The world as we knew it has changed, but there is no need to fear– we have the info you need to know regarding your fertility treatment goals for the future after COVID-19.
Postponing Your Treatment
There is still a lot to learn about COVID-19, especially in regards to how it can affect fertility, pregnancy, and the children that result. COVID-19 is also considerably more contagious to the flu, meaning that the more you interact with new people (including those in the medical field), the greater your chance of contracting the virus.
Due to the high-risk factor and a lack of information, it is suggested that new fertility treatments are postponed until the virus subsides or more information can be gathered to support resuming treatments safely. Specifically, this means procedures such as hysteroscopy and HSG, or treatments like intrauterine insemination and IVF should not be started until it is confirmed it is safe to do so.
Aside from needing to learn more about the virus, there is also a good chance that any treatments begun in the near future may be forced to be canceled due to city or state restrictions or reduced availability in healthcare staff. Additionally, donors who are not local may not be permitted to travel, making planning difficult to coordinate.
Those who are affected by another medical emergency that may inhibit their fertility (such as beginning chemotherapy in the near future or certain surgeries) may be offered the option to begin treatment despite the recommendation if deemed reasonable by a doctor after a consultation, but this will vary by circumstance and clinic.
This may be a difficult realization to accept, and rightfully so– those who turn to fertility treatments have likely already been through years of hardship and grief, not to mention the daunting task of navigating insurance and payments during a pandemic. While putting off treatment may spark worry about the ability to conceive, the good news is that there is no evidence to support delaying treatment for a month or two will ultimately affect your ability to have a child. Advanced age and decreased ovarian reserve (or low egg count) will not cause additional issues to your fertility in just a few weeks’ time.
You may worry about treatments being postponed for longer than two months, and you’re not alone. Luckily, the ASRM website is continuously reviewing their data and updating their site with more information as it is made available.
Currently in Treatment
If you or your donor are currently taking fertility medications as part of an IVF cycle, you may finish your current cycle and have the eggs/embryos frozen to be transferred later.
While it is not yet known if cross-contamination between frozen samples is possible, samples from patients with COVID-19 are being treated as samples from any patient with an infectious disease. As such, there is no immediate threat to the safety of cryopreserved eggs, sperm, or embryos. Additionally, clinics have policies and procedures to maintain the liquid nitrogen tanks containing frozen embryos, eggs, and sperm. You can always ask your doctor if you have any questions or concerns about the systems in place at your provider’s clinic.
Just as beginning new treatments are not recommended during the pandemic, it is advised that you wait to begin a new treatment cycle. If you are diagnosed with COVID-19 during a cycle, be sure to inform your physician as quickly as possible.
If You Get Pregnant
While it has not been said that you should not get pregnant, or try to become pregnant, during the pandemic, it can not be said that there is no risk involved. The dangers and effects of acquiring the coronavirus in the first trimester are not known and will not be known for a while, but it IS known that severe illness can lead to pregnancy complications.
If you are already pregnant, it is important to take all precautions possible to reduce your risk of exposure to the coronavirus by following CDC’s current recommendations, such as handwashing with soap, not touching your face, and practicing social (physical) distancing. You can schedule non-essential visits with your healthcare provider via virtual services such as telehealth.
If you think you MIGHT be pregnant, getting the ultrasound and lab testing are recommended for now, since they are necessary and are considered an urgent matter. As with any time you go out in public, the use of face masks, hand washing, and physical spacing are strongly recommended.
Based on currently available information, pregnant women who become infected with COVID-19 do not appear to be at increased risk. However, pregnant women are known to be at greater risk of severe complications from other respiratory viral infections such as influenza and SARS. For that reason, pregnant women are considered an at-risk population for COVID-19. Notably, in many reports, cesarean delivery has been used for women who presented in labor and needed delivery. Though evidence is limited, there are anecdotal cases where pregnant women infected with COVID-19 have encountered an exacerbation of breathing difficulties after delivery.
Some pregnancy complications have been reported among infants born to mothers positive for COVID-19, such as preterm delivery and low birth weight. It is not clear whether these outcomes were related to maternal infection. It is possible that other unforeseen complications may be discovered in the future, and more reports are becoming available every day to update our current knowledge on the virus’ effects.
Collectively, we are going through a lot, but now more than ever, it is important to look after yourself as an individual. Social distancing, a delay or interruption in your fertility treatment, the ubiquitous unease and uncertainty during a pandemic… Even when taken one at a time, these problems are stressful, and collectively they can be downright overwhelming.
Make sure you are looking after your physical health by eating well and exercising regularly– many gyms and YouTube creators are providing free workout routines that you can do for free at home. Maintaining social distancing and wearing your mask while in public will also lessen your chances of contracting COVID-19, or spreading it to loved ones.
Your emotional health needs extra attention now as well; while social distancing and quarantining are needed to flatten the curve, it’s easy to feel isolated and cooped up. It’s normal to need some additional support during tough times, and your clinic can provide you with a referral to a trained mental health provider who can consult with you on how to manage the emotions surrounding this extremely difficult set of circumstances. Many of these providers are prepared to offer telehealth options that may be covered by your insurance carrier. Below, we’ve listed some more ideas that might help:
- Get accurate and current information to calm your fears and stay informed– Facebook doesn’t count! Utilize reliable sources such as the CDC, WHO and ASRM.
- Speaking of Facebook, tone down your use of social media and other sources of news to avoid the anxiety. Set a certain time of day for gathering news, choose a time when you aren’t likely to be triggered, and stop using tech devices an hour or more before bedtime for better sleep.
- Download relaxation or mindfulness apps to reduce anxiety and tension and improve sleep further, such as Headspace or Personal Zen.
- Take at least a ½ hour per day to focus on things other than COVID, like a new hobby or skill.
- Pay attention to the messages you give yourself, and try to stay positive. Saying things like, “This isn’t the situation I expected, but it doesn’t mean it won’t work out eventually” can put you at ease.
- Stay in touch with your friends and family via virtual connection like the phone or video chat, and reach out on social media/forums for new experiences. RESOLVE is offering its peer-led support groups via virtual technology so that you can connect with others going through the same thing as you.