Specialist recommendations on deferral of sperm or egg donations following exposure to Ebola virus
Following the outbreak of Ebola virus disease in West Africa in 2013 to 2016, studies of possible routes of virus transmission have shown that sexual transmission of the infection can occur from male to female because of persistence of viable virus within the testes in Ebola virus disease survivors.
The duration of Ebola virus persistence in seminal fluid is rather variable, but viral RNA has been detected for up to 565 days after infection. This is because the testes are an immune privileged site and thus are relatively protected from the immune responses that clear Ebola virus in convalescence.
It is not believed that ovaries are an immune privileged site in the same way and therefore prolonged persistence of Ebola virus in the female genital tract would not be anticipated, although this has not been proven.
Evidence also has shown that, although rare, subclinical or asymptomatic Ebola virus infection can occur.
Advisory Committee on Dangerous Pathogens (ACDP) recommendations
After consideration of this evidence, the Ebola Working Group of the ACDP made the following recommendations on sperm or egg donation:
- a lifetime ban on any gamete donation from known Ebola virus survivors
For those who are not known to have been infected with Ebola virus but who have been in an area of active Ebola virus transmission:
a 2 year deferral from treatment or donation for sperm donors or male fertility patients after leaving the affected area
a 6 month deferral from treatment or donation for egg donors and female fertility patients after leaving the affected area
If there are any concerns regarding patients undergoing fertility treatment or gamete donation and the risk of Ebola virus disease, further advice may be sought from the Rare and Imported Pathogens Laboratory.