“The trauma and distress of suspending IVF treatments simply cannot be underestimated.”
Dr. Geeta Nargund, Medical Director, Create Fertility and Lead Consultant for Reproductive Medicine at St George’s Hospital NHS Trust, London.
Fertility clinics globally are in a hiatus, as current guidelines recommend the suspension of treatments due to the COVID19 pandemic.
The decision to recommend the closure of IVF clinics was sensible based on the information available at the time. However, outside of the fertility community, the trauma caused by this decision is largely underestimated by the general public.
Fertility patients are anxious
For instance, in the UK, Alice Matthews, a co-ordinator for Fertility Network UK, says the support organisation has seen a surge in calls and emails over the past weeks. And the same is true, here at The Fertility Hub.
Ms. Mathews said, “People are feeling extremely anxious, like they’ve got absolutely no control over their lives, they’re in limbo with treatment on hold and there’s very little that anybody can do.”
With this is in mind there are growing calls from both patients and assisted reproduction service (ART) providers for governments and fertility authorities to prioritise the re-opening of fertility clinics as an essential service.
Call to reopen IVF clinics
This is driven by what we NOW know about COVID19 and fertility:
- There is no evidence that pregnant women are more susceptible to infection from coronavirus, however pregnancy does alter the immune system and therefore pregnant women should take different precautions to the rest of the population
- There is currently no firm data suggesting an increased risk of miscarriage or early pregnancy loss in relation to Covid-19, although ALL conditions that produce a moderate to high fever are a risk for pregnant women and unborn babies
- There are already scientific papers and guidelines being published that highlight how an effective and safe exit strategy from the lockdown can be achieved with suitable safety measures
- For women with a low egg reserve (i.e. generally, older women), time really is of the essence, and a delay of more than a few months could even deny some of them the chance to have a biological child altogether.
The mental health challenge
There is also another consideration here. Many governments and national/federal health authorities have recognised that the lockdown represents a challenge to mental health. For instance, many nations and states are already witnessing a predicted rise in domestic violence that is a natural consequence of forcing affected people into close proximity their abusers.
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The distress arising from the denial of fertility services will add to this mental health burden. Dr. Nargund told Huffington Post, “At my clinics we have fielded countless calls from those devastated by an indefinite delay. Many with depressive and even suicidal thoughts, whom we have had to refer to mental health departments and counsellors for urgent help. Fertility treatment is a process that can take months or years to reach, and so this wait is adding to an already stressful and overwhelming journey.”
Fertility patients feel punished
As Dr. Nargund points out, there is no ban on natural conception for the fertile, and therefore the suspension of fertility services has left women who struggle with conceiving feeling penalised for their condition. After all, the World Health Organisation has defined infertility as a disease since 2009.
In Europe the lockdowns are gradually being relaxed in a phased and careful manner. For instance, Germany continued with some IVF treatments from the start of the crisis, while Denmark re-initiated IVF treatments last week.
Other countries, when considering reopening fertility clinics, can now quickly learn from what Germany and Denmark has put in place. And clearly, a priority should be given to women with low egg reserve, and to those others who are most at risk of losing their chance to become biological mothers.
Dr. Nargund said, “At a time when saving lives is the focus, creating life should also remain important.”
For her part, as a UK hospital consultant and media influencer, she is urging the UK authorities to come together with health professionals, patients, regulators and professional bodies to prioritise this vital service and act to protect women’s health.