COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management

Alviggi, Carlo; Esteves, Sandro C.; Orvieto, Raoul; Conforti, Alessandro; Marca, Antonio La; Fischer, Robert; Andersen, Claus Yding; Bühler, K.; Sunkara, Sesh Kamal; Polyzos, Nikolaos P.; Strina, Ida; Carbone, Luigi; Bento, Fabiola C.; Galliano, Daniela; Yaralı́, Hakan; Vuong, Lan N.; Grynberg, Michaël; Drakopoulos, Panagiotis; Xavier, Pedro; Llácer, J.; Neuspiller, Fernando; Horton, Marcos; Roque, Matheus; Papanikolaou, Evangelos; Banker, Manish; Dahan, Michael H.; Foong, Shu; Tournaye, Herman; Blockeel, Christophe; Vaiarelli, Alberto; Humaıdan, Peter; Ubaldi, Filippo Maria

doi:10.1186/s12958-020-00605-z

Cited by 91 publications

(97 citation statements)

References 25 publications

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“…For now, the consensus appears to be "proceed with caution" as fertility treatment is restarted. Studies show that fully modified protocols and codes of conduct are developed to provide a safe practice [3,5,35] abided by both practitioners and patients. Recommendations and guidelines from highly esteemed reproductive societies are in place, and so it appears that we are well prepared and may be in the clear-albeit all recommendations may be subject to future reconsiderations and modifications [36].…”

Section: Resultsmentioning

confidence: 99%

“…A systematic review [11] of the current evidence showcased a clear impact of the COVID-19 pandemic on the mental health of the general population, health workers, and patients who seek various treatments during this period [12][13][14]. Considering the given and acknowledged psychological strain and the burdened mental well-being of couples pursuing infertility treatment that has been showcased [15][16][17], it becomes evident that infertile couples subjected to IVF treatment during the pandemic may face a heightened psychological distress under the circumstances of this global health crisis [5]. With infertile patients being more susceptible to suffer from anxiety than in other medical disciplines where time may not be of the essence, psychological support by clinicians and embryologists is recommended [8].…”

Section: The Matter Of Patients' Psychological State During the Pandemicmentioning

confidence: 93%

“…Highly esteemed societies issued recommendations for practice and announced the restart of ART treatment. Prognostic stratification coupled with apt identification of patients requiring timely treatment was highlighted as the means to ensure an optimal and gradual restart of ART services [5]. Following "restrictions' relaxation," and in an effort to convey safety in practice, certain strategies have been adopted.…”

Section: Recommended Guidelines For Restarting Practice and Emerging mentioning

confidence: 99%

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Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Simopoulou

Sfakianoudis²,

Giannelou

et al. 2020

J Assist Reprod Genet

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The COVID-19 pandemic has fueled numerous debates in the field of assisted reproductive technology (ART) as the effect of SARS-CoV-2 on pregnancy and infancy is still considered uncharted territory. Various theses and recommendations on what optimal practice is have emerged, as evidenced by surveys, webinars, and recent publications. ART specialists are faced with dilemmas in light of the lack of concrete scientific evidence required to pave the way towards future safe practice. Meanwhile, infertile couples were similarly left in limbo unable to exercise their reproductive autonomy unlike fertile couples-where achieving a pregnancy via natural conception is a matter of decision. ART treatment being classified as non-essential has only recently restarted , facing new challenges while enabling pregnancy at a time of uncertainty. This article highlights matters of bioethical nature to be considered in the ART world at the time of COVID-19 while presenting an all-inclusive critique of the current status. When pursuing pregnancy through IVF treatment during the pandemic, distancing and caution have the lead role in an effort to defend the health of the intended parents and future children. To promote patient autonomy along with our ethical, moral, and legal duty towards our patients, emphasis should be given on ascertaining shared decision-making, and ensuring that an appropriate all-inclusive informed consent is signed prior to initiating any IVF treatment.

