FAQ about Fertility Treatment at SGF during the COVID-19 Pandemic
First and foremost, while the world grapples with an issue of enormous scale, our hearts go out to those who have been affected.
The rapidly evolving situation with the coronavirus (COVID-19) can be unnerving, and new information is coming to light daily, even hourly. Please be assured that SGF is closely monitoring real-time developments and continually looking to experts such as the Centers for Disease Control (CDC) and the World Health Organization (WHO) for guidance.
The safety of our patients and staff is our foremost concern. We have taken numerous actions to address this.
Q: How is SGF responding to the public health emergency of COVID-19?
A: The key elements of the health system response to this challenge include limiting the risk of exposure and maintaining the capacity of the health care system to respond to the needs of those who are sick, from COVID-19 or other ailments. As freestanding, single specialty treatment centers, the resources we utilize to treat our patients do not draw from the same pool as those available to take care of patients suffering from COVID-19 and other serious conditions. This is in dramatic contrast to fertility centers based in hospital settings. Therefore, we have and will take the following steps in response:
- We will continue to screen all patients for exposure and risk factors for COVID-19. Patients who fail screening will not be seen in our facilities. If a patient becomes quarantined or sick from COVID-19, their treatment will be cancelled.
- Patients will need to come to our offices unaccompanied, for all types of visits. Spouses/Partners may wait in the car and will be notified that the appointment is over. Spouses/partners may be permitted to “attend” portions of the appointment virtually.
- SGF will continue to follow CDC guidelines for our staff in managing any possible exposure.
- SGF will continue to structure monitoring and waiting rooms to provide appropriate physical and time distance according to CDC guidance.
- Our procedures are performed in dedicated rooms with sterile or disinfected equipment. One case at a time, one room at a time. Procedure and operating rooms are disinfected between cases.
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 guidance does SGF consider when assessing the level of care it will provide?
A: SGF’s physician leadership continues to diligently review the American Society for Reproductive Medicine (ASRM), CDC, ACOG, and SMFM recommendations in response to COVID-19. Practice leaders examine the implications of all recommendations with a careful focus on our duty to our patients and to public health.
Infertility is a disease, and for many couples, it is time sensitive. As we see every day, our patients’ suffering is acute and real. Having children is fundamental to humanity, and we have dedicated our careers to treating the disease of Infertility.
We will continue to monitor the situation closely and change these plans as indicated, with practicing only evidence-based medicine as our standard.
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.
- All care is subject to changing conditions as the pandemic evolves.
- Consultations have been moved to telemedicine platforms.
- We will continue to streamline and limit visits for routine bloodwork as well as hCG testing and OB ultrasounds.
- 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.
- 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.
- This is not business as usual. We will limit new treatment cycles to patients for whom a delay could reduce their chances of success in the future. We will continue to offer autologous treatments including ovulation induction (OI)/intrauterine insemination (IUI), in vitro fertilization (IVF) under this limitation.
- We will continue to provide limited diagnostic testing as appropriate.
- We will not institute new frozen embryo transfer (FET) cycles, donor egg, or gestational carrier cycles at this time.
- We will continue to perform D&C procedures for patients with miscarriage.
Q: How will SGF care for patients in need for third-party reproduction?
A: While we believe treatments involving a third party fall broadly under the same paradigms as described above, there are important differences, especially in terms of travel and risk; therefore, SGF will not be starting any new donor cycles at this time. Consult your clinical team for more information.
Q: Will SGF continue performing hysteroscopies?
A: SGF will not be performing any hysteroscopies at this time. Consult your clinical team for more information.
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 come in for my appointment even if I have cold or flu symptoms?
A: If you answer “yes” to any of the questions below, please notify our front desk staff BEFORE coming in to an SGF office. Special accommodations will be made for you.
- Do you feel like you have a cold or the flu today?
- Do you have a fever (temperature over 100.5) or feel like you may have a fever?
- Have you recently been exposed to someone who is sick and has tested positive for COVID-19?
