Getting Pregnant Using Fertility Services during the COVID-19 Pandemic
As of November 15, 2020, the U.S. continues to lead the world in COVID-19 deaths and cases.
COVID-19 cases now exceed 10.9 million in the U.S. with more than 245,000 deaths. With respect
to excess deaths in the U.S. largely attributable to COVID-19, the largest percentage increases are
now being seen among younger adults aged 25–44 years and among Hispanic/Latino persons (1).
We know that many patients are anxious about the implications of trying to conceive during the COVID19 pandemic’s recent spike in cases. The fear of a “shutdown” certainly creates anxiety. ASRM has a lot of information on mental health and coping during the pandemic.
At this time, we continue to provide the full service of fertility treatments while focusing on risk mitigation strategies
We are still limited in our knowledge about coronaviruses and pregnancy, but this is what we know
- Pregnant women who have COVID-19 and show symptoms are more likely than nonpregnant women with COVID-19 and symptoms to need care in an intensive care unit (ICU), to need a ventilator (for breathing support), or to die from the illness. The overall increased risk of these outcomes for pregnant women compared to nonpregnant women is small.
- Pregnant women with some health conditions, such as obesity and gestational diabetes, may have an even higher risk of severe illness, similar to nonpregnant women with these conditions.
- Pregnant women who are Black or Hispanic have a higher rate of illness and death from COVID-19 than other pregnant women. But it’s not about biology. Black and Hispanic women face social, health, and economic inequities that put them at greater risk of illness. To learn more about these inequities, see this page from the Centers of Disease Control and Prevention (CDC).
There are many scenarios in which treatment plans may need to be postponed, cancelled, or modified.
- If a patient becomes a patient under investigation (PUI) or becomes COVID-19 positive immediately before IUI or embryo transfer, IUI will not occur, and in the case of an IVF cycle, an embryo transfer will not be performed. In this instance, any acceptable embryos will need to be cryopreserved.
- If a patient becomes a PUI or is found to be COVID-19 positive prior to an egg retrieval, the cycle will be cancelled.
- Also, if a patient’s partner becomes a PUI, or is found to be COVID-19 positive, it must be assumed that the patient was exposed and the cycle will also be cancelled or, if after retrieval, embryos will need to be cryopreserved.
- In the future, if significant changes occur, we may consider continuing with a planned egg retrieval in a hospital operating room as long as the patient is stable and does not have severe symptoms. At this time, that will not happen.
- For patients that need to cryopreserve embryos, these will be frozen until complete recovery. These last minute cancellations may be associated with financial costs. Expenses already incurred for medications or monitoring will not be reimbursed.
There remains a low but possible chance of future treatment cancellation due to exposure, infection, unavailability of PPE or other hospital resources, or changes in regulations and state/federal guidance.
While we are maximizing compliance with CDC, WASHU, BJC, and public health regulations by using appropriate PPE and sanitation techniques, minimizing in person visits, maximizing telehealth, and spacing out existing appointments, there remains a risk of exposure to the novel coronavirus by having contact with individuals at the clinic during treatment.
Moving forward with treatment is optional. You may choose to postpone treatment.
We are available and happy to answer any questions that you have on this topic. Please send a MyChart message to your physician if you have any questions or concerns regarding getting pregnant during the COVID-19 pandemic.
We know this is a stressful time and will continue to provide facts as they become available. The American Society of Reproductive Medicine has excellent patient resources for coping during this time. The ACOG Pregnancy and COVID-19 Website is also an excellent resource.