We protect you against COVID-19

Medical practice measures

WE CONTINUE ON THE WATCH FOR ANY CORONAVIRUS CHANGES WITH THE CONCERN AND CAUTION SO NECESSARY THESE DAYS, WHEN THE VIRUS KEEPS SHOWING ITS VERY WORST SIDE.

OUR PRIORITY IS TO SAFEGUARD OUR PATIENTS AND INSTITUTO BERNABEU’S HUMAN TEAM SAFETY, THIS IS WHY WE HAVE TAKEN ALL NECESSARY MEASURES TO MINIMIZE THE INFECTION RISKS. 

Safety protocols

Since May the 4th, 2020 the Spanish Authorities gave green light to reopen all assisted reproduction clinics. We then implemented all recommendations made by the mail American and European scientific societies, ESHRE and ASRM. Furthermore, Instituto Bernabeu applies protocols that goes beyond indications, being more restrictive and doubling all efforts to avoid possible infections.

Since the very first moment, we created an Experts Committee Group Covid-19, who follows very closely the pandemic evolution and its novelties. This allowed us to immediately update our protocols as the pandemic keeps evolving, to continue taking care of our patients and all of us. At present, we follow the guidelines provided on the last protocol published the 14th of November.

Overall, these are to date the main measures taken:

Safe clinic

  • Vaccination status:
    • Vaccinated patients. Some local authorities ask patients and accompanying persons to voluntarily share information about their immunisation status upon presentation of an identification document: ID card or passport and one of the following options:
      • Covid Passport with QR code (This is a digital accreditation endorsed by the Ministry of Health and Brussels/European Union) European certificate applied in all European countries and describes the patient’s status: partially vaccinated, fully vaccinated, or if the patient has recovered from Covid infection in the last 6 months.
      • Vaccination certificate: this is a document issued by the health authorities in each country when the vaccination schedule has been completed.
      • Negative PCR test for Covid19, performed in a period of less than 72h.
      • Antigen diagnostic test negative result for Covid19, performed in a period of less than 48h. (If not provided or not available, Covid AG tests are performed prior to each medical/surgical procedure).
    • Non vaccinated patients. Patients without the full certified vaccination are monitored with clinical follow-up and in the event of the appearance of symptoms or having had risky contact with a patient with active infection, they are referred for medical follow-up or quarantine pending results and medical and epidemiological control in accordance with the operations of the Health Centres. In our facilities, preventive measures are maintained at all times wearing masks at all times, safety distance in rooms and corridors together with repeated disinfection of hands and surfaces.
  • We perform the PCR test within a few hours for all international patients who request it. This way, the patient avoids the required quarantine when returning to their country.
  • We do not take samples for PCR or covid-19 serology except for those we perform on our assisted reproduction patients and always following our doctor’s  indications.
  • In the event of a positive PCR in patient, the isolation protocol is applied and treatment is postponed.
  • Access to Instituto Bernabeu will not allowed to any person who doesn’t follow the mandatory measures ordered by the Health Authorities: hand disinfection and the use of masks at all times.

Protocol design

To design our protocols, we considered many important factors:

  • ALL the established protection measures will be maintained with special rigour, at all times for both patients and staff.
  • The designed protocol can be modified according to the new findings.
  • The objective is to keep Instituto Bernabeu free of COVID-19; therefore, in the case of patients with PCR+, any face-to-face consultation and treatment of assisted reproduction will be postponed until a negative result is obtained.
  • The Informed Consents for treatments are modified, extended and personalized, especially for high risk cases of COVID19.
  • Risk patients are informed of the possible cancellation of programmed explorations, In Vitro Fertilization (IVF) cycles and transfers if symptoms appear and PCR+, and this circumstance is clearly stated in the Informed Consents.
  • The instructions and protocols regarding COVID-19 followed at Instituto Bernabeu exceed the indications recommended by the main scientific societies (ESHRE and ASRM).
Appointments spaced out between patients, to avoid overlapping and to allow proper cleaning and disinfection of the practice. Daily health checks for our staff, who will be given personal protection material to wear as well
 
Disinfection and cleaning of consultation rooms after every patient Control at entrances to avoid patients crossing, ensure compliance with procedures and assess health status prior to admission. With body temperatures over 37 degrees or unsuitable epidemiological questionnaire , access to the clinic will not be allowed
 
You must come wearing a surgical mask (not fabric) Companions are allowed on visits and simple examinations, as long as maintaining precautionary measures.
 
