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March 17: Why Some, But Not All, Clinics are Closing This Week

By Dr. Tom Hannam MD FRCSC REI

Clinics are finishing up their last IVF retrievals, and it isn’t clear when any of them will choose to reopen to full scope of care.

Fertility clinics don’t usually close. It is the nature of the space that top clinics are open seven days a week, every week of the year, with the exception of the December holiday season, when we close for business reasons (to give our staff a holiday).

The photos posted here give you a glimpse at what our clinic looks like right now.

Are business reasons motivating closures at this time? Not really, no. Everyone is making the best decisions they can within their restrictions. Different governing bodies are doing the same.

Some pressure has also come from the Ontario Medical Association. The OMA represents physicians, not the public, and does not direct national, provincial, or city Public Health teams. So why are they weighing in? Because they are looking out for all doctors, and what is happening with COVID in Italian ICUs right now is a real worry. It is possible that over time resources destined for elective care could need to be re-directed.

[Edit 28March: at HFC we contributed PPEs including N95 masks to local hospitals and women’s clinics. As everyone knows, the concerns for medical supplies didn’t end in northern Italy]

Stand alone fertility clinics are not set up to help with COVID. We don’t have respirators, we do have pregnant women, and our skills are misaligned with the care that patients would need. We can help indirectly of course, as you can, by adhering to public health policies that are in place to help all Canadians.

Around the world, different organizations are choosing to limit different services. For example, the position of Dr. Bill Schoolcraft (founder of CCRM, our laboratory partner) was captured in this note to patients 12 March:

We want to help you take control of your fertility. Though very little is known about COVID-19 effects on pregnant women, and there are few recommendations specific to pregnant women regarding the evaluation or management of COVID-19, international experience to date suggests that pregnant women are not at greater risk. Specifically, there is no evidence the virus can pass to a baby during pregnancy.

We recognize that COVID-19 infections will be with us for the foreseeable future. Our personal and professional lives are going to be disrupted. For these reasons, our near-term emphasis will be on freezing eggs and embryos for when you are ready. You and your doctor can then initiate pregnancy when together you feel the time is right. 

[Edit 28 March: in the end, this information changed too. A recent report suggests the virus can pass the placenta to the baby during pregnancy, though the clinical significance of this event remains unknown.  Unfortunately it really isn’t possible for me to provide a broad overview of the fertility community as I had intended with these posts…access to services and optimized care remains different on a clinic by clinic basis, and keeps changing]

Our goal at HFC/CCRM Toronto

Covid-19 is going to be with us for a long time yet. We want to create a solution that allows for egg and embryo freezing while remaining responsible to the greater community. There isn’t going to be a perfect plan.


 

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.

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