In vitro fertilization (IVF) can be a lifeline after devastating loss or disappointment. I know from experience. Three years ago, I lost my baby at six months gestation and fell into a deep depression, desperate for a reason to put one foot in front of the other. A reason revealed itself when my doctor suggested IVF and genetic testing of embryos as a way to boost our chances of having a healthy baby. Going through the process was far from easy, but looking forward helped me heal and find purpose at a time I truly needed it.
And so, my heart broke when I learned that in light of the current COVID-19 crisis, as of March 17, the American Society for Reproductive Medicine (ASRM) recommended that fertility treatments be suspended. This happened in light of the Centers of Disease Control and Prevention (CDC)'s released guidelines for health care facilities to "reschedule elective surgeries as necessary."
This means new treatment cycles should not be initiated, and no new ovulation inductions, egg retrievals, or frozen embryo transfers should be performed. The recommendation further extends to IUI, or intrauterine inseminations. It's worth noting that for patients who are currently in cycle, it's recommended their care continue.
These restrictions are deemed necessary because it's not clear what impact COVID-19 has on fertility, pregnancy, and transmission patterns, explains ASRM. They are also necessary to protect patients, something Zev Williams, M.D., Ph.D., director of the Columbia University Fertility Center, agrees with.
"This is a very complex situation without precedent in modern medical history," says Dr. Williams. "Our paramount concern is always the health and well-being of patients, staff, and the community and consistently doing everything possible in the most responsible way to ensure the success and safety of our patients. There are many unknowns right now, including concerns regarding the rapid pace at which the rate of infections are accelerating."
Those Dealing With the Repercussions
But the situation is still tough on people whose family planning goals are being put on hold after going through the lengthy, time-consuming, expensive, and often draining process, like Denver-based mom-of-one, Brandy Schultz, who also owns Adventure Nannies. Earlier this month, her fertility doctor at CCRM Colorado advised Schultz and her husband not start their planned frozen embryo transfer cycle. Her doctor did suggest initiating the necessary screening tests, like a saline sonogram, so she can get started right away when things get back to normal. Whenever that may be.
"I'm disappointed," says Schultz. Ideally, she wanted to have her children born close together, and worries about getting older.
Age is a big factor as to whether a fertility treatment will be successful. There's a 41 to 43 percent live birth rate for each IVF cycle for women under age 35, and that percentage decreases in older age groups, according to the American Pregnancy Association. That is why not all fertility practices are making the decision to suspend treatment. My New Jersey-based fertility practice sent out an email just this week announcing it will keep its clinics open for patients. The reasoning was explained in part in the email: "We know how stressful infertility is, and how big a role time plays in this journey. For some of our patients, it is imperative they begin treatment as soon as possible so they can maximize their chances of success. We recognize that it is our responsibility to help them accomplish their family-building goals, and we remain open for patients who wish to continue or begin care with us."
The letter goes on to detail the new measures the practice is putting in place to allow for social distancing and increased sanitation, as well as COVID-19 screening for patients. Indeed, as if fertility treatments aren't stressful enough, now women and their partners have an entirely new worry to contend with, whether their plans are moving ahead or not.
Elyse Ash, founder and CEO of fertility mentorship app Fruitful Fertility, seconds that notion. "There are so many barriers to fertility treatments under the best of circumstances and now there's this whole new barrier that's unknown and out of everyone's control." Ash points out that in this current climate, it's an especially difficult time to be dealing with the pain of infertility since, well, we're all home without as many distractions as we typically have.
Another hopeful mama, Rachel Villena, from Atlanta, is also dealing with the pause on her IVF treatment dreams. "My husband and I have waited over a year and a half to finally get the chance to have a baby through IVF. We started our first cycle in January of this year and experienced ups and downs, but got healthy embryos for transfer. As we counted down the days until our transfer, COVID-19 was becoming more and more serious. That's when we got the news from our clinic that fertility treatments were being stopped indefinitely," says Villena, a grantee of the Jewish Fertility Foundation, an organization offering financial assistance, educational awareness, and emotional support to women going through fertility issues.
Villena says she was shocked because, like many women—myself included—she didn't consider fertility treatments as "elective." Still, she adds, "I understand the clinic's need to follow the latest guidelines for the health and safety of their patients and their staff." For now, Villena feels OK and actually welcomes the break from constantly thinking about IVF. "I feel like there are currently bigger stressors like job security and the health of everyone I love." She adds that going through IVF has taught her not to sweat the small stuff. And ultimately, Villena says, "I know that when it's safe to proceed with IVF, I'll be able to."
Besides, as Schultz points out, the grass isn't always greener on the other side. "It's a scary time to be pregnant," she adds, echoing fears many pregnant women currently have in light of COVID-19. (Keep in mind, it's not certain mothers with COVID-19 can pass it to the fetus, as one study didn't find intrauterine fetal infection.) For now, Schultz says she is keeping in touch with her doctor, and just waiting it out to see what happens.
How to Cope With IVF on Hold
As women like Villena and Schultz are waiting for when they can continue, Ash recommends taking this time to tend to physical and mental health. "Feel your feelings," says Ash. If your treatment has been put on hold, those feelings are probably, "Some kind of hybrid of grief, despair, sadness, loss, anxiety, disappointment, confusion, and anger."
To help cope with complex emotions, Ash suggests connecting online with infertility and trying to conceive support groups (there are many private infertility-related groups on Facebook and virtual support websites like Beat Infertility, as well her own Fruitful Fertility). Scheduling phone meetings with a therapist is also helpful.
"There are lots of mental health experts out there who know what to say and how to support you," says Ash. "Remember, you are not alone. And this too shall pass."
