Coronavirus and Infertility Treatment

Your'e doing everything in your powers to build your family, and so are we

March 30, 2020

 

Dear Valued Patients,

 

We realize the ongoing situation related to COVID-19 has added additional hurdles to the already challenging infertility journey.  Please be assured that the health and safety of our patients and fertility care team remain our top priority.

Based on current guidance from outside medical advisers, we have made the difficult decision to grant access to our center to only those actual patients who have a scheduled appointment. No additional guests will be permitted entry at this time.

Additionally, in order to remain in compliance with local mandates, the following policies remain in effect:

Appointment Check-In

For patients who require on-site appointments, we request that you please check-in from your vehicle by calling our Welcome Center. Our patient advocates will then notify patients when the time has arrived to enter our clinic. For checking in at our St. Louis center please dial 636-778-9899 and to check-in at our Tulsa location, please dial (918) 872-0867.

 

Guests

We apologize in advance for any inconvenience that may arise; however, to maintain appropriate measures for social distancing we are only permitting the Patient with a scheduled appointment within our clinic until further notice.  We know this may be extremely difficult but minimizing the risk of exposure is extremely important.

 

Screening

All patients being seen within the clinic will be screened for possible exposure and risk factors of COVID-19. Those who fail the screening process will not be allowed to be seen.

In the event a patient is quarantined or becomes ill from COVID-19 prior to or during a patient’s cycle, their treatment cycle will be cancelled.

 

Social Distancing

Please forgive us for not shaking hands or hugging. Supporting you is an essential part of patient care, but for now, we must reduce physical contact and will abide by the 6ft guidelines recommended by the CDC

 

We apologize for any inconveniences and are committed to resuming normal daily operations as soon as possible.

 

The MCRM Team

March 22, 2020

 

Dear Valued Patients,

The environment related to COVID-19 is ever evolving with new information arriving daily.  We want you to feel confident that we are continuously monitoring all updates and that we are complying with the recommendations set forth by the Centers for Disease Control (CDC), American Society for Reproductive Medicine (ASRM) and local and state governments.  Our MCRM Fertility team appreciates your understanding and patience as we review and make necessary changes to ensure your health and the health of our fertility care team.

 

We understand this may be a difficult time for you as you have already been traversing the journey of infertility.  Rest assured, MCRM Fertility remains committed to you.

 

After careful considerations and discussions with our advisors we are continuing to proceed with fertility treatment cycles for patients who have already started an IVF cycle.  Additionally, we will continue to schedule new patient and follow-up appointments and offer them through the use of telemedicine.

 

At MCRM Fertility, our number one priority is always your health and the health of our staff. In order to comply with local mandates, we have instituted the following policies:

 

Appointment Check-In

For patients who require on-site appointments, we request that you please check-in from your vehicle by calling our Welcome Center. Our patient advocates will then notify patients when the time has arrived to enter our clinic. For checking in at our St. Louis center please dial 636-778-9899 and to check-in at our Tulsa location, please dial (918) 872-0867.

 

Guests

We apologize in advance for any inconvenience that may arise; however, to maintain appropriate measures for social distancing we are only permitting the Patient and their partner or significant other within our clinic until further notice.  We know this may be extremely difficult, but minimizing the risk of exposure is extremely important.

 

Screening

All patients being seen within the clinic will be screened for possible exposure and risk factors of COVID-19. Those who fail screening will not be allowed to be seen.  In the event a patient is quarantined or becomes ill from COVID-19, their treatment cycle will be cancelled.

 

Social Distancing

Please forgive us for not shaking hands or hugging. Supporting you is an essential part of patient care, but for now, we have to reduce physical contact and will abide by the 6ft guidelines recommended by the CDC

 

Please know the situation is fluid and changing rapidly and this is not business as usual.  We are committed to resuming normal daily operations as soon as possible. As always, MCRM Fertility will continue to advocate for our patients through their fertility care journey.

 

The MCRM Team

March 18, 2020

The COVID-19 virus, also known as coronavirus disease, is upon us. The COVID-19 virus is novel and new. The infectious disease specialists around the world are still characterizing and learning about its effects. What we do know is that it is very contagious and harmful, especially to those in poor health.

