In response to the global Coronavirus pandemic, a number of Societies involved in reproductive medicine, have issued statements on patient management and their clinical recommendations. Here, we focus on the latest COVID-19 updates from ASRM, ESHRE and BFS to provide an overview of current thinking. These organisations urge practitioners to stay up-to-date and to comply with their national public health recommendations with a particular duty to avoid any additional stress to healthcare systems, which in many places are already severely overloaded.
American Society for Reproductive Medicine (ASRM)
Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic.
17th March 2020
As a result of the COVID-19 pandemic, ASRM recommendations’ include:-
- Suspend initiation of new treatment cycles
- 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
European Society for Human Reproduction and Embryology (ESHRE)
Conronavirus COVID-19: ESHRE statement on pregnancy and conception
19th March 2020
Due to the impact of the Coronavirus pandemic, ESHRE recommends that all fertility patients considering or planning treatment, even if they do not meet the diagnostic criteria for Covid-19 infection, should avoid becoming pregnant. For those patients already having treatment, ESHRE suggests considering deferred pregnancy with oocyte or embryo freezing for later embryo transfer.
British Fertility Society (BFS)
The BFS issued their original guidance on 18th March, which should now be read alongside the open letter they issued on 23rd March.
An open letter to members of the British Fertility Society and the Association of Reproductive and Clinical Scientists and Persons Responsible for UK Licenced Fertility Services.
23rd March 2020
This letter outlines the rapidly changing situation and reaffirms their position on fertility treatments for the foreseeable future:-
“Given the daily escalation of restrictions on public movement and the increasing pressure on NHS facilities particularly in London and North West England, coupled with predictions that the crisis will continue to intensify for at least the next twelve weeks, the BFS and ARCS stand by their recommendations that centres in the UK work to cease treatments. We are however committed to review our guidance as the situation progresses, with reference to national advice and new evidence as it emerges and hope to work with colleagues over coming weeks and months to consider how and when best to resume normal activities.”
Read letter in full.
Guidance for the care of fertility patients during the Coronavirus COVID-19 pandemic
NB since issuing this guidance, the BFS have published the open letter (see above), which should be read alongside this original guidance published on 18th March
- Whilst pregnant women can be generally reassured they are asked to consider themselves a vulnerable group
- It is expected that UK licenced fertility centres will now be working to suspend treatments
- UK fertility centres must establish the requirements to maintain a minimum service – this may include non-elective fertility preservation
- Centres are expected to keep communication open with patients for advice and reassurance
- Centres are expected to minimise their impact on NHS resources.