Infertility treatment during COVID-19 pandemic
COVID19 is a global crisis that has significantly affected the field of infertility and IVF practice. As a result, a variety of public health responses have been implemented depending on location and perceived level of threat. It is, therefore, very pertinent for us to conduct an international survey to ascertain the impact on IVF practices in different regions of the world. Our purpose is to ascertain similarities and differences in the regional response to the COVID-19 pandemic among infertility practices as well as trends in practice changes over time. Because the pandemic has arisen in different countries at different times, and the number of IVF cycles done varies significantly by country, information based on the region will be elicited for some countries.
Before the COVID-19 crisis estimate the total number of IVF cycles performed by your unit annually
is your practice:
- University-affiliated
- Private
- Public
- Public and private combined
- Other
Did your country’s reproductive medicine society release recommendations related to Covid-19?
- Yes
- No
Did those recommendations suggest a complete shutdown?
- Yes
- No
- Partial shut down
- No recommendation
Did health authority ban fertility investigations / treatment?
- Yes
- No
- Partial shut down
- Health authority did not declare opinion
Were there any exceptions to the ban? (multiple answers allowed)
- No, there are no exceptions
- Urgent medical indication- oncology patients are allowed to undergo ovarian stimulation, egg collection, in vitro fertilization, oocyte/embryo cryopreservation
- Women over a certain age allowed
- IUI permitted
- IVF permitted without fresh transfer
- Other
- No ban in place
How much did your monthly fresh IVF cases decrease after the declaration of pandemic?
- 0 (no change at all)
- 1% – 25%
- 26% – 50%
- 51% – 75%
- 75% – 99%
- 100% (complete shutdown)
How much did your monthly frozen embryo transfer cases decrease after the declaration of pandemic?
- 0 (no change at all)
- 1% – 25%
- 26% – 50%
- 51% – 75%
- 75% – 99%
- 100% (complete shutdown)
7. How much did your monthly IUI cases decrease after the declaration of pandemic?
- 0 (no change at all)
- 1% – 25%
- 26% – 50%
- 51% – 75%
- 75% – 99%
- 100% (complete shutdown)
If you stopped or reduced services, what were the reasons? (selected all that apply)
- Government mandated lockdown and patients were not able to access services
- Staff unwilling or unable to work
- Staff redeployed to other medical services
- Employer’s concern for health and safety of staff
- Lack of Personal protective equipment
- Concern of effects of Covid-19 on early pregnancy
- Patient related causes (e.g. patients cancelling appointments, patients not being able to travel, patient’s desire to postpone treatment etc.)
- Other
- No reduction of services has occurred
If you are continuing any treatments and/or investigations, what provisions in your practice have been implemented to ensure patient and staff safety? (Please select all that apply)
- For consultations and reviews, only by telehealth
- Maintain social distancing by separating appointment times (i.e. seeing less patients with fewer scheduled appointments coming to clinic).
- All staff and patients are questioned for COVID symptoms before admitting them onto the premises.
- All staff and patients undergo temperature checks before admitting them in the premises.
- Personal protect equipment provided to all staff and patients bring their own PPE.
- Personal protect equipment provided to all staff and patients by clinic.
- Hand sanitizing for all staff and patients at entrance.
- Required Covid-19 testing (e.g. PCR, from couples prior to treatment).
- Fewer active staff and modification in working schedules.
- OPUs and ETs and procedures spaced out more widely.
- No additional precautions taken.
- We did not continue providing treatment during the pandemic.
What measures are you planning on implementing before resuming activity? (Please select all that apply)
- For consultations and reviews, only by telehealth
- Maintain social distancing by separating appointment times (i.e. seeing less patients with fewer scheduled appointments coming to clinic).
- All staff and patients are questioned for COVID symptoms before admitting them onto the premises.
- All staff and patients undergo temperature checks before admitting them in the premises.
- PPEs provided to all staff and patients bring their own PPE
- PPEs providing to all staff and patients by clinic
- Hand sanitizing for all staff and patients at entrance.
- Required Covid-19 testing (e.g. PCR, from couples prior to treatment).
- Patients have to have –ve antibody (igM and IgG) before commencing treatment
- Fewer active staff and modification in working schedules.
- OPUs and ETs and procedures spaced out more widely.
- Starting all ART procedures except fresh embryo transfers until further information on Covid-19 infection on ART results and early pregnancy becomes available.
- No additional precautions taken.
If you are continuing care, do you inform patients about (more than one acceptable)
- Unknown risk of possibly increased miscarriage rates
- Unknown risk of possibly increased fetal abnormalities
- Unknown other adverse pregnancy outcomes
- Unknown possible risk of lower ART success rates
- Cycle may be cancelled mid-way if patient turns COVID positive, if staff COVID positive or quarantined, or if government shutdown.
- None of the above
