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Fertility treatment and coronavirus (COVID-19) Frequently asked questions

What has CARE done to ensure that treatment is provided as safely as possible?

During the pause in treatments, we developed a robust plan that makes sure we can offer treatments safely for all our patients and staff. The protective measures we have put in place include screening everyone visiting our clinics for COVID-19 with a questionnaire, reducing the number of people in our clinics, following social distancing as much as possible, providing PPE to all who need it, encouraging good hand hygiene, and minimising face-to-face interactions. We are also reducing the need to visit our clinics with at-home fertility tests, Skype and telephone appointments, and encouraging you to use our Patient Portal to complete consent forms, pay for treatment, and to learn how to administer your medication. 

  

What is the process for making appointments?

We are encouraging our patients, current and new, to continue their fertility journey to Be Treatment Ready by having Skype consultations, at-home AMH, diagnostic semen analysis and completing consent forms through our secure, online Patient Portal.  

Whether you are a new or current CARE patient, you can call our patient enquiry team on 0800 564 2270 to discuss starting or resuming fertility treatment. They will be happy to answer all your questions.

 

Is it safe to resume treatment?

While fertility treatments were paused, we considered all aspects of how we can resume treatment safely. We have put many measures in place to keep all our staff and patients safe, including minimising the number of people in our clinics and face-to-face interactions, maintaining social distancing everywhere possible, and having personal protective equipment to the level recommended by Public Health England.

We are also checking that everyone entering our clinics – staff and patients – is healthy and well. If you plan on visiting our clinics, we’ll ask the following questions:

  • Have you or your partner or a person in your household had any of the following symptoms in the last 2 weeks:
    • fever
    • persistent cough
    • loss of the sense of smell
    • loss of the sense of taste
    • sore throat
  • Have you been in contact with anyone in the last 2 weeks who has any of these symptoms or has been diagnosed with Covid-19

If you answer no to these questions, you should feel confident to start treatment, but we understand that you may be uncertain or still have concerns. If you are worried about resuming treatment, you can access testing through the NHS, or we can offer you tests to check whether you currently have the COVID-19 infection or if you have had the COVID-19 infection in the past. It’s up you whether to take these tests, but we hope they will help you feel confident in starting treatment, as you can then be sure you won’t be wasting your medications.

If you answer yes to any of the above questions and decide against the screening test, we’ll ask you to delay your appointment and avoid starting treatment until you have completed your isolation, as advised by the government.

 

Will I need to have a COVID-19 test before starting treatment?

Patients will not need to have a COVID-19 test before resuming treatment*. We will ask everyone visiting COVID-19 screening questions to minimise any potential risk to our patients. You can access COVID-19 testing through the NHS, or we can offer you a test to check whether you have the COVID-19 infection. It’s up you whether to take this test, but it may help you feel confident in starting treatment, as you can then be sure you won’t be wasting your medications.

* As CARE Fertility Chester is based within an NHS Trust site, all patients attending for a procedure will need to have a negative COVID-19 swab before admission. Please contact the CARE Chester team for more information and advice.

 

Is it safe for me to become pregnant?

COVID-19 is a new virus, so there is limited scientific and medical evidence on how it affects pregnancy. However, UK’s specialist body, The Royal College of Obstetricians and Gynaecologists (RCOG), has advised that there is no evidence that COVID-19 infection is any worse in pregnancy, increases the risk of miscarriage or pregnancy complications. The RCOG have also advised that there is no evidence of babies being born with harm as a result of COVID-19 infection, and the UK Government has not advised people to avoid becoming pregnant. For these reasons, we have decided to start offering fertility treatments again.

We hope this reassures you, but we of course realise that you may have your own personal reasons for wanting to delay becoming pregnant. If you are worried, please speak to the team at your CARE clinic, and we will help you explore your options, including the possibility of creating and freezing embryos for when you feel ready for a frozen embryo replacement cycle.

 

Should anyone consider delaying their fertility treatment?

Everyone is different, and there may be factors in your medical history that prompt you to consider delaying your treatment.

