COVID-19 has put countless plans on hold. Whether it’s travel, marriage, or work, we all have made sacrifices in the face of the pandemic. But, some sacrifices weigh heavier than others. Patients experiencing infertility all over the world have been forced to postpone their treatment, leaving them confused, scared, and unsure of what the future holds.
Now, as clinics are reopening, new guidelines and restrictions are being implemented for the safety of clients and doctors alike. Yet, both groups have unanswered questions and nagging concerns.
To address and relieve some of those concerns, this article will discuss:
In 2020, the American Society for Reproductive Medicine (ASRM) as well as the UK’s Human Fertilisation and Embryology Authority (HFEA) recommended the temporary shutdown of all fertility clinics. This decision came with consideration for the immense strains COVID-19 has placed on the medical system as a whole. Supporting their case, the ASRM cited overcrowded hospitals, exhausted doctors and nurses, as well as a lack of protective equipment.
At the time of the shutdown, some patients had been on waiting lists for months, investing hundreds of thousands of dollars into their treatment, or had even been in the middle of preparing for implantation, taking doses of potent fertility medication.
Taking fertility boosting hormones, like oestrogen and progesterone, can be taxing on the body. And to face the side effects of these treatments without the pay off of even trying for conception can be devastating. Additionally, these hormones may leave patients feeling mentally unstable, aggravating pre-existing stressors and concerns.
These factors plus the general turmoil of the pandemic left many fertility patients feeling lost at best and hopeless at worst.
In a survey from Columbia University, doctors asked fertility patients how the closure of fertility clinics affected them. While yet to be peer reviewed, the study showed that 85% of women were “moderately to extremely upset” over having to put their treatments on hold.
While infertility is a condition that demands medical attention and can be time sensitive, it is not considered a medical emergency. Many other treatments are facing the same restrictions or delays as infertility, such as orthopedics, dentistry, and ocular surgery.
In some extreme cases, such as with women and men battling cancer through chemotherapy, patients have been allowed to continue their fertility treatment, but most are left with no guarantees that their treatment will pick up where it left off.
Commenting on whether the ASRM’s moratorium was the right decision, fertility coach Rachel Shapiro said, “Infertility is painful, challenging, and full of grief, but it will not take your life. Covid potentially could, and for me that’s where the line is.” But, the knowledge of whether the ASRM’s move was right or wrong has done little to mitigate the heartache felt by fertility patients.
Throughout the pandemic, many feel as though they are being bombarded by reminders of their infertility. With mothers doing viral challenges alongside their children, constant talk of children remaining at home rather than attending in-person school, and the prediction of a baby boom following the end of quarantine, patients are undergoing immense emotional and mental stress.
With the COVID-19 vaccine rolling out, fertility clinics are beginning to reopen. But, most are not yet providing their full array of services. To comply with federal and state COVID-19 restrictions, clinics are changing the way they interact with patients.
Changes at fertility clinics can include:
But there is no certainty regarding whether the clinics will stay open. Another spike in infection rates could result in more safety restrictions, meaning more cancelled appointments and more lost time, money, and energy.
If another lockdown does occur, it should comfort patients to know that according to a 2020 study, “there is no evidence that delaying treatment until vaccinated will affect your ability to have a child, even if you have concerns about advanced age and/or diminished ovarian reserve... A delay in IVF treatment up to 180 days does not affect the live birth rate for women with diminished ovarian reserve when compared to women who initiate IVF treatment within 90 days of presentation.”
When restarting or beginning fertility treatment, there are always important questions for a client to ask their specialist.
Here are some COVID-19 specific questions you should ask your clinic about ASAP, including:
Patients should also take the time to research their fertility options. Some clinics may not be offering all services, so understanding the differences in treatments is essential.
In addition, those seeking fertility treatment must weigh the financial, physical, and mental costs of beginning or resuming their treatment in the midst of the pandemic. In times like these, it is important to evaluate your health and consider which step is best.
If you feel overwhelmed, exhausted, or even confused, it may be time to reach out.
As Dr. Philomena da Silva, a fertility psychologist, puts it, “The journey towards parenthood as a fertility patient can be a long, emotionally heightened and precarious experience in itself, and these feelings seemed to increase during the isolation period.”
Her thoughts reflect how many fertility patients have found their mental health dipping over the course of the pandemic. To find healthy coping mechanisms, it is vital that patients discuss their mental health with their PCP, their fertility specialist, and their personal support network.
Those struggling with infertility can also find resources, including support groups, counselling recommendations, and an emergency hotline, on Resolve.org, courtesy of the National Infertility Association.
Infertility will never be easy to face and COVID-19 has only made the battle that much harder. But, fertility clinics are adapting to their patients needs and are finding ways to provide hope and good health during the darkest of times.