Abstract
Men seeking surrogacy in the United States must undergo Food and Drug Administration (FDA)-mandated infectious disease screening within seven days of the sperm collected for fertility treatments. Travel bans imposed during the COVID19 pandemic (April 1, 2020 to March 7, 2022) did not deter 156 men from 12 countries from pursuing fatherhood by traveling to facilities to cryopreserve and screen semen specimens for virus, along with paired FDA serology and urine tests. Heterosexual couples not needing FDA serology testing collected specimens remotely and shipped them overnight for cryopreservation and testing. A total of 464 semen specimens were evaluated for viable sperm, 453 of which were RT-PCR tested for HIV and cytomegalovirus (CMV). More specimens tested positive for CMV (136, 30%) than for HIV (52, 11%). Fifty two men (33%) had at least one CMV-positive specimen, 38 men (24%) had at least one HIV-positive specimen, and 16 men (11%) had at least one specimen test positive for both HIV and CMV. Results were similar for the 32 international clients as for domestic clients and for gay clients as for heterosexual clients. No correlations between virus-positivity and CD4+ blood cell counts, leukocytospermia, anti-HIV medications, nor age were noted. During the same time frame, 43 babies were born to gestational carriers and wives, 82 gestational carriers and wives underwent embryo transfer without consequent infection, and 32 pregnancies from nine fertility clinics were reported. Virus shedding into semen is in urgent need of better understanding to avoid the risks associated with new infections early in pregnancy.