Here are the measures that we’re taking to make sure that we can continue to provide you with the highest standard of fertility treatment while keeping not only your health and safety, but everyone’s, as our top priority:

 

  • Offices, the waiting room and shared spaces are sanitized by staff every 1-2 hours
  • Exam rooms are sanitized between patients
  • All linens, drapes, and devices are used only once and are either discarded or disinfected between patients when reusable
  • Fertility consults may be conducted through a tele-health visit
  • We will ask patients to check-in from your car when you arrive. Arriving patients should call our office and then wait in your car until we text you for your appointment
  • We ask that you please do not bring anyone with you to appointments (relatives, children, etc.) except for your partner. We know this may be extremely difficult, but minimizing the risk of exposure is extremely important right now
  • Non-urgent interventional procedures, such as hysterosalpingograms, may be temporarily suspended.
  • Please forgive us for not shaking hands or hugging. Supporting you is an essential part of patient care, but for now, we have to reduce physical contact and will try to abide by the 6ft guidelines recommended by the CDC

We need to keep our patients and staff healthy, you can help. We need you at 100%. If you have even a sniffle, please stay home. If you feel fantastic, but someone you have close contact with has experienced flu-like symptoms, please refrain from coming in. You will not be charged a cancellation fee if you are sick.  We would rather be overly cautious and keep everyone safe.

  • If you’ve had exposure to COVID-19 or know anyone who has, we’ll stop treatment immediately.
  • If you have traveled to a high-risk area in the last two weeks (please see the CDC website for high-risk areas), please arrange for a tele-health visit or reschedule your appointment.

If you are in an IVF stimulation cycle and you become exposed to COVID-19, per the guidance established by local and national agencies, we may be required to cancel your IVF cycle. We know how difficult this can be. To help you as much as we can in this event, we will credit our services of your IVF cycle not yet rendered to repeat at a later date. This does exclude medications

Right now, much is unknown about COVID-19 and pregnancy. We do know, however, that because pregnant women experience changes in their bodies that may increase their risk of some infections, it’s important to take extra safety precautionsPer the recommendations of the American Society for Reproductive Medicine (ASRM), MCRM Fertility will temporarily suspend initiation of ovulation inductions, intrauterine inseminations (IUIs) and embryo transfers.

Our advice for patients is:

  • Stay healthy; wash your hands often and wash for at least 20 seconds, or use alcohol-based hand sanitizer
  • Embrace social distancing
  • Avoid others who are sick or have been sick
  • Avoid unnecessary and non-essential travel
  • Remain calm and optimistic; stay informed with verified news sources such as the CDC and WHO

You know as well as we do, that the global situation is changing by the minute. We’re not only looking to the guidance of the Centers for Disease Centers (CDC) and World Health Organization (WHO) for guidance, we also look to our colleagues and professional societies including, but not limited to, the American Society for Reproductive Medicine (ASRM) all of whom, are updating their recommendations rapidly.

Infertility is a disease and we must consider the necessities of those who require treatment for their conditions as well as the necessities of public safety.

As soon as we have updates, we will share them here on the COVID-19 page of our website. Please continue to check for updates.

Our goal is to resume usual patient care as soon and safely as possible.

Warmly

 

Peter Ahlering, MD / Mira Aubuchon, MD

P.S. There are many twists and turns on the fertility journey and it often takes longer than one would have liked. This is just one more twist; and we’ll work together to achieve your goals.

ASRM Bulletin, March 17, 2020

Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic

Along with others in the global community, reproductive medicine professionals and their patients are battling an unprecedented viral pandemic.

 

The priority of the ASRM is to maximize the wellbeing of patients, staff, and society at large. As such, ASRM aims to provide guidance and support based on existing scientific knowledge, to its members and the patients they care for during the coronavirus (COVID-19) pandemic.

 

This guidance addresses a gap in current guidelines addressing COVID-19, which only indirectly mention infertility and its treatment.

 

The recommendations laid out in this document are guided by COVID-19’s steep daily rise in incidence, the impact of the virus on patient health and fertility care providers, and the known and unknown impact of coronavirus on fertility, pregnancy and transmission patterns. These recommendations are aimed at guarding the health and safety of patients and providers, while also recognizing that it is our social responsibility, as an organization and as a community of providers and experts, to comply with national public health recommendations and apply them to all reproductive settings during this unprecedented time.

