Fertility Treatments During The Pandemic

The pandemic caused by COVID-19 has affected every single person in one or many ways. The healthcare sector is badly hit too, including the postponement of “non-essential planned procedures” which included fertility treatments as well.

For those couples undergoing fertility treatment before the lockdown and for those who were planning to start the same, this has been a very stressful time. However, infertility specialists are continuing with online video and telephonic consultations for patients, even though it has been difficult, not being able to personally visit the doctor for follow-ups and also due to lack of some medicines. Reproductive consultations for males should also continue via telehealth or other video facilities as this will be a key component to assess the man’s health where possible.

The FOGSI (Federation of Obstetric and Gynaecological Societies of India), in a short-term advisory mentioned:

“For women undergoing assisted reproduction, who have already begun ovarian stimulation, care can be continued after counselling with the couple. The decision to transfer embryos in all cycles whether fresh, thaw or recipient cycles in not suspected patients can be individualized after proper counselling and as per the couple’s wish. If there is a diagnosed positive COVID-19 infected patient or if there is a strong suspicion based on travel history and/or clinical features, embryo transfer should be deferred”.

IFS (Indian Fertility Society), ISAR (Indian Society for Assisted Reproduction) and ACE (Academy of Clinical Embryologists), in their recommendations regarding resuming ART treatments, have mentioned that:

• High-risk patients (those with diabetes, hypertension, transplant patients and those with renal, liver, lung or medical conditions) should be deferred for treatment at present.
• Third party reproduction should be avoided (including donor with fresh oocytes and surrogate cycles)
• Low risk cases should be taken, who require minimum visits to the clinic
• Patient prioritization to be based upon the impact of delay on patients due to age, ovarian reserve or endometriosis and also on the impact of treatment delay on the emotional and mental status of the patient.
• ART cycles for fertility preservation in cancer survivors to be started at the earliest.

Sperm Cryopreservation: This is the procedure used to preserve the sperm cells at cryogenic (very low) temperatures. It is important for men, especially before treatments/therapy for infertility or malignant diseases, as it is an efficient procedure to store spermatozoa and ensure the recovery of at least some spermatozoa in the event that the male infertility factor is severely affected after such treatments.

Placental transfers: At present, though there are no proven results for placental transfers, there are possibilities that a pregnant woman can pass on the disease to the newborn, due to the close vicinity of the mother delivering the baby.

Suggested precautions at this time: While it is not safe to leave your home during the lockdown, women undergoing fertility treatments, or planning to do the same, need to take care of their health at home – and so do the male partners.

Keep a check on your weight: Weight gain can lead to various complications. Alternatively, keeping your weight intact will be beneficial while undergoing fertility treatments. For men, too, keeping a check on your weight will help with sperm production, as it is known that increased BMI has an impact on sperm quality.

Dietary changes: Reducing total calorie intake can keep a check on weight gain. Instead of restricting carbohydrates completely, choose those which are high in fibre content. Try and focus on fruits and vegetables that are easy to digest and avoid processed food and those items high in calories and fat. Vitamins and minerals, via natural sources, or supplements are beneficial.

Exercise: Exercise is known to produce endorphins or the “feel good” hormones. Mild exercise will help blood circulation and regulate blood pressure and glucose levels. Carrying out regular household chores (without stress) can also prevent weight gain.

Radiation through Mobile Phones and Laptops: These gadgets are known to emit low levels of radiation which can affect sperm production. So, for men, avoid sitting with the laptop directly on your lap for a long time. Also, it is preferable to keep your mobile in the pocket of your shirt and not in your pant pocket or fitted to your belt.

Emotional health: For those couples planning to or undergoing fertility treatments, the present pandemic situation can cause stress and anxiety. Many couples have had to postpone their fertility treatments due to various reasons in the current situation. It is very important to maintain a positive attitude for emotional and physical well being – for both the partners. Some tips that will help is establishing a good focused daily routine which includes some form of exercise, yoga or meditation, sufficient number of hours of sleep, good nutrition and spending time doing a recreational activity of your choice where time permits. Talking to your infertility doctor about your concerns at this time will also help clarify your doubts and bring you peace of mind.

While it is true that IVF procedure requires special attention and care during the process, the pregnancy as such will require precautions just as a normal conception. According to IVF expert, Dr. Arvind Vaid, “With the ongoing corona pandemic situation, counselling plays a major role. Understanding and supporting each other around this time could bring about a great deal of strength in progressing with the treatment.”

So, try not to panic and keep your emotions well balanced, so that the ultimate gift of Parenthood can be truly enjoyed!