有~~~巨細胞病毒~~可不可以做~~~~~試管嬰兒？

Cytomegalovirus (CMV) is the most common intrauterine infection affecting 1% of live- borns in the US. It is a herpes virus. Most cases are asymptomatic. About 1% of pregnancies are complicated by primary CMV. 2/3 of infants will not be affected and 10%-15% of the remaining 1/3 will have symptoms in the neonate at birth. There is little risk (1%) in women infected more than 6 months before pregnancy (cdc.gov, 10). There is no treatment in pregnancy. Symptomatic infants may have jaundice, hepatosplenomegaly, pancytopenia, deafness or mental retardation. Maternal primary CMV infection is viremic with transplacental spread. Reactivation CMV may be less severe due to maternal IgG anti-CMV crossing the placenta (11). The gold standard for diagnosis is viral culture from maternal blood, cord blood saliva, fetal tissues or urine. The typical nuclear inclusions are not always diagnostic. CMV IgM may be present in newly acquired or reactivation CMV, so it is not always helpful. For immunocompetent patients, primary infection is best diagnosed with conversion from CMV IgG negative to positive and a positive IgM. A carrier may be IgG positive and IgM negative (i.e. 1%). A patient that has never been infected (negative IgG and IgM) would be at high risk if she were to become infected. She should exercise good personal hygiene, wash hands after contact with diapers of oral secretions, especially with children in day-care. Almost 80 % of adults have been exposed and have positive CMV IgG and would not have problems in pregnancy.

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