23 Mar 2020 ASRM Advises Delaying Non-Urgent Fertility Treatment, New York Times Reports
In the midst of the coronavirus COVID-19 pandemic, reproductive healthcare professionals are advised to avoid initiating non-urgent new fertility treatment, under new guidelines just issued by the American Society for Reproductive Medicine (ASRM).
The ASRM recommendations include:
- Suspension of initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
- Strongly consider cancellation of all embryo transfers, whether fresh or frozen.
- Continue to care for patients who are currently ‘in-cycle’ or who require urgent stimulation and cryopreservation.
- Suspend elective surgeries and non-urgent diagnostic procedures.
- Minimize in-person interactions and increase utilization of telehealth.
ASRM will revisit the new recommendations no later than March 30, “with the aim of resuming usual patient care as soon and as safely as possible."
The new guidelines are not without controversy, according to a March 22 New York Times report, even as several large reproductive health providers, including Brigham and Women’s Hospital Center for Infertility and Reproductive Surgery in Boston and Weill Cornell Medicine’s Center for Reproductive Medicine in New York City, had already stopped accepting new patients. At the New Hope Fertility Center in New York, The New York Times reports, doctors are “having conversations with each patient and deciding on a course of treatment on a case-by-case basis.”
As the Times reported, one fertility doctor at IVFMD, near Dallas, created a Change.org petition to protest the new guidelines. The petition text reads, in part:
Despite the COVID-19 outbreak, no guidelines or organizations have asked fertile patients to avoid pregnancy or use contraception. Our infertility patients are now asking us: “Why are WE the only ones being asked to make a sacrifice to avoid pregnancy?” And this does not just affect infertility patients. What about same sex couples and single mothers by choice? Are they being treated equitably?
As the scope of the COVID-19 pandemic and its impact on intended parents, surrogates and reproductive healthcare providers has become more apparent, our goal has been to share the latest and most relevant information from our colleagues in the profession. Although initial, limited studies from Wuhan, China, did not indicate that birth mothers who tested positive for COVID-19 transmitted the virus to their unborn babies or newborns, much more research is needed. The impact of COVID-19 on maternal health, fetal health and the sustainability of the pregnancy are unclear.
We applaud ASRM and other professional and advocacy organizations such as RESOLVE: The National Infertility Association and Society for Assisted Reproductive Technology (SART) for stepping up to help formulate best practices and guidelines for protecting families’ health and safety during this trying time. As the New York Times article highlights, the stress to intended parents, donors and surrogates, some of whom were between procedures when the COVID-19 crisis struck, has been immense. In some cases, biological factors such as age or advancing disease add immeasurable pressure and anguish for patients stuck on hold.
As a parent of twin boys born via surrogacy and egg donation, it is easy to imagine myself in a similar situation. I can imagine the disappointment, the frustration of nearly reaching one’s goal only to be delayed, the worried calculation of financial losses from wasted medications or cancelled procedures. I hope, under those kinds of stresses, that I would do as Tommy and I always did during our own journey to parenthood and trust the advice of our medical professionals.