By Dr. Tom Hannam MD FRCSC REI
We are contacting patients for treatment dates. If you haven’t heard from us already, don’t worry, you will be hearing from us soon.
Medical services are conditionally opening up or having dates planned across the province. We expect all of our fertility patients will have access to care in this first wave too.
Fertility was always an essential service due in part to the time-based definition of the condition. But offering care safely has been conditional on three criteria:
1. Community safety
2. Availability of PPE
3. Community support
Community safety is a judgement call that is being made on a daily basis by our peers in public health. Governing bodies have left it up to us when we provide services (or not), and along with other leaders we have been working with our national society to provide specific guidance for all out of hospital fertility clinics.
The availability of PPE is being tracked through a registration program run by the Province of Ontario. We now report a daily inventory to the Ministry
Community support is another judgement call. The virus isn’t going to go away entirely. Today some clinics are already open, others have committed to next week, and many are signalling they will be opening in June. I think everyone is doing their best under difficult circumstances.
What we are doing:
Our IVF lab partners, CCRM, are ready now. From egg freezing to IUI, our team wants to work. No workflow changes have been necessary & we anticipate the same high success rates we enjoyed before closure.
On the clinic side, we have rebuilt the patient experience literally from the ground floor up. For example, the most efficient way to run a series of procedures has always been to have patients waiting and ready to go i.e. keep a busy waiting room. Our goal is to eliminate this aspect of care. We think the result will be safer for you, safer for our staff, and, well, just better.
Natural Conception Program
If you are an NCP patient, Dr Schram recommends that you call in your next cycle day 1. If you aren’t cycling, email NCP@hannamfertility.com and the team can help you set expectations for care.
We believe we can implement most aspects of this program very quickly. We hope everyone can be in active-care this June.
Egg and embryo freezing (IVF) patients
We need to successfully pass through one stage before going on to the next. Here is the list in chronological order:
•Virtual consults (already in place)
•IVF and egg freezing: AMH <12
In the past days, we have been calling our AMH <12 patients. For some, protocols are allowing for planned dates and we are making cycle date commitments now.
For others, specialized cycle setups will take longer. But we are on track: in a personal letter to all active patients last month I had said we would have plans in place in May, and nothing has changed. We expect all patients with an AMH <12 to have plans in place before the end of the month.
The week of 18 May we will also be calling patients for planned date cycles:
•IVF and egg freezing: AMH 12+ to 23
•IVF and egg freezing: AMH 24+
FETs and diagnostic evaluations should be ready for June too but I’ll commit properly in another post.
Care that involves third parties or other clinics (donor egg, surrogacy, satellite) is the most complicated in our current environment. I recognize these cycles are not infrequently a need for people who are extremely time-sensitive. In addition to speaking with peers across Canada, we have had the privileged opportunity to leverage the experiences of other CCRM clinics that already opened across the US. My hope is that we can learn from others and move quickly when the time is right.
We will continue to open in stages. We are less committed to timelines than to safety and responsibility. With that caveat, we anticipate all services should be opening through June.
If you aren’t sure what to do next, let us know your next day 1 so we can set expectations.
On a personal note, thank you for your trust, and thank you for partnering with us through this unique time.
We are ready.
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.