If you have an underlying health condition, please read the Government guidance about minimising contact with others outside your household and, when you are ready, speak with your local CARE team about when it could be safe for you to resume treatment.

If you are clinically extremely vulnerable, as identified by the Government, you will have received a letter from the NHS with advice. Though we ask that you wait for further advice before resuming treatment, we are happy to work with your GP or hospital doctor to create an individual plan for your safe treatment once it is safe for you to leave your house.

 

How will you minimise any strain on the NHS as a result of fertility treatment? 

It is very important to us that we give treatment without adding to the strain currently faced by our wonderful NHS. During fertility treatment, one common side-effect of stimulation medication is a condition called ovarian hyperstimulation syndrome (OHSS), which, in a very small number of cases (fewer than 2 in every 100 patients), can result in patients being admitted to hospital for observations and, occasionally, treatment. Much less often, fertility patients could also be admitted to hospital because they have an infection after egg collection or because of an ectopic pregnancy.

We are doing everything we can to reduce the possibility of hospital admission during the pandemic, and have adapted our protocols and procedures to further reduce any risk to patients. These changes include recommending the GnRH-Antagonist protocol for certain patients, carefully managing your medications if there are signs of OHSS, and recommending an embryo freeze-all if you experience symptoms of OHSS after egg collection, as this would give you time to recover before becoming pregnant.

 

Mark Wilcox, CARE's Group Medical Director, explains adapted protocols for fertility treatment during COVID-19. 

 

If you feel unwell at any time during your treatment cycle, we would urge you to contact us at CARE for advice. If necessary, we’ll happily organise a face to face appointment to help provide the reassurance you need and avoid seeking help from the NHS while hospitals are so busy.

 

I read that you are providing protocols via the Patient Portal. Is that the case for all patients?

Most CARE patients will be able to get their protocols through the Portal - please check with your own CARE clinic.

 

Is there anything I can do to plan for my treatment?

We are continuing to offer consultations by Skype or telephone. If you already have a recent ultrasound scan and semen analysis (if not using donor sperm), we should be able conduct a full consultation and, using our secure patient portal, complete all necessary documentation and consents, helping your treatment resume quickly and smoothly. You can also take a look at our injection teach videos on our website or on the Patient Portal, familiarising yourself with the process before you receive your medication.

We can also organise for AMH tests to be done at home and sent for analysis before your Skype consultation. New patients can now have a diagnostic semen analysis. You can also upload any previous test result to the Patient Portal for your consultant to review before your appointment, in addition to the detailed online medical questionnaire.

 

How do we get as ready as possible to start treatment if our referral is through the NHS?

If we have received your referral, you can book an online consultation with one of our fertility specialists by calling your clinic or by booking online. We can then start planning your treatment, your protocols, and get all consent forms signed on our secure online Patient Portal.

If we have not yet received your referral, you can help your body be in the best position possible to continue treatment – take a look at our dedicated IVF and Coronavirus webpage for advice on improving your fertility at home.

 

When can I come to the clinic for a scan?

We are offering treatment monitoring scans and initial (baseline) scans – please call your local clinic or our patient enquiry team on 0800 564 2270 to arrange your appointment.

  

What happens if I test positive for COVID-19 during treatment?

If you start to have symptoms of COVID-19 during treatment, you can choose to cancel your treatment, or we can offer you a test to check if you have an active COVID-19 infection. If you test positive, we will need to cancel your treatment. If you develop symptoms after egg collection but before embryo replacement, we will ask you to freeze all of your embryos and have an embryo replacement once you are fully recovered. To protect all our patients and staff, we will not treat anyone with an active COVID-19 infection until they are fully recovered.

We are minimising the possibility of patients developing COVID-19 during treatment by screening everyone for symptoms before visiting our clinics, and by offering a COVID-19 test. By taking the COVID-19 test before treatment, you can feel confident in starting your treatment and then take informed lifestyle choices to reduce any possible risk of becoming infected while you are having treatment.

 

Can COVID-19 affect male fertility and sperm quality?