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Section: Resultsmentioning

confidence: 99%

Section: The Matter Of Patients' Psychological State During the Pandemicmentioning

confidence: 93%

Section: Recommended Guidelines For Restarting Practice and Emerging mentioning

confidence: 99%

See 1 more Smart Citation

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Simopoulou

Sfakianoudis²,

Giannelou

et al. 2020

J Assist Reprod Genet

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“…Significant changes in the infertility field can, however, also be expected in how fertility services will be provided. A group of mostly European colleagues recently published in this journal a proposal for individualized clinical management of assisted reproductive technology services in a COVID-19 environment [ 48 ]. The routine face-to-face consultation, which represented a large majority of patient-physician encounters in all of medicine, has been largely replaced by electronic platforms.…”

Section: The Future Post Covid-19mentioning

confidence: 99%

The COVID-19 pandemic through eyes of a NYC fertility center: a unique learning experience with often unexpected results

Gleicher

2020

Reprod Biol Endocrinol

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Affecting basic tenets of human existence such as health, economic as well as personal security and, of course, reproduction, the COVID-19 pandemic transcended medical specialties and professional disciplines. Yet, six months into the pandemic, there still exists no consensus on how to combat the virus in absence of a vaccine. Facing unprecedented circumstances, and in absence of real evidence on how to proceed, our organization early in the pandemic decided to act independently from often seemingly irrational guidance and, instead, to carefully follow a quickly evolving COVID-19 literature. Here described is the, likely, unique journey of a fertility center that maintained services during peaks of COVID-19 and political unrest that followed. Closely following publicly available data, we recognized relatively early that New York City and other East Coast regions, which during the initial COVID-19 wave between March and May represented the hardest-hit areas in the country, during the second wave, beginning in June and still in progress, remained almost completely unaffected. In contrast, south western regions, almost completely unaffected by the initial wave, were severely affected in the second wave. These two distinctively different infectious phenotypes suggested two likely explanations: The country was witnessing infections with two different SARS-CoV-2 viruses and NYC (along with the East Coast) acquired during the first wave much better immunity to the virus than south western regions. Both hypotheses since have been confirmed: East and West Coasts, indeed, were initially infected by two distinctively different lineages of the virus, with the East Coast lineage being 10-times more infectious. In addition, immunologists discovered an up to this point unknown long-term anti-viral innate (cellular) immune response which offers additional and much broader anti-viral immunity than the classical adaptive immunity via immobilizing antibodies that has been known for decades. Consequently, we predict that in the U.S., even in absence of an available vaccine, COVID-19, by September–October, will be at similarly low levels as are currently seen in NYC and other East Coast regions (generally < 1% test-positivity). We, furthermore, predict that, if current mitigation measures are maintained and no newly aggressive mutation of the virus enters the country, a significant fall-wave of COVID-19, in combination with the usual fall wave of influenza, appears unlikely. To continue serving patients uninterrupted throughout the pandemic, turned for all of our center’s staff into a highly rewarding experience, garnered respect and appreciation from patients, and turned into an absolutely unique learning experience.

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“…Thus, this population deserves special attention. While it is critical for reproductive urologists and fertility centers to continue to offer care to this vulnerable population, it is also essential that all efforts are undertaken to deliver services in a safe environment (15). Equally important is to discuss the possible adverse impact of SARS-CoV-2 on male reproductive health.…”

Section: Adherence To Infection Preventionmentioning

confidence: 99%

Concise practice recommendations for the provision of andrological services and assisted reproductive technology for male infertility patients during the SARS-CoV-2 in Brazil

Hallak

Esteves

2020

Int. braz j urol.

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COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management

Cited by 91 publications

References 25 publications

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

Navigating assisted reproduction treatment in the time of COVID-19: concerns and considerations

The COVID-19 pandemic through eyes of a NYC fertility center: a unique learning experience with often unexpected results

Concise practice recommendations for the provision of andrological services and assisted reproductive technology for male infertility patients during the SARS-CoV-2 in Brazil

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