to the virus and therefore are immune . For those women who do not have antibodies, they can be immunized. However, it is highly recommended to avoid getting pregnant at least 3 months following the vaccination.
