Your questions answered as fertility clinics reopen

UK fertility clinics licensed by the UK’s Human Fertility and Embryology Authority (HFEA) have been applying to reopen since 11 May. This reopening comes with tight rules and regulations that clinics must adhere to for permission to reopen. The new regulations cover everything from COVID19 testing to donor screening and from infection control to social distancing measures.

As part of their compliance with the reopening process clinics will have to complete the HFEA’s Covid-19 Treatment Commencement Self-Assessment. This an extremely robust examination of standards put together by the government and HFEA. There was also input from various professional bodies such as ESHRE (European Society for Human Reproductive Embryology).

Before a clinic can commence treatment, it must have received approval of its self-assessment from its HFEA inspector.

What does this mean for patients?

The HFEA is aware that this is a period of uncertainty and that patients have many questions. With that in mind they have provided answers to some of those questions:

Q.​ What do clinics need to do before they can reopen?

A. In order to reopen a clinic must comply with new guidelines (General Direction 0014) for providing treatment during this phase of the COVID19 epidemic. The comprehensive guidelines aim to ensure the safety of staff, patients, their gametes and embryos.

Q.​ How long will it take to process the applications from clinics wishing to reopen?

A. The HFEA aims to complete the approval process within five working days of receiving the application and self-assessment form.

Q.​ Do I need to be tested for COVID-19 prior to treatment at my newly reopened clinic?

A. Some clinics may choose to include testing for COVID-19 as part of their treatment strategy, but the HFEA has not made this a condition of reopening as it is not a current recommendation made by the UK government. It is therefore up to each clinic how they proceed with testing for COVID19.

Q. Will clinics implement social distancing?

A. In a word, yes! ​The new guidelines set out ways in which clinics must introduce social distancing. This allow patients to be treated safely and clinic staff to work safely during the current situation with COVID-19. Clinics will need to demonstrate how they will comply with the new guidance on social distancing.

Q.​ When clinics reopen will they prioritise particular groups of patients?

A. It will be up to the individual clinics to decide how they manage their backlog. Clinics will be holding waiting lists of patients whose cycles had to be cancelled or who could not start planned treatment during the closure. It’s safe to assume that, apart from exceptional cases, most clinics ​will be carrying on where they left off and will be in touch to let those people know what to expect. If you have any concerns, contact your clinic for their advice.

Q. My clinic is not responding to me. What can I do?

A. This is probably because they are operating on reduced staffing levels. Many staff were furloughed or redeployed during the COVID19 crisis and it will take time to get back up to normal working speed. However, ​clinics are eager to resume treatment as soon as possible, and it is likely you will hear from them soon. In the meantime, continue to check their websites and social media pages for updates.

Q. ​I’m nearing the UK 10-year storage limit for my eggs/sperm/embryos. Will I still be able to use them if my treatment is delayed?

A. The UK government has confirmed that the current 10-year storage limit for embryos and gametes will be ​extended by two years​. This means that patients who have stored sperm, eggs or embryos that are reaching the 10-year storage limit do not need to worry.

Q. What if I am worried about the risks of COVID19 during treatment or pregnancy?

A. Firstly, it is fine to be apprehensive. We are, after all, just beginning to emerge from a pandemic phase of a new virus that we are still learning about! However, ​any risks about the impact of COVID-19 on pregnancy have been considered by the Royal College of Obstetricians and Gynaecologists (RCOG) who have regularly updated their ​guidance​. This guidance would be taken into consideration by your clinic before any treatment is started.

HFEA safety priority for patients and staff

Writing to patients about the reopening of clinics, Sally Cheshire, Chair, HFEA said, “I know that suspending fertility treatment from 15 April was extremely stressful for patients. I think it was the most difficult decision we have had to take at the HFEA in our 30-year history, realising what distress this would cause whilst doing our best to ensure that any treatment offered in clinics could be safe. Our priority was to keep patients and clinic staff safe, but we also had to consider guidance from the professional societies and government advice about the COVID-19 pandemic. Our aim has always been to restart treatment as soon as possible and we have been working tirelessly to allow as many patients as possible to resume safe treatment whilst adhering to the latest government guidance.”

However, she adds a note of realism about the new situation brought about by COVID19, “We will all, however, be working and living in different circumstances for some time to come due to the ongoing situation with the pandemic and the HFEA, as the regulator, will need to ensure all clinics who do reopen are able to put in place processes and procedures to keep patients and clinic staff safe.”

This makes perfect sense. Safety is the priority for patients and clinic staff as clinics move into a new phase of providing assisted reproduction services during this phase of the COVID19 challenge.

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