Q: What are the emergency warning signs for COVID-19 that require medical attention immediately?
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.
Q: What symptoms indicate that I should see a healthcare provider?
A: Current symptoms that have been reported include mild to severe respiratory illness with fever, cough, and difficulty breathing.
Call your primary healthcare provider if you feel sick with any of these symptoms and have been in close contact with someone who has COVID-19 or if you have recently traveled to an area with ongoing spread of COVID-19.
Your healthcare provider will work with the state health department and the CDC to determine if you need to be tested.
Q: Do I need to be tested? Does SGF offer testing?
A: SGF does not test patients for coronavirus.
Please contact your primary healthcare provider if you feel sick and have mild to severe respiratory illness with fever, cough, or difficulty breathing – especially if you have been in close contact with someone who has COVID-19 or if you have symptoms and have recently traveled to an area with ongoing spread of COVID-19.
Your primary healthcare provider will work with the state health department and the CDC to determine if you need to be tested.
Q: How can I protect myself/my family from coronavirus?
A: Currently, there is no vaccine to prevent coronavirus. The flu vaccine is not effective in preventing coronavirus. The CDC recommends the following everyday preventative actions to prevent the spread of respiratory diseases:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth.
- Cover your cough.
- Cough into a tissue and then throw it away after use.
- If no tissues are available, cough into your elbow, not your hand.
- Wash your hands frequently with soap and water.
- Practice social distancing.
- Anyone returning from a cruise must self-quarantine for 14 days.
Visit www.cdc.gov for more information about COVID-19 and prevention.
Q: Is SGF prepared to manage care for patients with the recent risk of coronavirus/COVID-19?
A: SGF staff members and doctors have the knowledge and training needed to safely care for patients while taking necessary precautions against the spread and transmission of COVID-19.
At this time, as stated above, SGF has taken measures to limit transmission by promoting hand hygiene and disinfecting protocols, inputting screening measures, modifying appointments and schedules, performing consults electronically, and making adjustments to treatment cycles if deemed necessary.
Please remember to use hand sanitizer before you enter the waiting room. If you prefer not to enter the waiting room, please inform our front desk staff that you will wait in your car. Our Patient Services Team will contact you via phone and/or Patient Portal message when we are ready for you.
Q: Should I avoid coming to SGF until new coronavirus/COVID-19 infections stop occurring in the US?
A: Consultations are proceeding via telemedicine. Consult your care team about in-cycle or other diagnostic testing.
Q: Do I/we need to wear masks? Are masks effective? Can I get masks for myself/my partner?
A: The CDC does not recommend that asymptomatic, healthy people wear a face mask. Face masks should be used by people who have COVID-19 and are showing symptoms to protect others from the risk of infection.
Respirator-type (N95) masks should be worn by those caring for persons infected with COVID-19.
Q: What should I do if I’m signed up for an injection training class?
A: We have cancelled our group injection classes until further notice, but we will provide one on one or video teaching options.
PREGNANCY AND 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.
Q: How can pregnant women protect themselves from getting COVID-19?
A: Pregnant women should do the same things as the general public to avoid infection. You can help stop the spread of COVID-19 by taking these actions:
- Cover your cough (using your elbow is a good technique).
- Avoid people who are sick.
- Clean your hands often using soap and water or alcohol-based hand sanitizer.
- Practice social distancing.
Q: Can COVID-19 cause problems for a pregnancy?
A: According to ACOG, at this time, very little is known about COVID-19, particularly related to its effect on pregnant women and infants, and there currently are no recommendations specific to pregnant women regarding the evaluation or management of COVID-19. There is no evidence to suggest that COVID-19 harms fetuses.
Q: Where do I turn for more information?
A: Further questions related to your care at SGF, we encourage patients reach out to their care team.
For more information about COVID-19, visit www.cdc.gov or your local health department.
Editor’s Note: This post was originally published on March 19, 2020, but was last updated for accuracy on March 30, 2020.