Coronavirus halts fertility treatments
Yes, the coronavirus pandemic is still raging on. Coronavirus, or COVID-19, has now dramatically affected every aspect of our lives. Fertility treatments have been impacted too, with large numbers of procedures having been cancelled in recent weeks.
But the latest guidance is more definite: all fertility treatments are now cancelled for the foreseeable future in the UK, starting from 15th April 2020.
Why is this happening? Apart from the obvious…
In case you have been living under a rock for the past month and been socially distancing so well that you haven’t heard about social distancing, the phrase means:
The purpose of these measures is to minimise your contact with other people. This reduces the chances of you catching or spreading the virus.
Fertility treatments involve a great deal of time in contact with other people. This includes time travelling to a clinic and having appointments with medical staff which include being physically examined. This is in addition to the time taken to carry out the fertility treatment, which can occur in a number of stages.
These events cannot happen in line with social distancing measures. Therefore it is safest for patients and healthcare staff if these treatments are delayed during this crisis.
Protecting the NHS
These words have probably been engrained in your brain thanks to countless politicians mentioning them at every opportunity.
For fertility treatments, the NHS is a key component of even the most standard and low-risk procedures. The truth is that there is always a chance that complications might arise in any procedure. The health service is essential for treating patients in these types of unforeseen emergencies.
But at this time, the NHS is already under a huge amount of strain dealing with COVID-19 patients. Therefore it is safest for everyone if we can reduce the pressure on the NHS by delaying any other less-urgent procedures until after the immediate crisis has passed. This boosts the chances of you receiving the best possible level of care in the hospital and all the resources you need, if the worst happens.
Coronavirus and pregnancy
Frustratingly, we know very little about the coronavirus as it is a new virus in humans. This is indeed the reason why it has brought our world to a standstill, and it is also one of the reasons why many countries have been ill- prepared to deal with this threat.
Importantly, we know very little about how coronavirus affects pregnancy. Therefore pregnant women are on the list of people who may be more vulnerable during this pandemic.
Initial evidence shows that pregnant women react to the coronavirus in the same way as healthy adults. This means that the usual flu-like symptoms occur and they are manageable in the majority of cases.
But the fact that we know little about the virus means that we still need to be careful. In general, viral infections can be more harmful to pregnant women than other adults. This is because of the changes that a woman’s immune system goes through during pregnancy. Additionally, some medicines which are used against viruses can be harmful during pregnancy.
The other problem is that it is likely that mothers can pass coronavirus on to their babies during pregnancy. This is called vertical transmission. In cases where this has happened in China, the babies recovered and were healthy afterwards.
There have also been reports of women with coronavirus having a higher risk of giving birth prematurely. But it is unclear whether this was due to the virus causing problems in the pregnancy, or because doctors decided it was better for the mother’s health to deliver sooner.
Doctors across the world are monitoring the situation closely and compiling data on the effects of the coronavirus as you are reading this. Therefore we will learn much more about this virus in the coming months. But for the time being, it is safer to delay pregnancies from fertility treatments until we know how to best manage them.
Lack of access to support
For many couples who have been eagerly waiting for their fertility treatment, this delay will be really upsetting. But the COVID-19 lockdown has drastically affected how our society works, and it is not an ideal time to be pregnant.
There has been a huge reduction in the number of face-to-face appointments with medical staff. Many routine medical appointments with GPs and midwives are being done via telephone, but this brings a danger of missing information that would be noticed in a traditional face-to-face appointment. It is impossible to examine patients without being in the same room as them.
The support system for expecting couples has been damaged by the coronavirus for the next few months. Many community support groups for expectant mothers have stopped running. With social distancing in place, you won’t be able to visit friends and family for support and a hug. Even your mother-in-law won’t be able to drop by for an unexpected visit to ‘help out’ (whether that is a blessing or a curse is up to you to decide).
On top of this, the shortages of some products in supermarkets will make dealing with pregnancy cravings a nightmare. Even stocking up on the essentials for a new baby is more stressful than usual, with supermarkets struggling to cope with the demand for online shopping.
Pregnancy can be stressful enough without having to do it in a pandemic. So although the delay in your fertility treatment is really disappointing, try to remember that it is the best and safest option for you and your family.
When will treatments resume?
This is the question on everyone’s minds but unfortunately, we do not know. The situation is changing rapidly with new data being collected and analysed every day.
It is likely that the lockdown will need to remain in place for some time yet. But when the government starts to relax the social distancing measures, it would be a good time to contact your fertility clinic.
What can I do in the meantime?
Keep calm and carry on
Going through a fertility treatment is a stressful process, and the coronavirus will only have added to the anxiety. On top of that, being cooped up with loved ones is a recipe for disaster.
Therefore it is important that you keep calm and look after your mental health. Take time out for yourself to do hobbies that you can still enjoy from home, such as reading, painting or mindfulness.
Stress can have a negative impact on your health and your fertility [1. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues in Clinical Neuroscience. 2018. 20(1): 41-47], so it is important to keep it in check. Try to remember that everyone is handling this unusual situation in different ways, so try not to take out your frustration on your loved ones.
Social distancing doesn’t have to be antisocial
Although you can’t visit friends and family in person, you can still stay in touch with them using emails, social media and other apps. Make sure you reach out for support from them if you need to.
Give the natural way a go
If you are able to, go back to basics and try to conceive naturally with your partner. Medicine does not always have all of the answers.
In a study published in 2016, doctors collected data from infertile couples undergoing IVF/ICSI treatments. In the 6 years after they stopped these fertility treatments, women had a 29% chance of conceiving naturally [2. Marcus AP, Marcus DM, Ayis S, Johnson A, Marcus SF. Spontaneous pregnancies following discontinuation of IVF/ICSI treatment: an internet-based survey. Human Fertility. 2016. 19(2): 134-41].
So the natural way is still worth a try, and it could be a good way to reconnect with your partner during this stressful time.
No gym? No problem! There are so many apps and online videos available to help you exercise from the comfort of your home. From yoga to cardio, there are lots of resources available. Exercise is a great stress buster and it releases happy hormones which will help you and your loved ones make it through the lockdown unscathed.
With stress eating and binge-watching everything on Netflix, it can be easy to put on some extra weight. But obesity can have a negative effect on your fertility and the success of fertility treatments [3. Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reproductive Biology and Endocrinology. 2018. 16(1):22]. Therefore it is important to maintain a healthy weight with regular exercise and a healthy diet rich in fruit and vegetables.
We are living through unprecedented events, but it is important to remember that these are temporary. By looking after ourselves and each other we will get through these difficult times. These challenges will only make you into a stronger and more resilient person who is well equipped to become a parent in the future, when it is a safer time for you and your family.
Take care and stay safe and healthy – with love from the Human Fertility team.
Dr. Kooner is Deputy Director of The Advanced Fertility Center of Chicago and has been a Specialist in Fertility Treatment since 1999.
As well as the areas that the clinic specialises in general, he is particularly interested in managing oocyte donation, female same-sex couples, single women having sperm donation and those considering egg freezing.
Dr. Kooner regularly speaks at fertility meetings. He has published in national journals and constantly contributes to the fertility research and publications from Advanced Fertility Center of Chicago.