Received February 04, 2026
Accepted February 10, 2026

OBJECTIVES: To assess the positivity of anti-ZIKV IgM and IgG antibodies in couples undergoing Assisted Reproduction Techniques (ART) and to analyze the reported ZIKV infections among women of reproductive age in São Paulo state. METHODS: A retrospective cohort analysis was conducted using medical records of ART patients consecutively tested for ZIKV between March 2016 and June 2024 at a private ART center. Testing was performed using a rapid immunochromatographic assay, with positive results confirmed by PCR. According to ANVISA regulations, anti-ZIKV IgG testing was required between 2016 and 2022, while both IgG and IgM testing were mandatory from 2022 to 2024. Additionally, ZIKV notification data from DATASUS for metropolitan cities near the ART center were collected and compared with positivity rates observed in the cohort. RESULTS: Anti-ZIKV IgM positivity was 0.18% (1/569 female patients; 95% CI ≈ 0.00–0.98%), while anti-ZIKV IgG positivity was 2.1% (2/96 tested; 95% CI ≈ 0.25–7.32%), indicating limited prior exposure. DATASUS data demonstrated a marked decline in ZIKV cases in São Paulo state, from 10,455 cases in 2016 to 228 in 2024. In cities surrounding the ART clinic, reported cases decreased from 73 to 1 over the same period. Among women of reproductive age, 42 cases were reported in 2016 and none in 2024. DISCUSSION: Massive population testing imposes logistical and financial burdens. In this ART population, ZIKV positivity was rare (<1%), with approximately 2% showing evidence of prior exposure, and patients were predominantly from regions with low ZIKV-related microcephaly incidence. CONCLUSION: Anti-ZIKV positivity was low among patients undergoing ART.