Semen donors and STD screening.

J M Craig, C L Barratt, G R Kinghorn
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引用次数: 14

Abstract

Aim: The British Andrology Society recommends screening semen donors for sexually transmitted infections to minimise the risk of pathogen transmission to the mother and fetus. The aim was to review recent findings of semen donor screening and, if appropriate, recommend changes to the screening protocol.

Subjects: 175 consecutive men attending for STD screening between January 1992 and December 1995 who had been preselected by the Department of Obstetrics and Gynaecology as suitable semen donors.

Methods: Retrospective review of case notes and group comparison of demographic and sexual history data.

Results: 11 men (6%) had evidence of infection, excluding CMV seropositivity, at their first STD screen. After semen donation, 109 men (63%) were rescreened and, of these, 12% had positive findings. Positive findings at initial screening were predicted by a history of more than one partner in the preceding 6 months (OR 7.11, 95% CI 1.66-30.4) but it did not predict rescreening findings. Other factors such as age, marital status, employment status or past STDs were not predictive for either screen.

Discussion: Less than 20% of initial volunteers meet the full criteria of high quality post-thaw semen, no transmissible genetic disorders, and no transmissible pathogens. Sexual history may predict but would not alone preclude all positive STD screening findings. It is essential that sequential STD screening of donors continues and that genitourinary physicians should be involved in this process. Validation of newer diagnostic techniques as screening tests in this setting is required.

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捐精者和性病筛查。
目的:英国男科学会建议对捐精者进行性传播感染的筛查,以尽量减少病原体传播给母亲和胎儿的风险。目的是回顾精液供体筛查的最新发现,并在适当的情况下对筛查方案提出修改建议。研究对象:在1992年1月至1995年12月期间连续参加性病筛查的175名男性,这些男性被妇产科预选为合适的精液捐献者。方法:回顾性分析病例记录,组间比较人口学和性史资料。结果:11名男性(6%)在第一次性病筛查时有感染的证据,不包括巨细胞病毒血清阳性。在捐精后,109名男性(63%)进行了重新筛查,其中12%的结果呈阳性。最初筛查的阳性结果可通过前6个月有一个以上伴侣的病史来预测(OR 7.11, 95% CI 1.66-30.4),但不能预测再次筛查的结果。其他因素,如年龄、婚姻状况、就业状况或是否患过性传播疾病,对两种筛查都没有预测作用。讨论:只有不到20%的初始志愿者符合高质量解冻后精液、无传染性遗传疾病和无传染性病原体的全部标准。性史可能预测但不能单独排除所有阳性性病筛查结果。对献血者进行连续的性病筛查是至关重要的,泌尿生殖系统医生应该参与这一过程。在这种情况下,需要验证较新的诊断技术作为筛选试验。
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