Fertility Treatment during the COVID-19 Pandemic
Posted Mar 27, 2020
by Nicola Martens
Medical Affairs Associate
This wasn’t in the plan!
Anyone who has undergone fertility treatment knows exactly how emotional and isolating it can be. The loss of control, the fear of the unknown, the expectations: all familiar feelings to those desperately trying to start their families. Sounds a bit like the feelings associated with COVID-19, right? Now imagine that you are planning fertility treatments during this pandemic.
There are major concerns regarding the effect of COVID-19 on pregnancy. Could pregnant women with COVID-19 develop symptoms different from those of non-pregnant women? Are they more likely to die of the infection or to give birth prematurely? And could the virus spread vertically and pose risks to the fetus and neonate?
At this time, very little evidence has been collected. There has been no hard evidence proving that COVID-19 causes vertical transmission from the expectant mother to the fetus or neonate. A recent paper published in the Lancet Journal outlines one case of a newborn that tested positive for COVID-19 in China. It is not known whether the infant contracted the disease shortly after birth, or while inside the womb.
The Center of Disease Control in the U.S (among other trusted sources) have recently stated that they do not know at this time whether COVID-19 could cause problems during pregnancy or affect the health of the baby after birth. Keeping that in mind, the following precautionary measures are being recommended:
New fertility treatment cycles will be suspended. Among other treatments, this includes all aspects of IVF (hormone therapy, egg retrieval, embryo transfers)
Elective surgeries and non-urgent diagnostic procedures will be suspended
A friend of Quno has graciously agreed to share her story with us:
It’s one thing to try IVF and have it fail. You grieve, but you get over it knowing that statistically, you didn’t have a great chance of success anyway. When the second fails, the bubble bursts and you realise that actually, shit, this might not ever work for me. The worrying and the grieving become stronger. The emotional toll is heavy, but the physical toll on your body is at an extreme. You’ve spent another 6 weeks as a person who is in pain, exhausted, and a hormonal car crash, “but it’s ok, it’ll be worth it!” you tell yourself. Then, it doesn’t work again.
Your doctor, your partner, and your friends try very carefully to tell you that maybe you should take a break for a month or two. Spoiler alert! Although you mean well and we know this, NEVER say that to a woman who has just suffered a failed IVF cycle! Sure, you can be empathetic and supportive, but we will just as easily punch you in the face.
It’s logical to wait until after a global pandemic has passed to try to become pregnant, but for women in their late thirties and early forties, these months may be crucial. At this age, a woman’s egg production and quality drops, so time is absolutely of the essence. I will be 35 in a few months, and I hear the clock ticking loudly.
A few weeks ago, I made the decision to start my 3rd cycle. I had the consultation with my fertility specialist, reviewed the protocol, accepted that I would again become a social recluse (funny how that worked out!), and prayed that I would have a newborn by Christmas. Then the phone call came. To be honest - I never really thought much about COVID-19 affecting my fertility treatment. Sure, it might be worrisome for expectant mothers, but was not really on my radar. I continued in pure ignorance and thought that once I am safe and take precaution, everything would still go according to plan.
How my brain works:
Can’t have babies? Tests.
Tests fine + traditional methods fail? IVF
IVF = The answer to my problems. I can try multiple times/ It’ll eventually work/ it’s science for God’s sake/It’s my only hope/I don’t care how long it takes/ Take all of my money
Do you see the problem when the fertility specialist tells me that I cannot start another IVF cycle!
I am feeling a couple of conflicting emotions, and am guilt-ridden:
I am devastated. After all this time, money, pain, heartbreak, and hope, this is all completely out of my control. Will I ever become a mother? How long will this crisis last for? How long will the wait list be after this is over, can I even do my 3rd cycle this year?
I am relieved (somewhat). Have my body and my heart fully recovered from the last failed attempt? Would it be a smart move for me to dive right in again so soon? Would I really want to be pregnant during such a time of uncertainty?
I am thankful in a sense that these decisions to postpone treatment have come from fertility experts, and not one I had to make myself. I'm not sure I could actively agree to not going ahead as planned. It's hard to imagine how many difficult conversations the clinics have to have with their patients at this time. I know it is the right thing to do -if I became pregnant now, I would be even more anxious about my baby's health in 9 months time.
There is a lot we don't yet understand about coronavirus. We need more data on how exactly it affects pregnant women and their babies before we can know for sure. For now, as new research is appearing daily, I urge you to stay well-informed and on top of the facts. I am taking comfort in the scientific evidence, and I encourage you to do the same.
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