Why can’t I start treatment yet? Are my embryos safe? And other important questions answered
Why can’t I start treatment yet? (When are you open)
Around the world, and here in Ontario, everyone is trying their best to provide access to care and safety for staff and patients.
Australia has opened again to fertility https://fertilityroad.com/australia-first-country-to-lift-coronavirus-ban-on-ivf-treatment/
USA: some procedures and some clinics are now open https://www.asrm.org/news-and-publications/covid-19/statements/patient-management-and-clinical-recommendations-during-the-coronavirus-covid-19-pandemic/
Canada: many Ontario clinics are talking about mid-late May; BC is already opening
CCRM: We *are* open https://www.instagram.com/tv/B_ihUuFB0eA/?igshid=1crukkmsxncg9
Tom Hannam: we will be opening in segments, to preserve safety and care https://youtu.be/JQdWOcg_1W4
New York Times: staying completely open has been consequential https://www.nytimes.com/2020/05/01/parenting/fertility-clinics-coronavirus.html
Of course, not providing services has been consequential too.
We closed because it was the right thing to do at the time. Now we are planning to re-open to procedures later this month
Wait: is it going to be safe? I don’t even want to go to the family doctor
If staying at home is right for you, then you should do that.
This is what we have in place for staff and patient alike for when you do come back:
-Aggressive social distancing policies
-Previous consulting rooms are now private offices
-Telemedicine consults only
-Mandatory health screening by emailed questionnaire for every visitor every day
-Distanced temperature checks
-Compulsory hand hygiene upon arrival
-No support partners
-Just-in-time arrivals planned (no waiting rooms)
-Evidence-based optimization of treatment protocols to greatly reduce or eliminate onsite monitoring
-Available nasopharyngeal swabs for COVID-19 checks if necessary; our expectation is that these will become nasal or just salivary swabs in time (Nasopharyngeal hurts)
-UV light sterilization in high-density locations
-Everyone in masks every day, all the time
In-person medical care is not a socially distanced experience but the screening we provide to protect our staff, and you is above and beyond what nearly every Canadian public space and many medical settings could achieve. We believe you will be taking greater risks of going food shopping or passing people on a busy walkway than seeing us.
‘Safety’ is a sliding scale. Only come to see us if you feel healthy and you feel safe. Our team is providing care to you on the same premise.
Are my embryos safe?
Yes, your embryos are safe. Alex Lagunov, our lab director, and I did a Facebook Live with the extraordinary group Fertility Matters. Skip to the parts where Alex is speaking. The level of care and attention that the CCRM team applies to laboratory medicine is extraordinary
Does COVID affect fertility?
I have seen some pre-publication papers on this topic. Yes, it can, in two ways:
1. Sperm. A high fever will often lead to compromised sperm for a few months. Complete recovery is anticipated.
2. Health during a stimulation. Clinics will cancel cycles if any screen suggests possible active COVID-19.
We cannot be sure about all the ways COVID may or may not impact fertility, but for many, it seems to be more of an issue of your time being consumed rather than a direct and lasting impact on, say, egg quality.
I am a strong proponent of egg and embryo freezing when you are well. This way you are controlling your fertility timelines.
Am I going to see the same faces when I come back?
We certainly hope so. Our dedicated staff is waiting to come back, just like you.
This is how we have been spending our time:
-Program building. We will continue our high laboratory standards but have had to rebuild the clinical side of care to match the moment. Our evidence-based approach will allow for nearly all (not all, but nearly all) care from home
-Optimizing for the flow of care on the clinic side. We want our patients to be able to stay home as much as possible while still reaching their goals. When it is time to come in, we want it to be a clean and efficient experience. We want to keep you and our team safe.
What’s been difficult:
-Communications. It is difficult to both plan, execute, and communicate at the same time. I hope you feel you are getting the supports you need. Let us know if you need more.
-Fairness. It is difficult to open services that will see one group access care, one team come back to the clinic, before another. There are not good answers here.
Looking forward to seeing everyone soon. Yes from a distance and safely behind our masks (you’ll be wearing one too) but we’ll be seeing each other again shortly.