Screening standards in assisted reproductive technologies - Is the BritishAndrology Society recommendation to recruit cytomegalovirus negative semendonors only, a reasonable one?

The British Andrology Society recently recommended the exclusion of all cyt omegalovirus (CMV) seropositive semen donors to prevent the risk of congeni tal CMV infection. The recommendation is based on the results of recent stu dies that identified a high percentage of symptomatic congenital CMV infect ions in newborns of women with CMV seropositivity pre-existing to pregnancy and on the fact that CMV can be detected in semen of CMV seropositive men. These are not new data. CMV seropositive women can infect their fetuses wi th their own latent CMV strain that can reactivate, or with an exogeneous s train that can be transmitted to them by a sexual partner, but also by cont acts, for example with an excreting child. The efficiency of these various ways of transmission to the fetus and the factors that could influence this transmission are for the moment completely unknown. An infectious virus is recovered by culture in the semen of <5% of CMV seropositive men. Exclusio n of a large population of donors on the sole criteria of a positive CMV se rology introduces the general message that this part of the male population is also not suitable as possible partners in couples who have no fertility problems. The problem of congenital infection in neonates of CMV seroposit ive women is a complex one that has just begun to be investigated. No data exists concerning this risk in the setting of assisted reproduction. We thi nk that alternatives to the drastic BAS recommendation exist and should be more deeply discussed.