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

Is there an estimate for when you will be able to resume treatments?

We have now received authorisation from the HFEA to reopen, and our clinics resumed treatment in the week beginning 18th May 2020. We have robust and comprehensive protocols to provide treatment in a way that is safe for you and for our staff, which have been approved by the HFEA.

 

What is CARE doing to meet the HFEA’s conditions for reopening?

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.

 

To help us keep all our patients and staff safe, we will ask you not to be accompanied on your visits to our clinics. If you need to be accompanied, we will of course make sure you have the support you need, including the help of a translator if necessary.  

 

It is still vitally important that you are accompanied home after having a procedure under sedation, such as egg collection or surgical sperm retrieval. We’ll chat to you about how you are getting home when we organise your procedure, and will organise for you to be delivered to the safe care of the person accompanying you home without them needing to come inside the clinic.

 

Which treatments will you be able to resume after reopening your clinics?

We can now resume all fertility treatments – please call our patient enquiry team on 0800 564 2270 to discuss resuming your treatment. FETs and IUIs are beginning first, with fresh embryo transfers (which take a little longer to plan) resuming shortly after.

  

Will consultations still continue by Skype, or will I be able to choose whether to have my consultation face to face?

Now we have reopened, you can choose whether to have your consultation by Skype or face-to-face, complying with guidelines about social distancing. We understand that everyone is different, and that some patients might prefer to speak with their consultant in person, but we are encouraging our patients to have their consultations via Skype, minimising the number of people in our clinics and helping us to keep everyone safe. As our specialist fertility doctors have all the information required prior to an online appointment, a Skype consultation is just as effective as a face-to-face conversation.

 

What is the process for making appointments once services resume?

We are already 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. This will not only ensure that patients can continue their treatment as soon as social distancing restrictions are relaxed, and when patients feel ready, but we hope will help them feel more in control of their treatment during this uncertain time.

 

Whether you are a new or current CARE patient, please call our patient enquiry team on 0800 564 2270 to discuss starting or resuming fertility treatment.

 

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 (feeling hot or a temperature above 37.5°C)?
    • 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, 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, and 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 we hope it will help you feel confident in starting treatment, as you can then be sure you won’t be wasting your medications.

 

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 to reopen our clinics 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.

 

 

How are you planning on dealing with a ‘backlog’ of patients?

We believe we have the capacity to provide your treatment as soon as you’re ready. CARE Fertility is a family of twelve large clinics, and we have enough capacity and dedicated staff to resume treatment for all our patients – NHS or privately funded – quickly, safely and to our usual world-class standards. We have been busy preparing to resume treatment, and anticipate that there will be no waiting list now that treatment has resumed.

 

If we do find that capacity is greater than we expect, we will do everything possible to build that capacity and minimise further delays in treatment, such as by extending our opening hours or by asking patients to have treatment at a larger nearby CARE clinic with greater capacity. If we do need to prioritise treatment for some patients, we will do so fairly and based on your own personal and clinical circumstances.

 

 

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 have now resumed 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.

 

Will I need to repeat my blood tests before treatment?

Depending on how much time has passed between your tests and your treatment, we may need to repeat some of your blood tests. We will aim to minimise this and also the costs associated with it.

 

Will everything be safe in the laboratory when you reopen your clinics?

We always take every care to look after your precious eggs, sperm and embryos, and we have never seen an instance of cross contamination in any of our laboratories – even though some viruses are known to be present in body fluids like semen. However, COVID-19 hasn’t been found on sperm or eggs or in the fluid from around sperm and eggs, so we are confident that the embryos we create in our laboratories are virus-free.

 

We are not complacent and will always be cautious in our laboratories and wider clinics, so we are confident your embryos are safe in the lab, and are safe for your treatment or to freeze and store. We are also confident that our staff are safe when they are working behind the scenes to help you grow your family.

 

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.

 

When will the donation teams start matching again?

All of our staff are returning to our clinics, including the donation teams, allowing them to resume the matching process for our patients.

 

During the pause in treatments, we have been in communication with our donors to help them complete their application and preparing them to donate as soon as they are able. We have also still been receiving our deliveries of donor sperm from the European Sperm Bank and California Cryobank, ready for when treatment can resume again.

 

Now we are resuming treatments, our donation teams are resuming matching for patients who need donor eggs or sperm. As always, patients requiring a sperm donor can also search external banks for a match. If you’d like to learn more about the CARE sperm bank or would like help with finding a match, contact your local clinic or our new patient enquiry team, who will be able to put you through to your donation team.

 

We are soon going to launch our own frozen egg bank, which will greatly reduce the waiting time for patients needing donor eggs. We have also been in regular communication with our egg donors during the pause in treatment, and we will be resuming their donation cycles alongside patients’ treatment once we are able to reopen our clinics.  

 

If you have been matched to donor eggs from our frozen egg bank, we may be able to create embryos using either your partner’s sperm or donor sperm before we resume your treatment. We will freeze all of the suitable embryos for a frozen embryo replacement as soon as you’re ready to proceed after we re-open.

 

As always, if you have any questions about your treatment, including everything to do with donation, contact your local clinic and the team will be able to answer your question.

  

I have drugs which are due to go out of date, and some expired. What do I do when they go out of date, and will I get help from CARE?

If you are concerned about your medication going out of date, please speak with your local clinic, who will be assessing how we can help each patient individually.

  

Has there been any clarification about how COVID-19 has affected NHS funding?

Though we do not control the criteria, eligibility or availability of funding for patients, we have been emphasising to all local Clinical Commissioning Groups (CCGs) the weight of how the current situation affects patients’ ability to access the treatment they need.

 

For our Manchester NHS patients, the NHS Trafford Clinical Commissioning Group (CCG) and their associated CCGS have put NHS funding for fertility treatment on hold until 1st July. This means that we are unable to resume treatment for patients whose NHS funding is through these CCGs – please check our CARE Manchester page for a full list of the affected CCGs. We have written to Trafford CCG to ask them to reconsider their position and we will update our affected patients as soon as possible. If you would like more information, please call our Manchester clinic team on 0161 249 3040. You may also wish to contact your local CCG for more information and clarification on funding for your area.

 

If a patient had NHS funding for fresh transfers, but we advised them to do a freeze-all, we endeavour to be as fair as possible, so there will be no charge to them.   

 


What emotional support are you offering patients in the meantime?

We know that struggling to conceive is emotional 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.

  

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 through this.

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