The French High Council for Public Health (HCSP) has been asked by the French General Directorate for Health to assess the risks associated with two arboviruses of the Flaviviridae family: the Zika virus and the dengue virus on people undergoing medically assisted reproduction (MAR) and on gametes, embryos and germ tissues.

The HCSP’s recommendations were based on further knowledge of the persistence of Zika virus in the male and female reproductive tract and international and national epidemiological data supporting a limited risk of Zika virus circulation since 2019. Other data taken into account were the relative complexity of the current measures for Zika virus in terms of MAR and gamete donation, delaying patient care; the availability in France of diagnostic tests likely to characterise a possible evolving Zika virus infection and finally the absence of a clearly established risk in MAR for the dengue virus.

In its recommendations on the risk linked to the Zika virus, the HCSP identifies two situations of exposure: people living in areas where the circulation of the Zika virus is considered to be active at the time of treatment (MAR or donation of gametes or other germinal products) and people returning from an area of active Zika virus circulation. For each of these two situations, three scenarios are considered: gamete donation, MAR and fertility preservation. Detailed recommendations are given for each of these circumstances, including usual management or deferral with or without additional virological tests. The time limits to be respected and the virological tests to be carried out are detailed in flowcharts.

For the risk linked to the dengue virus, the HCSP does not issue any particular recommendation for people undergoing MAR, but encourages the implementation of studies to improve knowledge on the possible risks of sexual transmission of the dengue virus and of its persistence in the genital tract.