Check with your physician regarding your CMV status prior to placing an order. (See discussion below.)
CMV is a virus that most American adults have been exposed to and have immunity to. In healthy adults and children it produces mild cold or flu like symptoms for 1-2 weeks. If a woman who has never had CMV becomes infected with the virus during pregnancy, the child is at risk for developing severe medical problems, such as mental retardation, deafness and seizures. You can be tested to determine if you have been exposed to CMV. If you are CMV negative, you should consider restricting your selections to CMV negative donors, to prevent the small chance of developing CMV during pregnancy and passing it the developing child. Information on the CMV status of all donors is available on their summary profile.
Cytomegalovirus, commonly called CMV, is a member of the herpes virus family that includes chicken pox, cold sores, and infectious mononucleosis (mono). The virus is carried by people and is not associated with food, water or animals. Most individuals are exposed to CMV in childhood and have a mild infection similar to a typical cold, while the immune system develops antibodies to fight the infection. The virus remains alive, but becomes dormant, or hides, inside certain cells for the rest of the person's lifetime. Approximately 50-85% of American adults will test CMV positive, confirming exposure. In developing countries, or areas of poor sanitation, this number is almost 100%. However, in a small number of individuals, the virus may reactivate and be transmitted in bodily fluids, such as semen. This is very common in people with immune suppression or individuals that have only recently been exposed to CMV.
The CMV IgG test indicates previous exposure to CMV. The CMV IgM test indicates a recent or current infection, in which case all vials are discarded.
CMV is spread person-to-person by direct exposure to urine, saliva, mucus, cervical secretions, semen, blood, or breast milk. There is no vaccine for CMV. Daycare centers are one of the more common exposure settings, where children can transmit the virus through contact with each other's bodily fluids (infected children carry the virus in their respiratory and urinary tracts for long periods of time). Adults can also be infected through unprotected sexual contact. The production of virus may take place intermittently, without any detectable signs, and without causing symptoms. An infected mother can transmit CMV to her fetus either through the placenta or through exposure to her infected cervical secretions during birth.
The symptoms are usually mild, non-specific, hard to detect, and resolve in 1-2 weeks. An adult may not even realize that they have an infection. Some people develop a 'flu-like' illness with swollen lymph nodes or they may complain of feeling tired. Children may have a runny nose. In people with impaired immune systems may develop a serious illness. Pregnant women who are infected for the first time during pregnancy usually recover completely with few or no symptoms. The unborn baby is at risk for congenital infection.
If a pregnant woman has never been exposed to CMV and has her first infection during pregnancy, there is a chance that the fetus could become infected before the mother's body can eliminate the virus. Transmission to the fetus only occurs in a third of women who have a primary infection during pregnancy. Congenital CMV is the most common congenital infection in the US. Twenty percent of babies born with an infection develop medical complications over the first few years of life. Those symptoms can include low birth weight, deafness, blindness, mental retardation, small head, seizures, jaundice, brittle teeth and damage to the liver and spleen. While a child may develop some of the above symptoms, no baby develops all the symptoms and some infants have no symptoms at all.
Laboratory testing for antibody to CMV is performed on all donors. If the antibody test is negative or not detectable, the donor is presumed not to have been previously infected. A new test is done every three months to monitor for new infections. If the donor tests positive for antibodies, additional testing is performed to determine if the positive antibody test represents a recent or old infection. If a recent infection cannot be ruled out, all suspect semen vials are discarded.
You may wish to consult with your own medical practitioner as to whether he or she feels it is acceptable to use a donor who is positive for CMV IgG antibodies. Given our screening process, we presume that our donors who are positive for CMV IgG antibodies are non-infectious for CMV. Furthermore, our six-month quarantine policy ensures that should a donor test positive for a current or recent infection, we would destroy all his potentially infectious samples before they were ever released to recipients.
We would highly recommend that you use a CMV negative donor. However, you may use a CMV positive donor, if you wish. While the risk is not zero, the chance of transmitting congenital CMV to a developing fetus from semen used at the time of conception is extremely low. This is, however, a medical issue that you should discuss with your physician.
For more information you can view the CDC website fact sheet at http://www.cdc.gov/cmv/facts.htm