A landmark study has found that there was an average delay of 60 days for IVF during the COVID-19 pandemic
The study, led by researchers at Monash University and published in Reproductive Medicine, surveyed 43 IVF clinics across countries in Asia, Africa, Europe, North America, and South America focussing on the country’s response to the COVID-19 pandemic.
The study was led by Elizabeth Cutting, a Ph.D. student in the Department of Obstetrics and Gynaecology, who found that – in 34 countries – IVF/intracytoplasmic sperm injection (when a single sperm is injected directly into the egg) and frozen embryo transfers had an average of 59 days and 60 days, respectively. One clinic in Scotland registered a delay in these procedures of 228 days.
Elizabeth said: “Patients usually undergo one cycle of treatment in approximately three weeks (21 days). With the delays shown, patients on average missed at least two cycles of treatment. For instance, for those needing fertility preservation prior to chemotherapy, missing two cycles may be vital to their chances of parenthood.”
The authors called on a recognition by governments to introduce set protocols for any future pandemic lockdowns and also a strategy for prioritizing couples who need urgent care such as patients with advanced maternal age.
According to Elizabeth, the early days of the pandemic saw IVF clinics adopt a cautionary approach to their patients.
She said: “In the first months of 2020, the available knowledge regarding the effects of SARS-CoV-2 on the fertility of pregnancy was based on very limited data.
“Because of this limited knowledge most countries cancelled or delayed assisted reproductive technology treatments, opting for telehealth to at least stay in touch with their patients.
“They need to stop or delay treatment was guided by the uncertainty of the virus, and the new to reduce the burden of non-essential medical treatments in hospitals to allow resources to be allocated to dealing with people with COVID-19,” she added.
“On March 17, 2020, the American Society for Reproductive Medicine announced a “delay (to) any but the most important reproductive care cases.” Two days later the European Society for Human Reproduction and Embryology advocated a cautionary approach, recommending that all infertility patients consider planning treatment to avoid becoming pregnant because of the unknown effects of SARS-Cov-2 on pregnancy.
On March 19 the Fertility Society of Australia suggested patients discuss postponing their treatment with their specialist and fertility treatments were stopped in Australia on 27 April 2020.
Nine countries followed their government recommendations (Belgium, Canada, Iceland, Iran, Italy, Nepal, Peru, Saudi Arabia, United States of America)
Twenty-two countries followed a combination of recommendations, those being Argentina, Australia, Bangladesh, Barbados, Bolivia, Brazil, Czech Republic, Denmark, Finland, France, Greece, India, Indonesia, Israel, New Zealand, Portugal, United Kingdom, Scotland, Spain, Thailand, the Netherlands, and Uganda.
Chile, Egypt, and Pakistan made changes by clinic initiatives.
Austria, China, Germany, Hong Kong, Malaysia, Norway, South Africa, Sweden, and Vietnam did not specify their policies.
Elizabeth said most clinics preferentially followed the advice of their professional societies, which routinely advised them to take a cautionary approach.
“While there was advice regarding virus exposure and transmission, there was a uniform lack of advice regarding the provision of psychological support and how to prioritize patients,” she said.
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