14 Sep 2021 COVID Shutdowns Create Fertility Clinic Rush
Since the COVID-19 lockdowns in early 2020, demand for fertility services has skyrocketed. Fertility clinics and IVF providers report a recent rush on services, the result of a “perfect storm” of pandemic-defrayed dating and parenting plans, more at-home time to consider and pursue parenthood, and an accelerating trend toward egg freezing to preserve future reproductive options.
In early March 2020, in response to the COVID-19 pandemic, the American Society for Reproductive Medicine (ASRM) called for an indefinite pause on fertility treatments, with the exception of fertility preservation for women with cancer. Authorities designated fertility services “non-essential,” forcing many clinics to close their doors for several months and those undergoing or waiting to begin assisted reproduction procedures forced to cancel or delay their plans.
COVID Lockdowns Meant Time to Consider Future Parenthood
The pause was short-lived. Fertility clinics and donor agencies, incorporating best safety practices and technological efficiencies developed in response to the lockdowns, as we reported earlier, rebounded quickly. On reopening, in addition to catching up on delayed procedures, they faced a wave of new customers, created in part by the unique circumstances of the lockdown.
Although the already falling U.S. annual birth rate dropped more than 8 percent during the pandemic, the demand for fertility services only grew. In Texas, where the birthrate dropped 2.5 percent from 2019 to 2020, the Texas Fertility Center, which operates six clinics across the state, has seen a nearly 30 percent increase in services.
Patients offer several reasons for deciding to pursue fertility services now, Dr. Kara Goldman, an infertility specialist and medical director of fertility preservation at Northwestern Memorial Hospital in Chicago, told NPR station WBEZChicago.
For many people, COVID lockdowns and the ongoing need for social distancing putting a hold on dating. Women concerned about finding the right partner before their “biological clocks” impacted their fertility had to adjust their timelines.
As millions of people shifted to working from home, many reproductive-age workers and professionals suddenly had time and energy to think about the possibility of future parenthood and do something about it.
As clinics reopened, women who pre-lockdown were too busy with work and careers to think about family-building found they now had the flexible schedules to accommodate time-consuming medication regimens and clinical procedures.
Pandemic Accelerates Egg-Freezing, Sperm-Freezing Trends
A large portion of the growth in demand fertility services is driven by the fertility preservation trend, or egg and sperm freezing, as we wrote earlier. For a growing number of young people, planning for parenthood means planning to defer parenthood, by harvesting eggs or sperm and freezing or cryopreserving them for use in conception sometime in the future. The age when people marry and have their first child in the United States has been steadily rising for years. Today, the average age for woman’s first child is 32 in San Francisco, 31 in New York, as The New Yorker reports,
New York City’s NYU Langone Fertility Center saw a 41 percent jump in egg freezing cycles in 3rd quarter 2020 compared to a year earlier, The New Yorker reports. Sperm testing and freezing company Legacy reported a ten-fold growth in sales from 2019 to 2020. Experts estimate that total demand, including single and same sex intended parents and individuals facing invasive therapies for cancer and other conditions, could reach 1.1 million cycles a year.
Feeding the trend is the growing number of employers who offer coverage for fertility preservation services as an employee benefit, particularly popular in the tech sector. Several states now require insurers to offer coverage for assisted reproduction, including fertility preservation, making the services increasingly available and accessible to more people, as we reported last year.
Post-Lockdown Rush for Fertility Services is Global
The post-pandemic demand for fertility services is not limited to the United States. Fertility clinics in Delhi report the number of walk-in patients has more than doubled since December 2019, The Hindu Times reports. Nova IVF saw more than 10,000 patients at its 27 IVF centers in 19 cities in the period since the closures, Aswati Nair, a fertility consultant for the company, told Hindu Times. “As both partners are at home, they have been getting enough time together to take decisions that took a backseat due to their pre-COVID busy life,” he said.
Likewise, some U.K. fertility clinics reported a 50-percent jump in new patient inquiries about egg freezing services this summer compared to a year ago, according to the Daily Mail.
In Australia, Medicare data showed a 35 percent jump in the number of IVF cycles from May 2020 to May 2021, “with every state and territory experiencing a growth of at least 21.5 per cent,” according to a report by the Australian Broadcasting Corporation.
COVID-19 Lockdowns Accelerated Assisted Reproduction Trend
Although the confinement and unique circumstances of the COVID-19 lockdowns undoubtedly boosted the number of people seeking fertility services, in fact they only accelerated a trend: For many young people today, using technology to “hack” reproduction and parenthood only makes sense. “Reproductive entrepreneurs” have commercialized assisted reproduction, as The New Yorker reports, with national companies, such as egg-freezing franchiser Kindbody, creating a retail experience for potential customers. Some envision a future norm of “managed reproduction,” when eggs and sperm are harvested and safely stored away, to be thawed and used for conception at some future, more convenient time… and sex is just for fun. In other words, they envision a whole new customer base for fertility services, beyond the traditional population of infertile couples, singles, LGBTQ intended parents and cancer patients.
The growth of these innovative startups may very well be an important part of making the miracle of assisted reproduction more acceptable, accessible and affordable for everyone. As demand grows, the capacity will be needed. Due to a confluence of factors, assisted reproductive technology is one of today’s hottest markets, and entrepreneurs are rushing to meet the demand, and to profit from it.
But reproductive medicine experts are sounding notes of caution.
Complex Technology, Variable Success Rates = Buyer Beware
A 2015 Spanish study found that women aged 36 and older who freeze 10 eggs have less than a 30 percent chance of eventually giving birth. The process for successfully harvesting and freezing eggs for future conception is still relatively new and is highly technical and precise.
Most of the eggs that have been frozen to date using this complex new technology have not yet been thawed and used, so data on success rates is sparse, as The New Yorker article points out.
Experts express concerns that newcomers to the field, in an urgency to ramp up capacity, may lack the technical expertise to ensure positive outcomes. “When women come back for their eggs, it’s going to be a nightmare,” San Francisco reproductive endocrinologist told The New Yorker. “It’s going to be really bad for our whole field. It could make people say, ‘Well, egg-freezing doesn’t work,’ because there’s massive variability” in outcomes between clinics.
As with any new medical technology, it is essential that providers be forthcoming and transparent to ensure that patients are fully informed about both the risks of the procedures and about the ultimate chances of successful conception and birth.
The fertility boom is heating up and not expected to slow down anytime soon, as more people understand and seek to take advantage of the expanded possibilities for future family-building. It’s up to consumers to do their own due diligence and to demand honest answers from providers. And it’s up to those of us in the fertility professions to adhere to best practices and to demand accountability from our peers.
As attorneys practicing exclusively in fertility law, we at IFLG work continuously to inform potential parents and the public about the possibilities of assisted reproductive technology and about the importance of experienced legal counsel to ensure families are legally protected and secure.
As part of that commitment to education, IFLG attorney Molly O’Brien and I are honored to be participating in the Men Having Babies East Coast Surrogacy Conference & Gay Parenting Expo on September 18 and 19 at The Westin New York Times Square in New York City. (Read more about the conference here.) Stop by and see us there, visit us in our New York office at Bryant Park, 501 5th Avenue, Suite 1900 (aka (5th and 42nd), or contact our experienced, multi-lingual team of fertility lawyers and paralegals at https://www.iflg.net/contact/.