Coronavirus and Fertility Treatments
Late-breaking news impacting infertility in the era of COVID-19.
““Suspend initiation of new treatment cycles””
On March 17th, the American Society for Reproductive Medicine (ASRM) released recommendations for managing fertility treatments during the pandemic. These recommendations came from the evidence we currently have on COVID-19. ASRM will update their position by March 30th or earlier as more information comes in.
Their recommendations were as follows:
No more new treatment cycles for the foreseeable future. By new treatments, they are referring to ovulation induction, in vitro fertilization – including retrievals and frozen embryo transfers, intrauterine inseminations, and non-urgent gamete cryopreservation.
Consider cancellation of all embryo transfers (fresh or frozen).
Keep caring for a patient who is already “in cycle” or who requires urgent stimulation for cryopreservation.
Stop any non-urgent diagnostic procedures and elective surgeries.
Minimize in-person interactions in favor of telehealth.
ASRM laid out how COVID-19 is more contagious and kills 10-15 times more people compared to the flu. There is a scary shortage of personal protective equipment for healthcare workers, so there is a suggestion that the gloves, masks, and other personal protective equipment used by the staff at fertility clinics could be rerouted to healthcare systems directly addressing COVID-19. Since the U.S. is severely deficient in testing and screening capabilities for coronavirus, staff at reproductive centers could unknowingly come into contact with the infection; if reproductive staff come down with the illness, this could easily impair the quality of care needed to treat patients. Most importantly, we still don’t know how COVID-19 infection will impact pregnant women; it’s unlikely yet still unclear whether or not a mother can directly pass coronavirus onto a baby in utero.
A recent publication discussed the outcomes of nine pregnant Chinese women who tested positive and showed symptoms for COVID-19. Six out of ten babies born to these COVID-19 infected moms experienced intrauterine fetal distress and met criteria for critical illness.
With the concern for negative impact to babies, women, and healthcare staff, ASRM’s recommendations to stop any non-urgent fertility treatments makes sense.
My advice to patients attending reproductive clinics — touch base with your clinic to know their stances on treatment during this pandemic and how they personally plan to attend to your case. For women who may have the possibility of conceiving naturally, please practice social distancing and keep taking your prenatal vitamins!
Resources
American Society for Reproductive Medicine (ASRM). Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic. Available at https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covidtaskforce.pdf
Zhu H, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020 Feb;9(1):51-60. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036645/
