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.
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, coordinated by doctor Francisco Sellers, 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:
- Control epidemic questionnaire that must be regularly filled in when coming to our facilities.
- We perform in a few hours the PCR test to the international patients who request it. This way, the patient avoids the quarantine period requested on their home countries.
- We do not take samples for PCR nor serologies covid-19 excepting those taken from our reproduction assisted patients and always following our doctors’ advice.
- When a patient is positive on PCR, we will apply the isolation protocol and the treatment is postponed.
- Access to Instituto Bernabeu is not allowed to any person not complying with the Health Authorities measures. Body temperature measured at entry, COVID epidemiological questionnaire, hands disinfection and use of face masks at all times.
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 will be spaced 40/60 minutes apart, to avoid patients crossing and to all for the correct cleaning and disinfection of the consultation rooms||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)||1 companion is allowed per patient|
|Phone and email contact hours: 8am – 8pm||Should keep a social distance of at least 1,5 meters|
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.
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 will be periodically reviewed and changed according to the reported data about the disease.
What do I have to do to enter in Spain?
As of today there are no special measures taken in order to enter in Spain. The Spanish Government has implemented some orders to protect your health, among which is the passengers’ health inspection and from the 23rd of November, a negative PCR performed within the 72 hours before your entry if you come from a country that is considered high-risk. This document must be an original, no copies, and drafted in either Spanish or English and can be presented in paper or electronically. They must fill in a Health Inspection Form that can be found at following link: spth.gob.es. Your body temperature might be taken at your arrival at the airport but, there’s no quarantine required once you arrive in Spain. You must wear a face mask at all times and keep the safety distance of 1.5 meters. All means of transport work with normality in the entire Spanish territory (airport, train, subway, taxis, etc.). Your Patient Coordinator will send you a written proof to validate your trip for medical reasons.
You must not travel in case of compatible symptoms with covid-19 such as fever, cough, breathing difficulty, you have been diagnosed with covid-19 or you’re waiting for a PCR detection test results.
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
We consider the vaccine should be administered to the entire population, always following the Health Authorities’ indications. We are in favour of its use, paying attention to prudence and taking into account each particular case. We recommend for those who have received the vaccine, to wait two weeks, after the second dose, to seek pregnancy. In fertility treatments we can start the previous studies immediately, but we consider it would be best to delay the embryo transfer until 14 days after having received the last dose. Those patients who are reluctant to vaccination or who are waiting to receive it, can undergo their assisted reproduction treatment, leaving evidence of this circumstance in the clinical course. More information about it.
Exclusive diagnosis test to our patients
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
- Any person with symptoms: patients, donors or IB staff; this allow us to immediately detect the disease.
- Positive epidemiological COVID questionnaire.
- FIV cycle with own egg patient and egg donors before the Trigger (ovulation triggering), at the moment of last ultra sound.
- 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).
- 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-.
- Before any surgical procedure (hysteroscopy, PAF, testicle biopsy, curettage, etc.)
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.