Impact of COVID on IVF treatment

Guest-post by Lauren W. Sundheimer, MD

Dr. Sundheimer is a board certified OB/GYN, Reproductive Endocrinologist and Infertility Specialist. Spanning the entire spectrum of fertility care, Dr. Sundheimer has clinical expertise and interests ranging from the diagnosis and management of infertility to family planning and building, fertility preservation, LGBTQ+ care, and single-parent family-building. Additionally, she treats women with reproductive endocrine issues regardless of their fertility desires, such as PCOS and other abnormal hormone-regulation issues.

Holding your baby for the very first time is a life-changing moment. For those yearning to grow their family, this day cannot come soon enough. Unfortunately, COVID-19 has created a pandemic that has and continues to change the world as we know it; and in a way that is far less idyllic from the way a new baby would change your world.


That being said, the COVID-19 pandemic does not mean that you must give up on your hopes and dreams of having that special baby bonding moment. As you seek fertility treatment to reach your family building goals, there are some important things to consider:

TELEMEDICINE

Telemedicine, or medical care provided digitally from a distance through a computer or over the phone, is now readily offered by many clinics to best serve patients during these unique times. Telemedicine is great in that it has no risk of COVID-19 transmission and is often faster and more convenient than going to a physician office, since it can be done from the comfort of your own home. Telemedicine appointments are often held for new patient consultations, preconception care, treatment planning for new and established patients, follow up visits, and so on. During a treatment cycle, you will still need to go into the office for your monitoring ultrasound, blood-work, and procedures.



CYCLE DISRUPTION

While undergoing treatment you want to be in your best state of health and this extends to avoiding COVID-19. Many centers will be checking your temperature, enforcing policies that mandate face coverings, and performing periodic COVID-19 testing. If you develop symptoms of illness during a treatment cycle or test positive for COVID-19, even in the middle of a treatment cycle, the cycle may be canceled. Though disappointing, canceling the cycle is for your safety as well as for the health and safety of other patients and staff. Additionally, each clinic may have other COVID-19 specific policies they have implemented, so be sure to check with your clinic and treatment for specific details.

TRAVEL/THIRD PARTY REPRODUCTION

For those seeking assistance by way of donor egg, donor sperm, or a gestational carrier, since it is common to have distance, careful considerations must be made with regard to travel. Be mindful of local disease prevalence and adhere to travel restrictions. For cases where intended parents are in different states, use of egg freezing (cryopreservation) or shipment of frozen sperm for embryo creation should be performed whenever possible as an alternative to travel.


For international patients, due to continued restrictions on global travel, ASRM (American Society of Reproductive Medicine) recommends “consideration of country of origin for intended parents, regional conditions in the gestational carrier’s state of residence and in the clinic where treatment is being sought.”


If you have recently traveled be sure to allow for time from the time of your arrival to the date of your clinic visit, as many clinics have a waiting period before you are able to come into the office after recent travel.



MENTAL HEALTH

Infertility is a disease that can have significant emotional and physical impact on anyone going through it and this can be compounded by the COVID-19 pandemic. Being socially distant and isolating from others can also take a toll on the psyche. It is important to prioritize your mental health during this time in addition to your physical health. Find a stress management method and relaxation technique that works for you. Things like exercising, reading, taking a nice bath, etc. are all good for self-care.



PREGNANCY

At this time, our understanding of the impact of COVID-19 on reproduction and pregnancy is limited. In general, avoidance of infection is best. A recent study suggests that pregnant women with COVID-19 are more likely to be hospitalized, are at higher risk of insensitive care unit (ICU) admission and require of mechanical ventilation as compared to non-pregnant women. The risk of death is similar for both pregnant and non-pregnant women. There is still much that remains unknown.

Limited data are available on the risks associated with COVID-19 infection in the first and second trimesters of pregnancy. Available data are reassuring, but are limited to small case series. Since COVID-19, or more formally SARS-CoV-2, is a coronavirus similar to other coronavirus outbreaks of human disease in the past -severe acute respiratory syndrome (SARS) caused by SARS-CoV and the Middle East respiratory syndrome (MERS) caused by MERS-CoV -we can extrapolate data from these outbreaks. Fortunately, data from these earlier epidemics are reassuring and suggest that there is no increased risk of fetal loss or congenital anomalies associated with infection early in pregnancy.

Overall, this is an unprecedented time that is filled with disruption and uncertainty. As the pandemic continues on, we must all adjust to a new normal and this includes our approach to fertility treatments. Your health and safety is always the top priority to get you to your goal of having a baby in your arms.

Sources


ASRM: https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covid-19/covidtaskforceupdate6.pdf


CDC: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/special-populations/pregnancy-data-on-covid-19.html#:~:text=Tracking%20data%20on%20COVID%2D19,mechanical%20ventilation%20than%20nonpregnant%20women.


MMWR: https://www.cdc.gov/mmwr/volumes/69/wr/mm6925a1.htm:



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