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COVID-19 has affected every area of medical care, and that includes care of women who are trying to get pregnant through fertility treatment, called in vitro fertilization (IVF). Back in March, when COVID-19 was surging and overwhelming some hospitals in big cities, fertility treatment, like other non-emergency medical care was put on hold. This was a devastating blow to thousands of women who were ready to start or just starting their treatments.
For a woman who has been trying to conceive for a long time, especially an older woman who may be nearing the end of her viable egg production for IVF, the shutdown of IVF centers was an emotional blow. In fact, according to one survey, over 20 percent of women said that their cancelled treatment felt like the loss of a child.
Why Did Treatments Get Cancelled?
Guidelines for cancelling treatments came from the American Society for Reproductive Medicine (ASRM). On March 17, 2020, ASRM advised suspending all new treatments. Even at the stage where an embryo was ready to be transferred into the womb, the advice was cancellation.
The recommendations seem cruel in retrospect, but at the time, ASRM was advising under the assumption that there could be 100 million new cases in the coming weeks. This estimate turned out to be wildly overblown. But at the time, ASRM’s primary concerns were the protection of patients and staff, and not adding to the burden of the health care system.
When Did the Guidelines Start to Change?
By the end of April, it became apparent that many areas of the country were not being overwhelmed with new cases of COVID-19. The prediction of millions of new cases did not occur. Although there were close one million cases, the curve was flattening in many areas. Recognizing the emotional distress of women in IVF limbo, ASRM adjusted the guidelines accordingly.
ASRM started their new guidelines by recognizing that IVF is an essential service for many women. They also noted that in many areas of the country, COVID-19 infection had gone down or had not spiked, and health care resources were not overburdened. In these areas, ASRM advised reopening. They advised the usual COVID-19 precautions including screening for COVID-19, social distancing, sanitation, handwashing, and facemasks.
What to Expect Going Forward
Due to the backlog of women waiting to start or resume IVF, many centers have had to prioritize care. You may go to the head of the line as a high priority if:
- You are having egg retrieval before a cancer treatment
- you are over age 40 and have a limited number of eggs to harvest.
- You are being treated for endometriosis as part of IVF.
- A further delay in treatment may affect your emotional health, financial situation, or access to insurance coverage.
Women may find that many of the services that used to be done at the center are now being done at home. This may include at-home sperm testing for males partners and at-home ovulation testing. Many consultations will now be done through video conferencing (telehealth).
Many women in the past have decided to get IVF treatment in another country. This option will depend on the ability to travel to another country, the risk of COVID-19 in that country, and local restrictions. At best, the option of overseas IVF for the near future is unpredictable.
If you are considering fertility treatment, and you are not in one of the high priority groups, you might consider waiting until a vaccine is available and COVID-19 is better controlled. These are some factors to consider:
- Although there is no strong evidence that it is dangerous to become pregnant during COVID, there are still a lot of unanswered questions. You may feel safer waiting.
- You might consider the possibility that you could be in mid-treatment during a possible COVID-19 recurrence during the fall cold and flu season. Service might need to be shut down again.
- You might live in an area of low risk, but need to travel to an area of higher risk for treatment.
COVID-19 continues to be an evolving pandemic. If you are ready to start or resume fertility treatment, call your fertility treatment center and talk through all the risks, benefits, and options.