Sanjay Kumar
February 2, 2024
What is CMV?
CMV, cytomegalovirus, is a member of the herpesvirus family and is highly prevalent worldwide. You can become infected with CMV through bodily fluids, including saliva, urine, blood, seminal fluid, and breast milk. The most common transmission modes are through close contact with infected individuals or exposure to bodily fluids. It is important to note that CMV can be present in an individual's body without causing any symptoms or illness, making detecting and preventing transmission challenging.
How Common is CMV?
The CDC states that nearly 1 in 3 children have already been infected with CMV by age 5, and by the age of 40, over half of the population is infected. The prevalence of CMV in sperm donors varies depending on the screened population. Studies have shown that CMV infection rates among sperm donors range from 30% to 70%. However, it is essential to note that the presence of CMV does not necessarily indicate active infection or the potential for transmission. Donor screening protocols typically include testing for CMV antibodies, which can help determine if the donor has contacted the virus in the past.
Symptoms of CMV Infection
CMV infection can manifest differently in individuals depending on their immune system and overall health. Many people infected with CMV may not experience symptoms or only have mild symptoms that resolve independently. However, those with weakened immune systems, such as individuals with HIV/AIDS or undergoing organ transplantation, may develop severe complications. These can include pneumonia, hepatitis, retinitis (inflammation of the retina), and neurological disorders. Awareness of these symptoms and seeking medical attention if necessary is crucial.
Becoming Infected With CMV
Primary CMV infection occurs in people who have never been exposed to the CMV virus before. Once a person becomes infected with CMV, the virus remains alive but dormant inside their body for the rest of their life. Recurrent CMV infection is when a dormant virus becomes active again. CMV infection is usually harmless and rarely causes illness. However, primary CMV infection can cause more severe problems for pregnant women than recurrent CMV infection.
Cytomegalovirus
CMV in human cells.
Diagnosis and Treatment of CMV Infection
Diagnosing CMV infection involves various methods, including blood tests to detect the presence of CMV antibodies or viral DNA. Other tests like urine or saliva samples may also confirm active infection. Treatment options for CMV infection depend on the severity of symptoms and the individual's immune status. A healthcare provider may prescribe antiviral medications to manage the condition and reduce the risk of complications.
Prevention of CMV Transmission in Sperm Donation
Preventing CMV transmission in sperm donation involves following proper protocols and procedures. Donor screening for CMV antibodies is essential in identifying potential donors who may pose a higher risk of transmission. Additionally, implementing strict guidelines for handling and processing donated sperm can help minimize the risk of contamination. Cryopreservation techniques, such as freezing and quarantine periods, can also be employed to ensure that donated sperm is free from infectious agents before use.
CMV Protocols At Cryobank America
The FDA requires CMV testing on all men who intend to donate sperm. A positive result, however, doesn't necessarily mean that a man will be ineligible to donate. Cryobank America will obtain semen samples from potential donors and then quarantine those specimens for at least six months. During that time, the donor may have had CMV antibody levels tested several times. If the antibody tests indicate the possibility of a CMV infection close to the time of the sperm donation, the donor will not be allowed to donate their specimens. If the testing demonstrates inconclusive results, the donor will not be permitted to donate. However, if a donor tests positive for CMV IgG only, indicating a past infection, he will be eligible to contribute. These samples appear in the Cryobank America donor database as CMV-positive.
Can Washed Donor Sperm Transmit CMV?
No, clinically washed sperm is typically free from CMV (Cytomegalovirus) transmission. The sperm-washing process separates sperm from the seminal fluid, which reduces the risk of transmitting infections such as CMV. However, no medical procedure can guarantee 100% elimination of all viruses or infections. You should always consult a healthcare professional for personalized advice and information.
Considering Pregnancy Through Donor Sperm?
Women considering pregnancy with donor sperm should have CMV antibody testing as part of their IDT. Those with a past infection are at low risk of transmitting CMV infection to a fetus and are at little to no risk if they decide to use a CMV-positive donor.
Women never exposed to CMV should consider using a CMV-negative donor. Even though the risk from a CMV-positive donor is low, it is impossible to determine whether there will be a risk for infection.
Cryobank America's donor catalog has a CMV search filter for positive and negative sperm donors. To find a CMV-negative sperm donor, select negative under the CMV option!
CMV Resources
For additional information on CMV, this link is especially helpful:
https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358
If you have any questions about CMV, please email us at [email protected] or call 817-945-8708; we will be happy to help!