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What to expect when resuming fertility treatment during COVID-19

The safety of our patients and staff is always our top priority.

All of our main CARE clinics are now open and we have been busy implementing our robust treatment commencement strategy, adapting how we work, our clinics, and our procedures to make sure that our patients and staff will remain safe: a plan that we have agreed with the HFEA.
So, you can expect us to be working slightly differently when you visit us for treatment. Just like all workplaces in the UK, the changes we have developed are mostly designed to reduce person-to-person contact, helping to reduce the spread of the COVID-19 infection.
Here’s what to expect when you resume your fertility treatment with us…

Before treatment begins

It’s likely that you have already seen some of our modified practices. To reduce the number of people visiting our clinics, we are continuing to encourage patients to have consultations with our doctors via telephone or Skype. You can also do some of your hormone tests, such as AMH, at home with a simple finger prick test, which you then post back to us to analyse in the laboratory. We have also resumed sperm analysis, prioritising proper social distancing with a minimal-contact drop off service when you bring your sample to the clinic.

We will also send you all the information to do with your treatment via our secure, online Patient Portal, including your medication protocol and the consent forms you need to complete before resuming treatment. There, or on our website or YouTube, you can also find our new injection teach videos, so you can familiarise yourself and become confident with the process of administering your medication.

We’ll also send you a questionnaire to complete in advance of your appointment. This questionnaire is designed to identify patients who are at risk of, or already have, and active COVID-19 infection, helping to keep everyone safe by making sure that no-one with the virus visits our clinic. If you have symptoms that could be of the virus, such as a cough, you can access testing through the NHS, or we can offer you a test to check if you currently have the infection, as well as a test to check if you’ve previously had the virus and now have the antibodies. We hope that these tests will help you feel confident with continuing your treatment.

 

Visiting our clinics

When you first enter one of our clinics, things will look a little different to normal; there may be a screen at the reception, we may have reorganised our waiting areas, and we’ve changed the way you’ll move through our clinics to help minimise contact with other patients. It may also seem like there are fewer staff in the clinic, but please be assured that we are fully functional (some of our staff are continuing to work from home). These measures are likely to vary from clinic to clinic as we adapt each space to be a safe as possible.

We will also ask that you wear a face covering when visiting our clinic. You don’t need to wear medical-standard PPE – any face covering or homemade mask that covers your mouth and nose will help minimise the risk of infection. If you don’t have a face covering, we will give you one when you visit the clinic.

 

Planning treatment

There is also a possibility that your consultant will recommend a different medication protocol when you resume treatment. These changes may be designed to reduce the number of times you will have to visit the clinic (minimising your contact with staff and other patients), so you may only need to visit the clinic twice for an FET cycle: once for your initial ultrasound scan to confirm you a ready for treatment, and then visiting us again for your actual procedure. Stimulation cycles will require you to visit us more often, but we will reduce these as much as possible by combining appointments, such as injection teach lessons and scans, together.

We are likely to  recommend altering protocols for patients who are at higher risk of developing ovarian hyperstimulation syndrome (OHSS), such as patients with polycystic ovarian syndrome (PCOS).

In fewer than 2 in every 100 patients, OHSS can result in patients being admitted to hospital for observation, so in these times of great demand on the NHS, we are taking extra steps to further reduce that risk – including recommending different types of protocol.

We may, for example, recommend the GnRH-Antagonist protocol. For this type of protocol, you would use Follicle Stimulating Hormone (FSH) as normal, but rather than starting small daily injection before, or at time of, your period, we would delay the start of that injection and change the type of drug so that we could avoid hCG by using a slightly different ‘trigger injection’ which lessens the risk of developing OHSS. If we recommend an antagonist protocol, it’s possible we may also advise an embryo freeze-all to further minimise any risk.

 

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

 

Of course, we will only recommend changing your protocol plan after carefully considering all factors related to your treatment, and discussing our proposed changes with you in detail. Your CARE team will answer all your questions, and make sure that you feel completely comfortable and confident with your new medication.

 

In the lab

Infection control is always our top priority, and in our state-of-the-art laboratories, we have all the technology and procedures to ensure your precious eggs, sperm and embryos remain safe, such as our extremely sophisticated air filtration systems. We have never had an instance of cross contamination in any of our laboratories, but that does not mean we are complacent, and we have put extra measures in place to make sure our laboratory environments are as safe as possible.

One of our most exciting changes is CARE’s new ‘Do Not Disturb’ policy, where we leave your embryos to develop in their specially-designed culture medium for five days without disturbing them.

As the first in the UK to use time-lapse imaging to monitor embryo development, we are very experienced at monitoring embryos without disturbing them. The ‘Do not disturb’ policy ensures that embryos are continuously in the optimum environment of their culture medium until they are ready for transfer, helping to keep embryos safe and secure with minimal dish handling and footfall in the laboratory.

 

Fertility breakthroughs and the future of embryology

Learn more about our ground-breaking CAREmaps technology and other fertility breakthroughs with this blog by Sam Duffy, Senior Clinical Embryologist at CARE Manchester and one of the scientists behind CAREmaps.

 

During procedures

At CARE, all the treatments we offer are low-risk, but we have still taken extra measures to help keep everyone safe. Though it’s not necessary to have the same degree of PPE that you may see in a hospital, we have implemented all current Government guidelines and recommendations, so you are likely to see some of our staff wearing a degree of PPE. We may also ask you to wear some PPE if necessary, and we will provide this for you – we have plenty available for our staff and patients.

 

These are just some of the ways we have adapted how we work to keep our staff, our patients, and your precious embryos safe. Though things may be a little different to usual when you visit our clinics, we are committed, as ever, to you receiving the very highest standard of care and treatment. We are not working in a completely new way; all the modifications to our treatment are procedures that we do regularly, but we are now expanding these measures across our clinics to make sure we are all as safe as possible.

We will continue to support you at every step of your fertility journey. We are here to advise and reassure you, answer your questions, and make you feel confident and in control of your treatment.

Whether you are a current patient or are looking to begin fertility treatment, contact our patient enquiry team to book appointments and find out how we can help you.

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