The COVID-19 pandemic caused fertility clinic closures worldwide. These closures were abrupt and sudden, patients undergoing treatment lost access to services during the first phase of the pandemic, the cycles that were in progress were abandoned which led to the freezing of all embryos in an IVF cycle without a fresh embryo transfer.
The COVID-19 pandemic has claimed the lives of over one million people worldwide and has affected all aspects of healthcare worldwide including the delivery of care to patients with fertility-related diagnoses.
Subsequently, only emergency medical services were functioning and all the assisted reproductive technology (ART) clinics were shut down which had an enormous impact on the patients already undergoing infertility treatment economically as well as mentally. But, as the ongoing coronavirus pandemic situation is stabilising, it becomes essential to resume the ART services in a gradual manner. However, strict vigilance and a stepwise approach to the treatment are being adhered to, to minimise the risks related to COVID-19 infection to patients and healthcare staff.
• Patients are fully informed about the nature of the Covid-19 pandemic and its effect on their treatment and future pregnancy outcome(s).
• Patients acknowledge all the facts and give informed consent for the fertility treatment at this particular time.
• The ART clinics modified their layout and working practices in accordance with National and local guidelines for Covid-19.
Couples are strongly advised to take an RT-PCR test before commencing treatment. This must be repeated before any ART procedure that is considered invasive and requires regional or general anaesthesia such as egg retrieval, HCG trigger or embryo transfer. It is advised that the test is done less than three days prior to the procedure. To avoid getting infected, patients are strongly recommended, partners and potential donors are advised to self-isolate from the beginning of ovarian stimulation until the procedure is finished.
When the pandemic first hit, there was a fear about the safety to conceive or even visiting the clinic for consultations. But people are more informed now.
In recent weeks, the highly contagious Omicron variant of COVID-19 has resulted in a surge of new cases across India and other countries. Mostly, all ART Clinics have additional protective measures in place, Staff members who cannot maintain a 2m distance from patients are required to wear an isolation gown, N95 mask, eye protection, and gloves to minimise transmission. Clinics are conducting regular Rapid Antigen tests on all their clinic staff members.
In addition to the existing precautions and safety measures a vaccine policy for all of our team members is being implemented, all staff must complete COVID-19 screening forms daily before entering the clinic.
The additional protocols followed by the clinics will ensure safety and will continue to offer all fertility services while maintaining a safe clinic environment for patients and staff.
For patients currently undergoing treatment, Self-monitoring for COVID-19 symptoms and completing pre-screening forms before appointments is mandatory. Patients are advised not to visit the clinic if experiencing any symptoms or are feeling unwell.
Patients are advised of getting fully vaccinated now to decrease the risk of developing a severe COVID-19 infection and to further reduce the risk of transmission. Recent public health initiatives have expanded vaccine eligibility, and all of our patients (whether they are trying to get pregnant or are already pregnant) are advised and encouraged to book appointments to receive their 1st, 2nd or booster dose when available.
In compliance with public health guidelines, ART Clinics continue to carefully minimise the number of people inside the clinics at any given time. To mitigate the risks of exposure for everyone, a no visitor policy is enforced.
All patients are encouraged to maintain social distancing, practice good hand hygiene and be diligent about social gatherings. All patients are required to wear a medical face mask at all times during their visit to the clinic. Nonetheless, this is a particularly challenging time for patients with infertility. Under the best of circumstances, infertility treatment is a time of uncertainty and emotional challenges; the coronavirus pandemic has intensified the distress many couples experience in this setting, while at the same time cutting off access to important sources of support, including family, friends, support groups, and professional mental health services.
Dr Rita Bakshi is the founder of RISAA IVF.