While coronavirus disease (COVID-19) is still very much present in the United States, we know many families are trying to get on with their lives safely and effectively. And for the many couples who are looking to start or grow their families but have difficulty in conceiving, Atrium Health Women’s Institute wants to ensure families alike that they don’t have to put their plans on pause and that our doors are open for COVID-Safe fertility care.
Providing the best and most convenient care for our patients, Atrium Health Women’s Institute is proud to stand behind our highly successful Reproductive Endocrinology and Infertility (REI) Program. Under this specialized program, our 86% elective single-embryo transfer (eSET) rate is one of our most successful methods of fertility treatment, ranking our practice the highest in the Southeast and t and No. 7 in the country (Top 1.5%). At the Women’s Institute, in vitro fertilization (IVF) – the process of fertilization where the egg is combined with sperm outside the body – the successful deliveries resulting in a healthy child is 63.6% for women under 35 years of age compared to a national rate of 46.8%.
Here, Ashley Eskew, MD, MSCI an OB/GYN and REI specialist at Atrium Health Women’s Institute shares answers of the most frequently asked question by families looking for fertility care amid the coronavirus pandemic.
Question 1: If I’m trying to get pregnant, should I stop trying to conceive due to COVID-19?
Answer 1 | Dr. Eskew: It is still very early in this pandemic and little is known about the impact of the virus on early pregnancies, so it is very difficult to make general recommendations in this regard. Over 100 million babies are born worldwide each year- and additional research is ongoing to help get more answers. Further, the decision to continue trying is a very personal one, and what’s “right” for one individual or couple may not be “right” for another.
Based on available information, pregnant people seem to have the same risk of COVID-19 as adults who are not pregnant. However, much remains unknown. We do know that pregnant people have had a higher risk of severe illness when infected with viruses that are similar to COVID-19, as well as other viral respiratory infections, such as influenza. Pregnant women also have physiologic changes in their bodies that may increase their risk of some infections. It is always important for pregnant people to try to protect themselves from illnesses whenever possible. These potential risks are something for you to be aware of and discuss with your partner and your doctor.
Most importantly, if you are acutely ill or have recent exposure, the recommendation is to wait to try to conceive as we know that fever early in pregnancy can be associated with an increased risk of adverse outcomes.
Q2: Will contracting COVID-19 now impact fertility later?
A2 | Dr. Eskew: Since we are so early in this pandemic, we believe it’s too soon to make and assumptions regarding the effect of this virus on future fertility.
Q3: What if I’m pregnant and test positive?
A3 | Dr. Eskew: If you’re pregnant and test positive, you should notify your physician immediately. According to the American College of Obstetricians and Gynecologists, “during acute illness, fetal management should be similar to that provided to any ill pregnant person.” Treatment and additional monitoring and supportive measures will largely depend on the severity of symptoms. Modified ultrasound surveillance may be indicated following a first-trimester maternal infection and for those experiencing illness later in pregnancy according to the Society for Maternal Fetal Medicine.
Q4: How can I get through this? Not knowing when COVID-19 will end is making my anxiety so much worse.
A4 | Dr. Eskew: Continue to lean on your partner, close friends and loved ones for support. We truly are all in this together. Find ways to continue to connect virtually with others. Join a local Resolve group to connect with women in couples who will be able to understand exactly where you are coming from. And most importantly, continue to focus on taking care of YOU. Maybe start a virtual yoga practice or download a meditation app (Calm & Headspace are some of my personal favorites) to get started. These types of activities have been shown to reduce anxiety and depression scores in couples undergoing fertility treatments and improve quality of life scores. These may seem like small things, but they will add and can be vital tools to reduce anxiety during this time.
Q5: I want to pursue IVF or other fertility medical treatments. Should I delay care during the COVID-19 pandemic?
A5 | Dr. Eskew: This is one of the most common questions I’m getting asked these days, and is definitely one of the most challenging ones for individuals and couples to consider. The uncertainty, surrounding this pandemic and sparsity of data as it relates to fertility adds an extra layer of concern when it comes to pursuing fertility treatments. Going through most fertility treatments requires multiple visits and touchpoints in the medical system that regardless of how stringent the cleaning, personal protective equipment (PPE) and social distancing, are a potential opportunity for exposure. We know that COVID-19 does have considerable health implications and that has to be taken into consideration when thinking about moving forward with or delaying fertility medical treatments.
If you have been trying to conceive for some time, with the increased access and ability to do virtual visits this is still a great opportunity to have that first virtual appointment with a fertility specialist from the comfort of your own home, to discuss your history, get the information you deserve and come up with a plan. Many factors should be taken into consideration with a couple’s decision as to when to delay care or move forward and that is a conversation that should involve you, you partner and your physician.
One of the biggest things I emphasize with my patients is even if you choose to delay active treatment, there is so much you CAN be doing while you’re waiting in terms of dietary and lifestyle modifications that can help set you up for success in the future. So much of the fertility journey feels like it’s out of any one person’s control, it’s important to remember and focus on the things that matter that ARE in your control.
Q6: Will postponing my care affect my ability to have a child?
A6 | Dr. Esksew: It is an incredibly difficult decision to consider delaying treatment during the COVID pandemic, and one that so many couples are currently grappling with. Couples who experienced infertility have often already waited SO long, and have already experienced significant amount of emotional distress related to the diagnosis. Delaying treatment by a month or two in general should ultimately not influence your reproductive success, but can certainly contribute to the already heavy emotional toll. Weighing the risks versus benefits of moving forward with treatment should be discussed with both you, your partner and your provider to determine what is best for you.
Q7: Has Atrium Health resumed fertility treatments?
A7 | Dr. Eskew: Yes, we have. We are taking all the appropriate precautions with appropriate use of PPE, social distancing, hand hygiene, continued rigorous cleaning protocols and the like to make our reentry to care COVID-safe.
Q8: Are my frozen embryos, eggs, or sperm safe?
A8 | Dr. Eskew: Yes. COVID-19 does not pose any direct, immediate threat to frozen eggs, sperm or embryos. The continuous, diligent monitoring and management of cryo tanks used for fertility storage has not changed.
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We understand that you may have had to postpone or delay care due to COVID-19 – if so, please contact your primary care provider or the Atrium Health Women's Institute to reschedule.
We are open and ready to take care of you, whether it be in person or virtually. Using our COVID-Safe protocol, we have enhanced safety measures to keep our facilities clean and our patients and teammates safe.
