COVID and Infertility: The (Im)perfect Storm
I’ve been a reproductive endocrinologist for more than 40 years and have performed more than 12,000 IVF and IUI procedures successfully, and one thing that is absolutely true is that every one of my patients wanted to have a child as soon as possible. It doesn’t matter what was happening in the world, or with the economy, or with anything else – the need is always strong and urgent. And yet for right now there are almost no fertility procedures performed in the United States or Canada because of the COVID-19 pandemic. The American Society for Reproductive Medicine (ASRM) has issued a guidance urging doctors to suspend almost all of their fertility work; it’s the first time in my career that I’ve seen infertility treatments and cycles simply end.
This is creating an obvious crisis for individuals and couples who badly want to have a child and had their treatment scheduled or even started – only to have it canceled. This isn’t like missing any other medical appointment. It is a huge blow. I’ve seen disappointed patients before, of course, but it’s never been like this. EVERYONE is devastated by this.
One major issue is that no one really knows how COVID-19 affects pregnancy, both in getting pregnant and possible complications during pregnancy. Some medical evidence suggests there is very little risk but a few cases give reason for some caution, resulting in uncertainty and anxiety for patients and providers. Because many assisted reproduction pregnancies are already considered to be at slightly higher risk, the potential for the virus to cause problems is enough to give doctors pause. In addition, the very real possibility of infection in medical facilities makes it potentially unsafe to perform even basic non-emergency medical procedures. That doesn’t diminish from the pain that it is causing so many people who need assistance to have a child.
That’s where things stand today. But what does the future look like? I don’t have a crystal ball, but here’s my prediction: IVF cycles will gradually get started again in the next month or two. There may be some initial limitation on numbers of patients seen, those with most urgent needs being seen first, but clinics working to ramp up care as quickly as possible. As the world returns to more normal life, IVF clinics will work to see as many patients as possible to meet their reproductive dreams.
So what advice do I have? First of all, make sure you have the support you need for the next few months. I know how difficult it’s going to be not only to be in a world of Social Distancing and trying to stay safe, but also having to put parenthood dreams on hold. There are some wonderful support groups and therapists out there who specialize in this area. The second recommendation is for you to communicate with your doctor to make a plan about how you will start treatment again—and make your appointment as soon as possible so you can move forward to have that baby you want!
By David Adamson, MD