Selecting a high-level disinfection method for IVF applications

When selecting a high-level disinfection method for transvaginal ultrasound probes used in oocyte retrieval and other IVF applications, special attention should be given to toxicity risks.

Automated hydrogen peroxide is a preferred disinfectant for IVF applications, with low toxicity and many favourable disinfection characteristics. Manual disinfection methods with soaks and impregnated wipes require PPE to prevent direct contact with chemicals, and may not guarantee the same reprocessing endpoints for each cycle.

Automated hydrogen peroxide is a preferred disinfectant for IVF applications based on:

• Centre for Disease Control (CDC) guidelines in the United States recommend H2O2 disinfection for retrieved cells based on its lesser toxicity compared to other disinfectants (1)

• Disinfectant studies conducted at the Food and Drug Administration (FDA) Office of Science and Technology in the United States showed that there is a several-hundred-fold difference in the relative toxicity of various disinfecting substances. Hydrogen peroxide was classified in the lowest risk group with the 50% toxic concentration (TC50) being greater than 1 mM (34ug/mL). (2)

• Most human cells are naturally exposed to some level of hydrogen peroxide and in contact with mammalian tissues, hydrogen peroxide is immediately broken down to oxygen and water by the action of catalases. (3,4) Hydrogen peroxide is produced naturally by commensal lactobacilli in the vagina and even plays an antibacterial role by preventing the growth of bacteria species associated with bacterial vaginosis. (5)

• Other HLD methods have been shown to affect respiratory health. Chlorine dioxide, used in some HLD wipes, is a known airway irritant at high concentrations when inhaled (6). Case studies have shown that chlorine dioxide can have hazardous effects on airways even at the concentrations used in commercial wipes. (7)

• Quaternary ammonium compounds, used in disinfectant wipes, can cause skin irritation even at low doses. (8) Several studies have linked higher doses of quaternary ammonium compounds with impaired reproductive health in mice. (9,10)

With the ever-increasing challenges in the fight against the spread of healthcare-associated infections (HAIs), trophon technology is setting a new benchmark in protecting patients.

Read more about trophon technology here

1. Rutala WA, Weber DJ, Healthcare Infection Control Practices Advisory Committee (HICPAC), Centers for Disease Control and Prevention (CDC). USA. Guideline for Disinfection and Sterilization in Healthcare Facilities. 2008.
2. Sagripanti JL, Bonifacino A.Surgical Infections 2000; 1:3-14
3. Halliwell B, Clement MV, Long LH. FEBS letters 2000; 486:10-13
4. (ECETOC) ECfEaToC. 1996. Special Report No 10: Hydrogen Peroxide OEL Criteria Document
5. Sgibnev AV and Kremleva EA. J Microbiol. 2015;8(10): e22913
6.Larideri A et al. Clin Toxicol 2021; 59(5):448-449.
7. Hassel E et al. Occup Med 2022; 72(7):492-494.
8. Goh C et al. Clin Dermatol 2021; 39(2):314—322.
9. Melin V et al. Reprod Toxicol 2014; 50:163-170.
10. Melin V et al. Reprod Toxicol 2016; 59:159-166.


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