The incorporation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing into patient care algorithms has been proposed to mitigate risk. However, the two main professional societies for human reproduction (ESHRE and ASRM) appear divergent on their clinical utility and whether they should be adopted. In this opinion paper, we review the currently available tests and discuss the strengths and weaknesses of the proposed clinical care pathways. Nucleic acid amplification tests are the cornerstone of SARS-CoV-2 testing but test results are largely influenced by viral load, sample site, specimen collection method, and specimen shipment technique, such that a negative result in a symptomatic patient cannot be relied upon. Serological assays for SARS-CoV-2 antibodies exhibit a temporal increase in sensitivity and specificity after symptom onset irrespective of the assay used, with sensitivity estimates ranging from 0 to 50% with the first 3 days of symptoms, to 83 to 88% at 10 days, increasing to almost 100% at ≥ 14 days. These inherent constraints in diagnostics would suggest that at present there is inadequate evidence to utilize SARS-CoV-2 testing to stratify fertility patients and reliably inform clinical decision-making. The failure to appreciate the characteristics and limitations of the diagnostic tests may lead to disastrous consequences for the patient and the multidisciplinary team looking after them.

已提议将严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 检测纳入患者护理算法以降低风险。然而，两个主要的人类生殖专业协会（ESHRE 和 ASRM）在其临床效用和是否应采用方面似乎存在分歧。在本意见书中，我们回顾了当前可用的测试并讨论了所提议的临床护理途径的优缺点。核酸扩增检测是 SARS-CoV-2 检测的基石，但检测结果在很大程度上受病毒载量、样本部位、标本采集方法和标本运送技术的影响，因此不能依赖有症状患者的阴性结果。无论使用何种检测方法，SARS-CoV-2 抗体的血清学检测在症状发作后都表现出敏感性和特异性的时间增加，敏感性估计范围从症状前 3 天的 0% 到 50%，到 10 天的 83% 到 88%天，在≥ 14 天时增加到几乎 100%。诊断中的这些固有限制表明，目前没有足够的证据利用 SARS-CoV-2 检测对生育患者进行分层并可靠地为临床决策提供信息。未能了解诊断测试的特征和局限性可能会给患者和照顾他们的多学科团队带来灾难性的后果。在≥ 14 天时增加到几乎 100%。诊断中的这些固有限制表明，目前没有足够的证据利用 SARS-CoV-2 检测对生育患者进行分层并可靠地为临床决策提供信息。未能了解诊断测试的特征和局限性可能会给患者和照顾他们的多学科团队带来灾难性的后果。在≥ 14 天时增加到几乎 100%。诊断中的这些固有限制表明，目前没有足够的证据利用 SARS-CoV-2 检测对生育患者进行分层并可靠地为临床决策提供信息。未能了解诊断测试的特征和局限性可能会给患者和照顾他们的多学科团队带来灾难性的后果。