IVF clinics reopen across the UK. What does it mean for you?
The UK’s fertility regulator HFEA announced that UK fertility clinics can now apply to reopen. Gynii Me has summarised all the key points of the government's guidelines that are relevant to fertility patients and their potential impact on your treatment.
*We’ll keep updating this page as more information becomes available. This article was last updated on: 16 May, 2020.
I am over 40, or I have low ovarian reserve, or I have other critical issues. Can I be prioritised? Yes
ARCS and BFS Guideline
- It is reasonable to prioritise patients in whom delay is most likely to significantly affect the outcome of treatment.
- Patients at special risk include those with a low ovarian reserve, advanced age and those facing extirpative pelvic surgery (for instance due to severe endometriosis or bilateral ovarian cysts).
Gynii Me’s Suggestion
If you are on the above list, it is best to contact your fertility clinic as soon as you can to get advice if you can be prioritised. If the clinic is unsure, please feel free to quote the guidance above, and seek input from their medical director.
I have underlying medical problems. Will my treatment be delayed? Maybe
ARCS and BFS Guideline
Particular caution should apply to patients with underlying medical problems that places them at a higher risk of complications in the event of contracting coronavirus infection. This includes patients with obesity, hypertension, diabetes and those receiving immunosuppressive medication. It may be appropriate for such patients to delay conception until epidemiological evidence shows a sustained reduction in the community spread of the infection.
Gynii Me’s Suggestion
If you have underlying medical problems, it might be best to delay your treatment. Also, please don’t blame the clinic for delaying your treatment, if they fail to follow official guidelines, it could jeopardise the treatment of other patients.
These guidelines are also there to protect high risk patients e.g. if such patients develop COVID-19 symptoms during the treatment, their treatment would be immediately cancelled incurring unnecessary inconvenience and costs.
Are fertility clinics carrying out COVID-19 testing before fertility treatment? Some are
ARCS and BFS Guideline
At the time of writing there are no widely available, reliable serological tests in the UK and reliance must be placed on symptomatic screening and antigen testing. It is likely that the coming weeks will see rapid progress in both the availability and efficacy of testing for coronavirus, and centres are advised to follow local and national guidelines and consider implementing a testing policy as soon as practicable.
Before starting treatment: A screening questionnaire and antigen test (if available) should be completed. Patients and donors with a diagnosis of COVID-19 infection should not start treatment until they have recovered and are not considered infectious. National guidelines should be followed in this regard. Centres should consider whether they advise patients and potential donors to self-isolate, if possible, from the start of ovarian stimulation treatment until egg collection.
Gynii Me’s Suggestion
Not all fertility clinics are asking patients and their partners to be tested ahead of the treatment. We believe more clinics will offer testing, once it becomes more widely available.
If I develop COVID-19 symptoms during the treatment, what will happen?
ARCS and BFS Guideline
If a patient or donor develops symptoms suggestive of coronavirus or screens positive on the questionnaire during treatment, an antigen screen should be arranged and treatment should not proceed unless the patient screens negative as defined by national guidelines.
In the event of a patient or donor presenting with suspected or confirmed COVID-19 after the ovulatory trigger, a multidisciplinary individual risk assessment should take place to balance the risks of refraining from oocyte retrieval against those of proceeding.
At present there is little data on the risks of minor surgical procedures in women with a diagnosis of COVID-19. Patients who become symptomatic after oocyte retrieval but prior to embryo transfer should be advised to freeze all their embryos for future use.
Gynii Me's Suggestion
If you or a member of your household have any symptoms, we suggest you do not seek an immediate treatment date. You can still contact your clinic to start your cycle in 4-6 weeks assuming you don’t have any ongoing symptoms. Further advice on COVID-19 symptoms can be found here.
Should I wear a face mask when I go to the clinic? Yes
ARCS and BFS Guideline
Centres should consider asking all visitors to the centre to use a face covering, and masks may be provided for those who need them. Provision must be made for safe disposal of PPE used by visitors.
Gynii Me’s Suggestion
We suggest all fertility patients wear a face mask when they visit fertility clinics and use hand sanitiser when they arrive and leave the clinic. If you don’t have a face mask, you can call the clinic to check if they provide one.
Can my partner attend egg collection or embryo transfer? No, they will need to wait outside the clinic
ARCS and BFS Guideline
The following measures should be considered to ensure physical distancing wherever possible:
- Production and delivery of semen samples from home, following guidelines to avoid compromising the sample
- Implementation of virtual meetings wherever possible, minimising face to face appointments. (e.g. consultation, injection teaching and counselling)
- Implementation of restrictions on partners and companions for appointments, where possible and appropriate
- Limiting staff and patient numbers permitted in each clinic area
Gynii Me’s Suggestion
Partners won’t be allowed inside the clinic for monitoring scans, egg collection and embryo transfers due to physical distancing. If you are traveling with your partner, he/she will have to wait outside of the clinic (i.e. stay in the car).
I am feeling very stressed about my treatment during the pandemic. Who should I speak to?
ARCS and BFS Guideline
Patient support during the pandemic is critical. Staff should be aware that there may be heightened anxiety around COVID-19. Centres should ensure appropriate self-help and counselling provision in order to cater for this and the potential anxieties created by both the delays already experienced and by undergoing treatment during the pandemic.
Centres should signpost to and assist patient support groups where they exist. These groups should be encouraged to meet through social media and video conferencing.
Gynii Me suggestion
If you feel stressed, confused or anxious, we suggest you book an appointment with the clinic’s counsellor (most clinics offer free counselling as part of your treatment). It is important to feel relaxed during the journey for you to achieve optimum treatment outcome.
You can also speak to Gynii Me to get free and impartial advice on your fertility treatment.
If you would like to speak to Gynii Me on any of these guidelines or get advice on your treatment options, choosing a clinics or your treatment plans, please email us at carrie.yang@gyniime.com or hello@gyniime.com.
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