By Dr. Tom Hannam MD FRCSC REI
This blog was initiated recently as a fertility news feed in a moment of extraordinary upheaval. I’ve made some edits to past posts for clarity and will set expectations for what’s planned in the weeks ahead
March 15: social distancing described some of the rapid changes we made to our clinic space and operations. Today, we are not seeing patients at any of our sites but when we reopen, social distancing will remain the new standard. In the future, when we can offer deeper levels of screening such as serum antibody testing for the coronavirus, we will do that too.
March 15: OMA Guidelines reported the moment when non-essential medical services were asked to close. But what is ‘essential’? Some fertility treatments could be considered essential services by some definitions. This post considered the question of globally restricted fertility services for the first time. At HFC, we anticipate being closed to all onsite patient services through April 14. Phone lines (and email and video) are still active of course. I appreciate everyone working with us as we make the pivot to virtual services as a preferred communication platform. This is truly going to be a sea change across all clinical disciplines.
March 17: Why some, but not all, clinics are closing was an attempt to explain why different sites around North America responded to medical Guidelines (and/or Provincial lists) differently. I don’t know that my explanations worked all that well, as there really wasn’t a consensus solution across the field. As a patient, best to contact your own clinical team. I believe everyone is doing their best.
March 18: the most impactful day yet was the day the Canadian Fertility and Andrology Society suggested that nearly all on-site fertility services should be wrapped up. We and other clinics reacted accordingly. Since March 25 we have stopped hosting on-site patient services. This abrupt transition has been extraordinarily difficult for patients.
While pregnancy still looks to be safe for the majority of patients, we are not comfortable endorsing active treatments just yet. As more information becomes available we will continue to refine our position. For patients reading this who currently are pregnant, today the RCOG in the UK released these guidelines. As of this evening, there are no new updates from CDC or ACOG (US) or SOGC (Canada). However, we can anticipate there will be soon. These documents usually take months of careful analysis to produce, but the entire field is working to provide both timely and accurate advice.
March 19: the new reality of fertility care sums up where we are now, including Dr. Schram’s take on the decision to limit support for most active attempts at pregnancy. Each Thursday we meet internally to plan for the week ahead. When updates to our clinical plans unfold, we will be sure to let you know in these blog posts.
March 20: planning for what’s next suggested I would soon have a mechanism for delivering FAQs. Finally, that’s in place, and we might have our first video up by tomorrow. For some general information, also consider watching my colleague Dr. Brian Levine from the CCRM clinic in New York City. I think FertilityIQ is really good too. Although both have a US slant, which is why information specific to Canadian patients remains so important.
We started to get a handle on the pace of change, and we were able to communicate more thoroughly. March 21 Dr. Redmond gave tips on the first-trimester experience, March 22 we posted a request to all medical organizations to consider donating PPE supplies, The next day the AtoZ Fertility team suggested some tips for healthy living while isolated at home.
Going forwards, our blog will change. These past two weeks have necessarily been, more or less, a news feed. Looking ahead our intention is to provide specific tips for fertility care in this new COVID-19 era. My hope is to have a shared language and understanding of where we are in our new reality. That way, you can quickly freeze eggs and embryos when you are healthy and society can support your goals—and we can do everything we can to preserve your opportunity for pregnancy.
More to come. Starting, unfortunately, with iPhone videos. A beginning indeed. I promise at least to keep them short. Let me know what information you hope to see: email@example.com
Be well everyone
About the Author
Dr. Tom Hannam
The founder of the Hannam Fertility Centre, Dr. Hannam has sat on the board of the Canadian Fertility and Andrology Society, and is a member of the American Society for Reproductive Medicine, the Society of Obstetrics and Gynaecology of Canada, and the European Society for Human Reproduction and Endocrinology.