pandemic effect?

There is so much uncertainty and anxiety in all of us at this time.  I felt so better to speak with Bethany this morning and to continue to be on the same page with our current timeline.  As it is now (and understanding that everything will be fluid), we all are agree that we will follow any guidelines that Shady Grove puts out and will go through with everything as planned, if permissible.

We did receive some FAQs from SGF and while so much remains to be unknown, here is what is being communicated (because there were so many, I am only highlighting those that I believe relate to us at this time):

Q: How will SGF manage risks to patients?

A: Risks to patients fall into two categories: 1. that a pregnant patient may become more ill from COVID-19, and that, 2. COVID-19 may affect a developing fetus or change the course of a pregnancy.  Pregnant patients are routinely exposed to viral infection. Some, like Varicella and Influenza can be significantly more severe, and even devastating in pregnancy. Others, including similar SARS-type viruses and the novel coronavirus to date seem to manifest similarly in pregnant women as in other infected patients. While we are still early in the evolution of this disease, there is no evidence that pregnant women are more susceptible to COVID-19.  In addition, there has been no evidence of teratogenicity (fetal damage) from the novel coronavirus. In fact, no coronavirus has ever been associated with this outcome.  Most importantly, no authority has recommended avoiding, postponing, or terminating a pregnancy due to COVID-19. In fact, the guidance from the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) has been reassuring regarding pregnancy risks.

Q: What fertility care will SGF provide during this situation?

A: As you know, the situation is changing daily, and therefore, we will continue our due diligence of prevention and adherence to public health guidelines. All care will be subject to the efforts to avoid community spread as described above.

1. All care is subject to changing conditions as the pandemic evolves.
2. Consultations are being moved to telemedicine platforms.
3. We will continue to streamline and limit visits for routine bloodwork as well as hCG testing and OB ultrasounds.
4. Before initiating procedures or treatments, patients will be counseled about the known and unknown risks of COVID-19 and will sign informed content documents, as usual, in advance of any procedures or treatments.
5. Our paradigms include: Healthy people should not be denied access to care if it does not unduly threaten public health or drain resources from the healthcare system. Patients have the autonomy to assess and accept reasonable risk. Access to care and having children are fundamental to our mission.
6. This is not business as usual. We will always offer patients sensible advice. For young patients with a good prognosis, delaying treatment may be the most prudent course of action.
7. We will continue to offer all of our autologous treatments: ovulation induction (OI)/intrauterine insemination (IUI), in vitro fertilization (IVF), and frozen embryo transfers (FET). Patients will have appropriate counseling before initiating these treatments. Importantly, OI/IUI and FET cycles can be accomplished with minimal visits and resources.
8. We will continue to offer egg preservation.
9. We will continue to offer hysterosalpingograms (HSG) within the limits noted above.
10. We will continue to perform D&C procedures for patients with miscarriage.

Q: How will COVID-19 affect fertility treatment outcomes?

A: According to the American Society for Reproductive Medicine (ASRM), currently, very little is known about the impact of COVID-19 on reproduction and pregnancy. We have no reason to believe COVID-19 will adversely affect the outcome of your fertility treatment.

Q: Should I strive to avoid a pregnancy during this pandemic? 

A: If you have COVID-19 or have a high likelihood of developing COVID-19 (fever and/or cough, shortness of breath, and either exposure within 6 feet of a confirmed COVID-19 patient and within 14 days of onset of symptoms, or a positive COVID-19 test result), including those planning to use oocyte donors, sperm donors, or gestational carriers, you should strive to avoid a pregnancy.  If you are undergoing active infertility treatment, we suggest that you discuss with your SGF physician the option to freeze all oocytes or embryos and avoid an embryo transfer.  Please note this recommendation does not necessarily apply when there solely is a suspicion of COVID-19, because symptoms of COVID-19 are very similar to other more common forms of respiratory illnesses. 

Q: Should I avoid coming to SGF until new coronavirus/COVID-19 infections stop occurring in the US?

A: At this time appointment scheduling is subject to local conditions. We will contact you if there is a need for you to cancel appointments, consultations, or surgery due to concerns about COVID-19.

Q: What is the risk to pregnant women of getting COVID-19? Is it easier for pregnant women to become ill with the disease? If they become infected, will they be sicker than other people?

A: According to the CDC, we do not currently know if pregnant women have a greater chance than the general public of getting sick from COVID-19 nor whether they are more likely to have serious illness as a result.