Infectious disease screening protects you, your partner, and your future baby.
Why Screening Is Required
Fertility clinics require testing for several reasons:
Lab safety:
- Protects laboratory staff handling sperm, eggs, and embryos
- Special handling protocols for positive cases
- Legal and regulatory requirements
Partner protection:
- Some infections transmissible through sexual contact
- Ensures both partners know their status
- Allows for treatment or protection
Baby protection:
- Prevents transmission to baby during pregnancy or birth
- Allows for preventive measures
- Ensures safest possible pregnancy
Treatment planning:
- Some infections require special protocols
- Medications may be needed before or during pregnancy
- Monitoring requirements differ
You cannot proceed with fertility treatment without current screening results.
Tests Included
HIV (Human Immunodeficiency Virus)
What it is:
- Virus that attacks immune system
- Can lead to AIDS if untreated
- Transmitted through blood, sexual contact, or mother to child
The test:
- Blood test (antibody or antigen/antibody)
- Results typically within a few days
- Very accurate
If positive:
- Fertility treatment still possible
- Antiretroviral therapy (ART) required
- With treatment, viral load can be undetectable
- Risk of transmission to partner and baby nearly eliminated
- Special IVF protocols (“sperm washing”)
- Maternal treatment prevents transmission to baby (less than 1% risk)
Modern HIV treatment is highly effective. Many HIV-positive individuals have healthy pregnancies.
Hepatitis B Surface Antigen (HBsAg)
What it is:
- Liver infection caused by hepatitis B virus
- Can be acute (short-term) or chronic (lifelong)
- Transmitted through blood, sexual contact, or mother to child
The test:
- Blood test for surface antigen
- Indicates active infection (acute or chronic)
- Results within a few days
If positive:
- Further testing to determine if chronic
- Liver function monitoring
- Fertility treatment can proceed
- Antiviral medication may be needed
- Baby receives immunization and immunoglobulin at birth
- Breastfeeding usually safe
- Partner should be vaccinated if not immune
Vaccination available – if negative, consider getting vaccinated.
Hepatitis C Antibody (Anti-HCV)
What it is:
- Liver infection caused by hepatitis C virus
- Often becomes chronic
- Transmitted through blood contact
The test:
- Blood test for antibodies
- Positive means past or current infection
- Further testing (viral load) determines if active
If antibody positive:
- RNA test to confirm active infection
- If negative RNA: past infection, now cleared
- If positive RNA: active infection, needs treatment
If active infection:
- Treatment available (highly effective cure rates)
- May be recommended before pregnancy
- Fertility treatment can proceed with precautions
- Low risk of transmission to baby (about 5%)
- Breastfeeding usually considered safe
New treatments have revolutionized Hep C – curable in most cases.
Syphilis (RPR or VDRL)
What it is:
- Bacterial sexually transmitted infection
- Progresses through stages if untreated
- Easily cured with antibiotics
The test:
- Blood test (rapid plasma reagin or VDRL)
- Screening test, confirmed with specific test if positive
- Results within a few days
If positive:
- Confirmatory testing performed
- Determines if active infection or past treated infection
- Treatment with penicillin (very effective)
- Retest after treatment to ensure cure
- Untreated syphilis causes serious pregnancy complications
- Can cause stillbirth, birth defects, newborn death
Highly treatable. If positive, treatment before pregnancy strongly recommended.
Other STI Screening (Sometimes)
Additional tests may include:
- Chlamydia and gonorrhea (urine or swab)
- More common in younger women
- Easily treatable with antibiotics
- Can cause tubal damage if untreated
When Screening Is Done
Timing
Initial fertility evaluation:
- Part of first round of testing
- Both partners tested simultaneously
- Results must be current (usually within 6-12 months)
Before treatment procedures:
- Updated screening if previous results expired
- Before IUI, IVF, or other procedures
- Some clinics require testing closer to procedure
Annual updates:
- Some clinics require yearly screening
- Especially if treatment spans long time period
Both Partners Required
Yes, both of you:
- Even if in monogamous relationship
- Even if both previously tested
- Clinic policy and legal requirement
- No exceptions
If using donor sperm or eggs:
- Donor already extensively screened
- You still need testing
- Protects lab and baby
Understanding Your Results
Negative Results
All tests negative:
- No evidence of these infections
- Can proceed with treatment
- Results valid for specified time period (usually 6-12 months)
- Keep documentation for clinic
This is the expected outcome for most people.