Phone and email contact hours: 8am – 8pm Should keep a social distance of at least 1,5 meters
 
ID card or passport and one of the following options:

Covid Passport with QR code.

Negative PCR test for Covid19, performed in a period of less than 72h.

Antigen diagnostic test negative result for Covid19, performed in a period of less than 48h.
 

1. Public common areas

  • Use of surgical face mask indoors and outdoors. Additionally, you will be provided with a face mask upon entering the clinic to put it on top of the one you already wear.
  • There’s Hydroalcoholic solution at your disposal to regularly clean your hands in common areas.
  • Constant cleaning of areas. Office and consultation room disinfection process after each gynaecological visit; this means medical agenda distancing and also avoiding contact between patients.
  • Controlled limit indoor capacity and seating area on waiting rooms is reduced.
  • Paper and magazines removal, increasing digitalisation.
  • Credit card or other digital means of payment is encouraged.
  • Please follow indications and keep social safety distance at all times.

2. Staff Instituto Bernabeu

All the staff at Instituto Bernabeu have received specific training and instructions on the virus, control measures and a code of conduct and we are under constant review of the protocols and clinical guidelines. From the beginning of the pandemic, we created a multidisciplinary scientific team responsible for keeping up to date with any scientific news published about the coronavirus and adjust our safety protocols accordingly.

3. Patients Instituto Bernabeu

All patients are informed in detail about the Pandemic COVID-19 situation and the current knowledge and the consequences in view of an upcoming pregnancy and during pregnancy, with appropriate verbal information and documents.  

Companions are allowed on visits and simple examinations, as long as maintaining precautionary measures.

4. Egg and sperm donors Instituto Bernabeu

At Instituto Bernabeu, we look after the health of patients and donors, maintaining strict quality controls that ensure the correct management of the health crisis caused by SARS CoV2.  As a result and about the gamete donation treatments, we have evaluated the measures that should be applied following the recommendations of the main scientific societies (ESHRE, SEF, ASEBIR) and based on the existing knowledge.

These measures are periodically reviewed and adapted in the light of new information on the disease. It is strongly recommended that all candidates are vaccinated as soon as possible for their health and to help protect society as a whole.

What do I have to do to enter in Spain?

At present, there are no special measures to prevent travel to Spain, with the exception of countries at risk (list of countries/areas at risk). In order to protect your health, a number of protection measures have been put in place, including health checks for passengers. Before your flight you must fill in a Health Control Form through the link spth.gob.es which will generate an identifying QR code that may be required upon arrival. It is likely that your temperature will be taken on arrival at the airport. You will need to wear a face mask at all times and keep a safety distance of 1.5 metres. All means of transport operate with complete regularity throughout Spain (airports, trains, underground, taxis, etc.). If you wish, your personal assistant will send you a voucher to certify your trip is for medical reasons.

You should not travel if you have compatible with COVID-19 symptoms such as fever, cough, shortness of breath, have been diagnosed with COVID-19 or awaiting a PCR screening test result.

Current Situation

All Instituto Bernabeu clinics are completely operational and Covid free. The current pandemic situation is Span is less serious than that of the Spring months. Indeed we still keep all safety and prevention measures which allow us to continue with all our activities without any incidences.

Our position about vaccination against COVID-19

Following the Health Authorities indications, we recommend completing the vaccination schedule as soon as possible and we support, where possible, the application of a 3rd dose in populations that can access  to it.

We recommend for those who have received the full vaccine schedule to start the search for pregnancy after the second dose. In fertility treatments we may initiate pre-studies, but we consider it prudent to delay embryo transfer immediately after receiving the last dose. Patients who are reluctant to be vaccinated or who are awaiting vaccination can carry out their assisted reproduction treatment, leaving a record of this circumstance in the clinical course. More information about it.

