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March 20: Planning for What’s Next

By Dr. Tom Hannam MD FRCSC REI

Things to think about. Also, I would like your help.

As a fertility patient, there are three issues you might want to consider in this time of coronavirus: the medical realities of COVID-19, how societal responses will be affecting your choices, and the additional anxiety (as if we needed any more in this moment) of social isolation.

Medical Realities

As per CFAS advisement, we have paused some treatments and are winding down others rapidly and safely.

“Rapidly and safely” is difficult for all involved. Our clinics are now entirely by phone or video, and our staff is doing their best every day to set expectations. The changes are so very fast.

COVID-19 has the potential to be of grave medical concern. But it isn’t setting up to be a unique fertility concern: your choices will be available to you when we get through this wave.

Perhaps the COVID-19 outbreak will peak four weeks from now; it might be eight or 12. Fertility doesn’t change that quickly.

If you have frozen eggs or embryos now, sit tight. If you still need to freeze, get in touch with your clinician.

To my understanding, all the clinics are “open,” just remotely. You can make plans now. Do so. Be ready, so that as soon as we can, as soon as you can, you can freeze your eggs and embryos too. Then you too can wait.

Along with lifestyle optimization, this is the best thing you can do for your fertility right now.

Societal Responses

From first responders to institutional leadership, Canada is stepping up. On a personal level, my brother is Chief of Emergency at North York General Hospital and I am extremely proud of the work he and his colleagues are doing every day. (At the moment, a lot of screening.)

What we at HFC can do right now is set up a communication service for women in the first trimester of pregnancy who have medical questions, but don’t know where to turn.

I know your family doctor offices are full, and Telehealth is going to be focused on COVID-19, not pregnancy.

We are planning today for a solution by Sunday. I’ve got the staff and we have the expertise, we just need the communication platform.

Anxiety and Social Isolation

In the fertility setting we are well used to seeing and managing anxiety.

In normal times, women are asked to endure the “two-week wait,” the time between embryo transfer or IUI or intercourse, and the pregnancy test.

This would be a natural time of stress. But here’s the thing about the two-week wait: all the usual mechanisms a person has to relieve that stress are taken away.

Exercise? Makes people feel guilty.

Smoking? Of course not.

Alcohol, marijuana, rituals like a morning coffee? All gone or laced with guilt.

What about reaching out to other people? It’s so hard; outside of the fertility community nobody wants to hear it. My point is: all the usual coping mechanisms, “good” or “bad,” are taken away. Anxiety builds.

So we are used to seeing anxiety, and know how important community and counselling are to helping people stay on point.

Collectively, our social isolation will be amplifying our anxiety. In times of stress, we want, we need, to come together.

In my office, now that we have so few patients in the building, the staff who remain are broadly spread out around the clinic. But of course, we are worried as much as you are, and when people worry, they come together. We can’t help it. We need each other.

Please reach out to others during this time. Even if you feel you can’t talk about your fertility concerns, human connection matters.

What You Can Do as a Reader

I’m writing this blog through the lens of the fertility community, so it is pretty focused. At worst though it could be myopic. I’m interested to hear how you think we may be able to do more.

You can reach me at tom.hannam@hannamfertility.com. I may not be able to respond, and may not have the resources to commit to your suggestion, but input is helpful when making decisions as rapidly as we all are.

Lastly, if you are finding this information here helpful, please go to Google reviews and spread the word. I know that’s not what the review platform is designed for, but everybody sees it when searching for information and the top few comments at least will be read.

I want to link people here who need help making sense of this time. As I wrote above, we are all feeling isolated these days.

Be well.


 

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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