IRMS views our role, during this global pandemic, as being proactive in doing our part to blunt the spread of COVID-19, while also recognizing the need to safeguard limited health infrastructure resources. We recognize and understand our patients’ time-sensitive aspirations to achieve pregnancy so; we will regularly reassess ASRM (American Society for Reproductive Medicine) recommendations regarding fertility treatment with a commitment to resume initiation of comprehensive fertility care as soon as possible.
At IRMS, our focus has always been on the health of our patients and staff. During this global pandemic, we feel we must recognize our social responsibility as a healthcare organization to comply with national public health recommendations. The guidance from ASRM below recommends the following:
- Suspend 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 (such as cancer patients embarking on treatment)
- Suspend elective surgeries and non-urgent diagnostic procedures.
- Minimize in-person interactions and increase utilization of telehealth.
IRMS will continue to revisit these recommendations as this pandemic evolves.
“Along with others in the global community, reproductive medicine professionals and their patients are battling an unprecedented viral pandemic. The priority of ASRM is to maximize the wellbeing of patients, staff, and society-at-large. As such, ASRM aims to provide guidance and support based on existing scientific knowledge, to its members and the patients they care for during the coronavirus (COVID-19) pandemic. This guidance addresses a gap in current guidelines addressing COVID-19, which only indirectly mentions infertility and its treatment.
The recommendations laid out by ASRM are guided by COVID-19’s steep daily rise in incidence, the impact of the virus on patient health and fertility care providers, and the known and unknown impact of coronavirus on fertility, pregnancy and transmission patterns.”
COVID-19: What We know Now:
COVID-19 (Coronavirus) has spread quickly owing to its rapid community transmission, high virulence and sustained surface viability. Many infected and contagious individuals may only have mild symptoms, including fever or, more rarely, be asymptomatic.
The current spread of this new coronavirus has been rapid, and the infection rate has been exponential. Current infection rates and mechanisms of transmission can be found on the CDC Coronavirus website. Primary transmission is believed to occur through respiratory droplets from coughing and sneezing and contagion requires close proximity (less than 6 feet distance) between individuals (Cascella et al, 2020). The AMA has updated its assessment of the role of pre-symptomatic people with coronavirus, based on the study published in the CDC’s Morbidity and Mortality Weekly Report. People with COVID-19 may be able to spread the virus one-to-three days before symptoms appear. The incubation period for COVID-19 is 3 to 7 days but can be as long as 2 weeks from infection to symptoms (Li et al, 2020). Therefore, social distancing is crucially important at this time.
COVID-19 is associated with fever and with mild symptoms (non-pneumonia and mild pneumonia) in approximately 80% of patients, severe disease (dyspnea, tachypnea, decreased blood oxygen saturation, or lung infiltrates) in approximately 14% of cases. Critical disease (respiratory failure, septic shock, and/or multiple organ dysfunction or failure) occurs in 5% of cases (Cascella et al, 2020; Wu et al, 2020). Many patients may be infectious 1-2 days prior to the onset of symptoms (Xu et al, 2020). Mortality rates range from 0.9% to 2.3% (Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, 2020) with most deaths occurring in older individuals (>70 years old), those with critical disease, and/or those with coexisting medical morbidity (e.g., cardiovascular disease, diabetes, chronic respiratory disease, cancer, etc.) (Li et al, 2020).
While the flu causes a large number of deaths globally every year, COVID-19 differs from the flu in a number of important ways:
- The pathophysiology, epidemiology and transmission dynamics of COVID-19 are not fully understood.
- There are currently no specific medications for the treatment of COVID-19. For example, there are no antiviral drugs licensed by the U.S. Food and Drug Administration (FDA) to treat patients with COVID-19. Some patients have received an investigational new drug, Remdesivir, through compassionate use outside of a clinical trial setting. At this time, it is unclear whether the drug can be used safely in pregnant or breastfeeding women.
- COVID-19 is a “novel” infection (new to humans) and host immunity is assumed to be minimal.
- COVID-19 is more contagious than the flu.
- COVID-19 has a 10 to 15-fold greater mortality rate than the flu.
- COVID-19 impacts the lungs differently than does the flu.
To continue to serve our patients, ALL IRMS Physicians are scheduling Telemedicine appointments, for both New Patients and Follow-up appointments. Please contact us at 973-548-9900 with any questions.
We are here to help you continue to progress on your fertility journey while remaining safe and healthy.