Donor Sperm

The FDA requires that Cytomegalovirus (CMV) testing be performed on anyone who intends to donate sperm. A positive result however, doesn’t necessarily mean that they will be ineligible to donate. Sperm banks will obtain semen samples from potential donors and then quarantine those specimens for at least six months. During that time, the donor's CMV antibody levels may be tested several times.

If the antibody tests indicate the possibility of a CMV infection close to the time of the sperm donation, or if testing is uncertain, the donor's specimen will not be accepted. However, if the donor tests positive for CMV IgG only, indicating a past infection, they will be allowed to donate. Those samples will be labeled in the sperm bank database as CMV positive.

If you test negative for CMV antibodies, you should consider choosing sperm from a donor who is also CMV negative

Individuals who are considering attempting pregnancy with donor sperm should include CMV antibody testing as part of their infectious disease screening. Those who have had a past infection are at very low risk of transmitting CMV infection to a fetus and are at little to no risk from using a CMV positive donor. Those who have never been exposed to CMV, however, should consider using a CMV negative sperm donor. Although the risk from CMV positive donors may be small, it is impossible to determine with certainty whether there might be some risk for infection, and so it is recommended that people who are CMV negative avoid those specimens.

Cytomegalovirus (CMV) is a virus that can be transmitted to a developing fetus before birth. CMV is a member of the herpes family of viruses that also includes chickenpox and mono. Primary CMV infection occurs in people who have never been exposed to the CMV virus before. Once a person becomes infected with CMV, the virus remains alive but dormant inside that person’s body for the rest of their lives.
Recurrent CMV infection, is when a dormant virus become active again. This can occur if a person’s immune system becomes weakened, such as in the elderly or in people who have AIDS. CMV infection is usually harmless and rarely causes illness. However, for those who are pregnant, primary CMV infection can cause more serious problems than recurrent CMV infection.
Most women who are infected with CMV, whether pregnant or not, will not develop any symptoms of the infection. Those that do experience symptoms may see fever, swollen glands, or lethargy.

About 50% to 85% of adults in the United States will become infected with CMV by the time they turn 40. About half of expectant mothers have never been infected with CMV. About 1% to 4% of uninfected mothers have primary CMV infection during their pregnancy.

If a pregnant person has never been exposed to CMV and has their first infection during pregnancy, there is a chance that the fetus could become infected before the body can eliminate the virus. About one third of those who become infected with CMV for the first time during pregnancy pass the virus to their unborn babies. Thus, CMV is the most common cause of congenital viral infection in the United States.

On average, about 40% of babies born to those who had a primary CMV infection during pregnancy will become infected themselves. Of the 40% who become infected, 20% will develop medical complications over the first few years of life. Symptoms can include low birth weight, deafness, blindness, mental disability, 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 of them and some infants have no symptoms at all. Each year in the United States, about 1 in 750 children are born with or develop disabilities as a result of CMV infection. For women who have been infected at least six months prior to conception, the rate of newborn CMV infection is about 1%, and these infants appear to have no significant illnesses or abnormalities.

Most CMV infections are rarely diagnosed because the virus usually produces few, if any, symptoms. However, people who have had CMV develop antibodies to the virus which remain in their body for the rest of their life. Two types of CMV antibodies may be found in the blood: IgM and IgG.

IgM antibodies are the first to be produced by the body in response to a CMV infection. They are present in most individuals within a week or two after the initial exposure. After several months, the level of CMV IgM antibody usually falls below detectable levels. IgG antibodies are produced by the body several weeks after the initial CMV infection to provide long-term protection. Levels of IgG rise during the active infection, then stabilize as the CMV infection resolves and the virus becomes inactive.

Once a person has been exposed to CMV, they will have some measurable amount of CMV IgG antibody in their blood for the rest of their life. CMV IgG antibody testing can be used, along with IgM testing, to help confirm the presence of a recent or previous CMV infection. If both CMV IgG and IgM are present in a symptomatic patient, then it is likely that he or she has either recently been exposed to CMV for the first time or that a previous CMV infection has been reactivated. This can be confirmed by measuring IgG levels again two or three weeks later.

A high level of IgG is not as important as an actively rising level. If there is a four-fold increase in IgG between the first and second sample, then the patient has an active CMV infection (primary or reactivated).