 

The role of ASRM during this pandemic is to proactively do our share in blunting the impact of this pandemic, while recognizing the need to safeguard limited health infrastructure resources. However, we also understand our patients’ time-sensitive aspirations to achieve pregnancy, and so we will regularly reassess these recommendations with a hope to resume initiation of comprehensive fertility care as soon as possible.

 

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 tele-health.

 

Note: This guidance will be revisited periodically as the pandemic evolves, but no later than March 30, 2020, with the aim of resuming usual patient care as soon and as safely as possible.

 

Read the complete nine page ASRM recommendations document. 

ASRM Bulletin, March 12, 2020

 

COVID-19: SUGGESTIONS ON MANAGING PATIENTS WHO ARE UNDERGOING INFERTILITY THERAPY OR DESIRING PREGNANCY

As the novel coronavirus disease (COVID-19) spreads around the world and throughout the USA, our professional community and policymakers, and the public in general, are seeking advice regarding how to manage patients who are undergoing or who are planning to undergo infertility treatment.

Currently, very little is known about the impact of COVID-19 on reproduction and pregnancy. There are reports of women who have tested positive for COVID-19 delivering babies free of the disease. (1,2) This data is reassuring but must be interpreted with caution given the small numbers. Other forms of coronavirus (3, 4) have been linked to increased adverse outcomes during pregnancy, but data specific to COVID-19 is not yet available. It should be emphasized, however, that coronaviruses are unrelated to the ZIKA virus, which had very clear implications for pregnancy and fetal development. Given the information we do have, while it would be wise for individuals with confirmed or presumed COVID-19 infection to avoid pregnancy, there appears to be no cause for alarm for those already pregnant.

Nonetheless, out of an abundance of caution, patients who have high likelihood of having COVID-19 (fever and/or cough, shortness of breath, and either exposure within 6 feet of a confirmed COVID-19 patient and within 14 days of onset of symptoms, or a positive COVID-19 test result), including those planning to use oocyte donors, sperm donors, or gestational carriers, should strive to avoid a pregnancy. If these patients are undergoing active infertility treatment, we suggest that they consider freezing all oocytes or embryos and avoid an embryo transfer until they are disease-free. Please note this recommendation does not necessarily apply when there solely is a suspicion of COVID-19, because symptoms of COVID-19 are very similar to other more common forms of respiratory illnesses.

ASRM/SART recommends that all its members and their staff be familiar with the travel guidance on a daily basis as provided by the CDC as it is anticipated to change frequently. (https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html) This advice applies to both men and women. Patients who have been travelling long distances for their care should also consider obtaining copies of their medical records in case they need to transfer their care to a local provider.

ASRM and SART remain concerned that travel restrictions due to the virus may cause intended parents who are using a gestational carrier not to be able to join their newborn in a timely manner. Consequently, we strongly encourage all intended parents and the legal professionals, organizations, and programs that facilitate these arrangements to promptly take the necessary steps to identify families that may be so affected and develop contingencies in the event that these babies need to be cared for following their birth. ASRM/SART member clinics who work with gestational carriers and intended parents are requested to reach out to their patients and those organizations and programs who facilitate gestational carrier arrangements to encourage them to ensure that these steps are taken.

Finally, all reproductive health care professionals and their patients are encouraged to follow instructions from state and local health departments and stay abreast of the latest guidelines and updates issued by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) websites regarding evolving developments concerning the COVID-19 pandemic.

Additional information can be obtained at:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.htm

https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/novel-coronavirus-covid-19

https://www.cdc.gov/coronavirus/2019-ncov/testing-in-us.html

https://www.asrm.org/news-and-publications/news-and-research/press-releases-and-bulletins/covid-19-suggestions-on-managing-patients-who-are-undergoing-infertility-therapy-or-desiring-pregnancy/

 

References:

1. Lei D WC, Li C, Fang C, Yang W, Cheng B, Wei M, Xu X, Yang H, Wang S, Fan C. Clinical characteristics of pregnancy with the 2019 novel coronavirus disease (COVID-19) infection. Chinese Journal Perinatal Medicine 2020;23(3).

 

2. Chen H GJ, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J, Yang H, Hou W, Zhang Y. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395(10226):809-15.

 

3. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERSCoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect 2019 Jun;52(3):501-3.

 

4. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004 Jul;191(1):292-7.