COVID-19 Information for Patients

Dear ACFS Patients, Friends, and Family,

We know that many of you have concerns about the coronavirus (COVID-19/SARS2-COV) pandemic and what it means for you if you are currently undergoing or considering fertility treatment and pregnancy.

The American Society for Reproductive Medicine (ASRM), the Centers for Disease Control (CDC), the American College of Obstetricians and Gynecologists (ACOG), and our reproductive medicine counterparts in the European Society of Human Reproduction and Embryology (ESHRE) have been monitoring the global and domestic health situation closely, and are especially focused on protecting potentially vulnerable individuals, including those who are pregnant or wishing to become pregnant and their future children.

We know that there are at least some potential risks to pregnant women and their pregnancies given the high threat of COVID-19 exposures as the virus continues to spread globally and now throughout the United States. Unfortunately, the absolute level of risk to pregnant women and their babies remains unknown. At the same time, there is a dire societal need to slow the spread of COVID-19 through our populations and to reduce the numbers of critically ill that may simultaneously require acute medical care and overwhelm the capacity of our healthcare systems.

As such, on March 17, 2020, ASRM issued the following key statement in a bulletin from their COVID-19 task force:

This ASRM guidance is in response to the coronavirus (COVID-19) global pandemic. Our goal is to provide practices with recommendations that guard the health and safety of our patients and staff, and recognize our social responsibility, as an organization and as a community of providers and experts, to comply with national public health recommendations. This guidance recommends the following:

  1. Suspend initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
  2. Strongly consider cancellation of all embryo transfers whether fresh or frozen.
  3. Continue to care for patients who are currently “in-cycle” or who require urgent stimulation and cryopreservation.
  4. Suspend elective surgeries and non-urgent diagnostic procedures.
  5. Minimize in-person interactions and increase utilization of telehealth.

Importantly, both ASRM and ESHRE are frequently reviewing their recommendations along with the rapidly evolving situation with COVID-19. The following are additional statements, cautions, and recommendations published directly by ASRM and ESHRE as of 3/17/2020:

  • Although there is no current evidence of maternal-fetal [(mother to baby)] transmission of COVID-19, data is limited and prior data support that a febrile illness of any kind in pregnancy may pose risks including miscarriage, stillbirth, and preterm birth. Further, medications to treat COVID-19 are not currently tested/approved in pregnancy.
  • There is no strong evidence of any negative effects of COVID-19 infection on pregnancies, especially those at early stages, as indicated by the latest updates from the Centers for Disease Control and Prevention (CDC) in the USA and others in Europe.
  • There are a few reported cases of women positive for COVID-19 who delivered healthy infants free of the disease.
  • There have been reports of adverse neonatal outcomes (premature rupture of membranes,preterm delivery) in infants born to mothers positive for COVID-19 during their pregnancy, but the reports were based on limited data. Similarly, one case report has been published of an infected infant, but again there was no strong evidence that this was the result of vertical transmission.
  • These data, although encouraging, only report small numbers and must be interpreted with caution. They refer to pregnancies in their final stages, but we have no information on the possible effect of COVID-19 infection on pregnancies in their initial stages.
  • It is also important to note that some of medical treatment given to severely infected patients may indicate the use of drugs which are contraindicated in pregnant women.

We at ACFS take ASRM’s recommendations very seriously and have implemented added precautions to systematically reduce the probability of COVID-19 transmission at our offices and to protect the wellbeing of our patients and staff. Further, we understand the individual and public concerns surrounding this viral pandemic and wish to remain faithful in service to our patients who are currently undergoing fertility treatment, as well as those who may wish to pursue treatment in the future. All patients should consider deferring treatment and becoming pregnant until the level of risk is clear and as low as reasonably possible at an individual and societal level. We will work with all ACFS patients to make future treatment feasible and successful as soon as the next opportunity should arise. For those who may already be in treatment and who wish to continue treatment despite the strong cautions detailed above, we will do our very best to help complete those cycles safely and successfully.

Clearly, we understand that these developments are going to be difficult for our patients, staff, and families. We want to assure you that we will remain open to support our patients and will work diligently to resume our usual clinical activities as soon as safely possible.

We echo the following safe practices advised by the CDC:

  • Practice social distancing
  • Avoid close contact (handshaking, hugging) and proximity to those who may be sick
  • Refrain from unnecessary travel, especially countries designated as high risk by the CDC
  • Wash hands frequently with soap and water for at least 20 seconds and use alcohol-based hand sanitizer if unable to wash
  • Avoid touching your face
  • Frequently clean and disinfect high-contact surfaces around you (home, work, car)

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