There has been a recent study which suggested that having the COVID-19 infection can impact male reproductive function. However, Dr Alison Campbell, our Group Director of Embryology, analysed the study to provide reassurance for patients, as reported by the Science Media Centre:

“Very little is known about the possible impact of the coronavirus responsible for COVID-19, or the disease itself, on sperm and the male reproductive system.

“The authors of this research study performed an assessment of biological and sperm quality markers in 84 previously-fertile men with confirmed COVID-19 infection and compared the results to men without the infection. They concluded that COVID-19 infection impaired male reproductive function.

“One issue with this study is that it only examined sperm quality for up to 60 days. As the length of the spermatogenic cycle (time to a man to produce mature sperm) is longer than this, most of the sperm analysed will have undergone part of their development prior to the COVID-19 infection. Further studies are required to follow up for a longer period after infection to monitor the recovery period more fully.

“Furthermore, the study group of men with COVID-19 were treated to varying degrees with corticosteroids and antiviral therapies which may have impacted their results. The control group were not exposed to these medications.

“It’s important to note that viral infections, and elevated temperature generally, can have a negative impact of sperm quality, and this negative impact is usually reversed upon full recovery. It is too soon to say whether COVID-19 is any different to this.

“Overall, men should not be unduly alarmed by this research. There is currently no definitive evidence of long-lasting damage caused by COVID-19, to sperm or male reproductive potential. More, larger studies are required in order to confirm whether COVID-19 may be damaging to male reproductive health and sperm function, and whether this is short lived.

“If men have concerns or require information, they should speak with their GP or a fertility specialist.”

What emotional support are you offering patients in the meantime?

We know that struggling to conceive can be emotionally challenging, and that many patients feel their anxiety about fertility treatment has been amplified by the current situation. We want all our patients to be able to access much-needed support during this truly difficult and uncertain time. As always, counselling is free and available to everyone at CARE, but our specialist fertility counsellors are now offering their appointments by ‘phone or online, such as via Skype – please get in touch with your local clinic to find out more and to book an appointment. One of our counsellors has also written a blog about how counselling can help process your emotions during COVID-19.

Our dedicated Patient Support Coordinator is also continuing her support group by Skype, as well as continuing to help patients with the CARE Buddy system, where you can share your journey with another patient. Our Patient Support Coordinator has made a video what to expect from, and how to access, peer-to-peer support at CARE during this time – on our website and our social media

We are also posting lots of information about support and physical and emotional wellbeing on our website and social media, including blogs and videos from fertility experts.

Of course, our team members available to support you and answer your questions during this difficult time – please contact your local clinic or our patient enquiry team, and we’ll do everything possible to support you.

 

Is it safe to get the COVID-19 vaccine if I am trying to conceive?

The Joint Committee on Vaccination and Immunisation guidance published on 30th December 2020 advises that those who are trying to become pregnant “do not need to avoid pregnancy after vaccination”. The Joint Committee on Vaccination and Immunisation guidance adds that “there is no known risk associated with giving non-live vaccines during pregnancy. These vaccines cannot replicate, so they cannot cause infection in either the woman or the unborn child.” There is no advice against male partners having the vaccine. 

The British Fertility Society and Association of Reproductive and Clinical Scientists have created a FAQ document all about the COVID-19 vaccines and fertility to answer common patient questions. If you have any additional questions about the COVID-19 vaccine and trying to conceive, please ask your local CARE team.

 

The RCOG response to misinformation around Covid-19 vaccine and fertility

Dr Edward Morris, President at the Royal College of Obstetricians and Gynaecologists, said: “We want to reassure women that there is no evidence to suggest that Covid-19 vaccines will affect fertility. Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data.

There is no biologically plausible mechanism by which current vaccines would cause any impact on women's fertility. Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems.

For women in the age group where they may be considering pregnancy, the vaccination is only currently being offered to two groups - health and social care workers (including carers for older adults in residential care homes) who are at higher risk of catching Covid-19 and those with serious medical conditions who have a greater risk of severe illness from Covid-19. Pregnant and breastfeeding women who are eligible will also be offered the vaccine".

Our CARE family

We care passionately about you and your future, please be assured that your need for family is at the heart of everything we do. We are here to support you and help you.

With love from CARE x

 

Updated December 2020

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