By Dr. Tom Hannam MD FRCSC REI
It has been such an odd time, such a worrying time for all of us who focus on health.
As you may know, at Hannam Fertility we focus exclusively on fertility care. When we aren’t thinking about COVID-19, when we are just thinking about how we can help patients become pregnant or preserve their fertility, we generally consider three categories: diagnostics, natural conception, and IVF. (Not everyone fits into these categories of course, but many do).
We no longer focus on labels so much as test results that suggest optimized treatment plans and prognosis.
The key tests for most people will be AMH, a sperm test if appropriate, and imaging of the uterus (usually a sonohysterogram). None of these tests are affected by the coronavirus. We did not plan to offer coronavirus screening to every asymptomatic patient when the tests become widely available, because there remains a relatively high false positive rate from these swabs at present.
‘Natural conception’ encompasses all the solutions that people look to when they hope to avoid IVF.
Natural conception includes individuals and couples who are focusing on naturopathy for example, or just need some cycle monitoring for irregular ovulation.
Some patients benefit from monitoring after surgery, to make sure they can get their timing right, and others benefit from intrauterine insemination (IUI), perhaps because they are using frozen-thawed sperm, or just want to disengage their sexual life from the act of procreation. All good plans.
Well, these are all good plans in normal times. The problem is, it can take three, four, even six treatment cycles for pregnancy, which in terms of time often means six to 12 months with missed cycles, time off, etc.
Usually that’s fine as long as the individual or couple are well informed.
My sincere concern is around the lifecycle of this new coronavirus. We expect it is going to be endemic for the next one to two years in Ontario and around the world.
You, me, all of us have no immunity yet, so we are all going to be at risk of suffering from COVID-19 until there are fewer people to catch the disease from.
It is likely that somewhere between 50-70% of the population, or a similar number, will have to be vaccinated before we can live freely again without undue concern for infection.
Might it turn out to be irrelevant well before then? Well yes, maybe. It certainly doesn’t appear to be irrelevant at present however (particularly for individuals well past reproductive age or with underlying health concerns).
IVF: Why Egg and Embryo Freezing is So Important Right Now
All of this means that there can’t really be a healthier, more fertile version of you than there is RIGHT NOW. This is the moment, now, that I hope patients can seize.
Please freeze your eggs if you are between the ages of 28 to 34 years old and are a good candidate for success (which we can help you confirm).
Or if you have been hoping for pregnancy, please please, freeze your embryos now.
In our IVF program, we preferentially freeze embryos for all cycles, as we get higher pregnancy rates long with the CCRM network labs.
Asking you to freeze eggs or embryos isn’t a great deviation from our standard of practice before now.
But now, instead of transferring embryos back the next cycle, or being hopeful within the natural conception program, I and we are asking if you are in the position to wait until the timing is right for you.
If you want to get pregnant now, understood. But if you pausing because you aren’t sure about the current health climate (reasonable), then please freeze.
I understand: this is a lot of pressure given the sudden financial jolts, and the general sense of unease today. This choice can’t be for everyone.
But if it sounds like it might be right for you, let us help you right away, with your very next cycle day 1, while your health is excellent, while we can freeze eggs or embryos while confident that you are in the best of health, and allow yourself confidence over the next one to two years that you’ll be getting pregnant when you feel ready.
Also, please let me and us know what more information we can provide in these blog pages to help you with these important family decisions.
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.