Positive Results
If any test is positive:
- Don’t panic
- Many are treatable or manageable
- Treatment often cures infection
- Fertility treatment still possible in most cases
- Specialist consultation may be needed
Your clinic will guide you through next steps.
Indeterminate or Borderline Results
Sometimes results are unclear:
- Repeat testing may be needed
- Confirmatory tests ordered
- May delay treatment start briefly
- Work with your doctors to clarify
Confidentiality and Privacy
Your Rights
Medical privacy protected:
- HIPAA protections apply
- Results kept confidential
- Lab and clinic staff bound by confidentiality
- Only those directly involved in your care have access
Cannot be shared without consent:
- Not shared with employer
- Not shared with insurance (unless you file claim)
- Not disclosed to others
Discussing with Partner
Open communication important:
- Partner has right to know if STI
- Affects their health too
- Joint decision-making on treatment
- Trust and honesty essential
If positive for STI:
- Partner needs testing and possibly treatment
- Prevents reinfection
- Contact tracing may be recommended for past partners
Treatment Before Pregnancy
Why Treatment First
For treatable infections:
- Eliminates or reduces infection
- Protects baby
- Improves pregnancy outcomes
- May be required before fertility treatment
Treatment Options
Bacterial infections (syphilis, chlamydia, gonorrhea):
- Antibiotics
- Usually single dose or short course
- Retest to confirm cure
- Wait period before conception (varies)
Viral infections (HIV, hepatitis):
- Antiviral medications
- May need to achieve specific viral loads
- Ongoing treatment during pregnancy
- Specialist management
Timeline
Treatment may delay fertility treatment:
- Weeks to months depending on infection
- Frustrating but important
- Protects your future baby
- Improves success rates
Use this time productively:
- Optimize other health factors
- Prepare emotionally and financially
- Make lifestyle improvements
- Learn about treatment process
Special Protocols for Positive Results
IVF with HIV
“Sperm washing” technique:
- Separates sperm from seminal fluid
- Removes HIV virus
- Tested to confirm virus-free
- Used for IVF/ICSI
- Extremely effective
For HIV-positive women:
- Antiretroviral therapy to undetectable viral load
- Standard IVF with precautions
- Careful medication management during pregnancy
Success rates similar to HIV-negative couples.
Hepatitis B or C
Standard IVF usually:
- Special labeling of samples
- Segregated storage
- Lab safety protocols
- Does not affect success rates
Partner vaccination (Hep B) recommended.
After Treatment
When infection cured:
- Retest to confirm
- Documentation for clinic
- Can proceed with standard protocols
- No special protocols needed
Preventing Infection
Before and During Treatment
Protect yourself:
- Mutual monogamy
- Condom use if any STI risk
- Avoid new partners during treatment
- Safe practices
Long-Term
General health:
- Regular STI screening (as appropriate)
- Vaccination (HPV, Hepatitis B available)
- Safe sex practices
- Know your status
Emotional Aspects
If You Test Positive
Common feelings:
- Shock and disbelief
- Anger (at self or partner)
- Shame or embarrassment
- Fear about fertility and pregnancy
- Worry about partner’s reaction
Remember:
- These infections are medical conditions
- Many people have them
- Not a moral failing
- Treatable in most cases
- You can still have healthy pregnancy
Support Available
Resources:
- Infectious disease specialists
- Fertility counselors
- Support groups
- Educational materials
- Partner counseling
Don’t isolate yourself. Help is available.
Impact on Fertility Treatment
Minimal Impact (Usually)
For most infections:
- Treatment doesn’t harm fertility
- May actually improve it (removing infection)
- Special protocols effective and safe
- Success rates remain good
When Treatment Delayed
Frustrating but temporary:
- Use time wisely (lifestyle improvements)
- Emotional preparation
- Financial planning
- Relationship strengthening
Moving Forward
After clearance:
- Standard fertility treatment proceeds
- No lasting impact in most cases
- Focus on future, not past
Questions to Ask Your Doctor
If you test positive:
✓ What does this result mean for my fertility?
✓ What treatment do I need?
✓ How long before we can start fertility treatment?
✓ Does my partner need treatment?
✓ How does this affect pregnancy?
✓ What precautions are needed during pregnancy?
✓ Are there specialists I should see?
✓ What’s my prognosis?
Remember
Infectious disease screening is standard medical care, not a judgment. It protects everyone involved.
Most people have negative results and proceed smoothly.
If you test positive, effective treatments and protocols exist.
Modern medicine allows people with these conditions to have healthy pregnancies.
This screening is an act of responsibility and care for your future family.