Exclusive diagnosis test to our patients

Diagnostic tests (PCR, AgCovid and IgG and IgM) will be applied in cases where our patients require these services: e.g. after documented risk contact with infected and sick people, the onset of symptoms, and in unvaccinated people before medical and surgical procedures in our specialised care activity.

COVID-19 ANTIGEN TEST

Pioneers in incorporating the antigens tests, a routine safety method against COVID.

Unlike the routine PCR, the antigen test has different qualities which makes it very useful: faster, inexpensive and easy to obtain. Is done with a simple nasopharyngeal sample and results are ready in 15 minutes.

Its specificity is so high that, if positive, it will be considered as COVID case and relevant measures will be taken.

Thanks to this high specificity, other relevant crossed reactions with other respiratory viruses are described. This specification makes this test really useful on those cases where the person has compatible symptoms with COVID infection. It allows us to distinguish between infection by COVID and other respiratory virus (flu, common cold, etc.)This fact is especially relevant when the autumn/winter months are arriving and the infections by respiratory virus are so frequent.

However, for asymptomatic patients, its utility is arguable as the test’s detection capacity will directly depend in the patient’s viral load.

We will always perform it under the following circumstances

  1. Any person with symptoms: patients, donors or IB staff; this allow us to immediately detect the disease.
  2. Positive epidemiological COVID questionnaire.
  3. FIV cycle with own egg patient and egg donors before the Trigger (ovulation triggering), at the moment of last ultra sound.
  4. On egg donation patients with fresh embryo transfer, it will be done on the transfer day (if positive, embryo will not be transferred and it will be vitrified).
  5. In frozen embryo transfers (cryotransfer), it will be done at the same time of the last endometrial preparation ultra sound. In patients where the geographical distance makes no possible to take the test, it will be done on the transfer day -before the embryo thawing-.
  6. Before any surgical procedure (hysteroscopy, PAF, testicle biopsy, curettage, etc.)

PCR

A technique based on “polymerase chain reaction”

This is a technique used in molecular biology laboratories and therefore requires specialized staff and equipment. The presence of the genetic material of the virus is detected in a nasopharyngeal exudate. It is the diagnostic test of choice, mainly because it can detect the infection at the beginning with a high sensitivity and specificity, that is, in a reliable way.

  • Sample type: nasopharyngeal exudate.
  • Detects specific and well-preserved regions of the viral genome (RNA virus). Sensitive even with low viral load in the first phases of the disease. It is the viral detection technique to be used in the earliest stages, as it can be detected within 2-3 days after infection.
  • VIASURE technology real time PCR detection kits by certest (biotec) SARS.
  • Test validated by the Carlos III Institute: coincidence of the test to be validated with the results obtained by the Carlos III Institute, both for positive and negative samples.
  • High sensitivity and specificity.

IgM and IgG

Serological antibody analysis

There are two types of tests for determining antibodies: the ELISA test, which requires specialized staff and equipment and, the rapid tests that informs us of the result within 15-20 minutes. These tests are performed in blood (finger prick) and will be able to differentiate both types of antibodies. It is important to perform them at the right time, as, if our inmune system has not produced them yet, we will obviously not be able to detect them. A positive result for IgM would indicate an active infection, meaning that we will be suffering the disease at that time. However, if the IgM is negative, but we present a positive IgG, we will have already passed the disease and these IgG antibodies will remain positive for a time still to be established, protecting us from another possible infection. However, must add that this is a controversial matter that has not been yet properly demonstrated.

  • Sample type: blood.
  • Sensitivity is associated with the moment the test is performed because during the seroconversion window period, antibodies may not be detectable.
  • If the test is performed at the right time, IgM 6-7 days after the beginning of symptoms and IgG 13-14 days after the beginning of symptoms, the sensitivity reported by our test is 94 % and the specificity 100 %.
  • Endorsed supplier; Roche company; COVID-19 IgG/IgM
  • False negatives: mainly associated with the test being performed before seroconversion (during the window period).
  • A positive IgM result indicates active infection. A negative IgM and positive IgG result would indicate pased infection and therefore would reveal the presence of acquired immunity.

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