Resuming Fertility Treatments at the Time of COVID-19 Pandemic

In order to facilitate a safe return to fertility treatment, IHR has completed a formal risk assessment and put together a set of guidelines to continue providing care, based on the recommendations from the CDC, FDA, Illinois Department of Public Health (IDPH), and the ASRM/SART. 

IHR will resume all fertility services from Early May 2020. This includes:

• Diagnostic tests, including ultrasounds, blood tests, 3D Hysterosonogram, HSG, and semen analysis.
• Induction of ovulation and IUI treatment.
• IVF treatment to  freeze all embryos with or without PGT.
• Fresh and Frozen Embryo Transfers.
• Fertility Preservation (Egg Freezing).
• Mock embryo transfer cycles for ERA testing.
• Reproductive Surgeries: Operative Hysteroscopy for polyps, adhesions, or fibroids, Ovarian Cyst Aspirations, and Operative Laparoscopy. Special procedures were developed and implemented at the surgical center / hospital and patients will receive the appropriate instructions as needed.

How was this risk assessment carried out?

A formal risk assessment was completed for IHR that included identifying predictable risks associated with patient care to assure safety for patients and staff. We weighed the time sensitive nature of infertility management and age effects on the prognosis with the risks of infection to patients and staff.

IHR is following several risk mitigation protocols, including but not limited to:

• Front desk will document a daily pre-screen for symptoms when calling to confirm appointments.
• Patients and staff will be screened upon arrival for symptoms and temperature daily, and a temperature log will be maintained. 
• Patients will be asked to come alone, unless the patient requires assistance and it has been approved in advance. 
• Patients will be asked to minimize exposure to others during treatment cycles and follow social distancing and mask recommendations.

Are there any other steps IHR is taking?

• Masks are required for all patients and staff. 
• Staff will be required to wear clean clothes everyday. 
• Waiting room seating is adjusted to permit seating 6 feet apart.
• All reading materials have been removed from the waiting area. 
• If needed, patients may be asked to wait in their car.
• Patients are encouraged to go up the elevator and down the stairs, if possible, in order to maintain clear entry and exit routes.
• Cleaning Protocol and Cleaning Log will be maintained:
• Staff and patients must properly wash hands upon arrival and staff between patients.
• Staff will repeatedly wipe down door handles and countertop surfaces, waiting room chairs and restrooms, as needed. 
• Patients and staff will be tested for COVID-19 according to guidelines when a reliable test is consistently available to IHR.
• All consults will continue via telemedicine. 

Are there any risks involved in pursuing infertility treatment during COVID-19?

Currently, there is no scientific evidence to suggest that COVID-19 is being transmitted by sperm, oocytes, or embryos, nor that it crosses the placenta. However, some of the potential risks and complications of pursuing care during the COVID-19 pandemic are:

• Risk of infection exposure at the clinic or surgery center during visits for tests or treatment. 
• Patients need to be aware of possible unknown impacts of COVID-19 on the outcome of a pregnancy, and a potential, yet undocumented, increased risk of pregnancy loss. 
• Pregnant women with COVID-19 infection may not receive antiviral medications at this time as it is not known it there is an adverse effect on the fetus.  
• There is still limited access to COVID-19 testing. 
• There is a potential for treatment cancellation due to exposure, infection, unavailability of PPE, or changes in national/local regulations. Cancellations of treatments may cause financial loss and patients will not be eligible for any compensation for services rendered. Some pharmacies are starting to offer some discounts related to such treatment cancelation.

Most importantly, patients need to know that they have the option to postpone treatment, and they need to be provided with opportunities to have their questions answered. Patients will be required to sign a special consent for fertility diagnostic procedures and treatments during the COVID-19 pandemic which addresses all of the above. 

What is the COVID-19 Prescreening?

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. In the past 14 days, have you experienced any of the following symptoms:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

This list does not include all possible symptoms. CDC will continue to update this list as we learn more about COVID-19 (this list was last updated on July 28th, 2020)

All patients must confirm that they were not diagnosed with COVID-19 and to the best of their knowledge they have not been exposed to COVID-19 positive individuals in the last 14 days.

Patients must agree to cancel appointments and to seek medical care with their primary care physician if they have any COVID-19 symptoms, identified to have fever at the clinic, or have tested positive for COVID-19.

What should I know before arriving at IHR offices? 

• Please  bring your own pen to sign in.
• Please bring your own masks. Wearing a mask is required.
• Please ask any person who may be  accompanying you to wait outside.
• Our staff will ask you screening questions and record your temperature.
• If your  temperature is OVER 99.9, we will kindly ask you to leave the office immediately, with no testing performed, and to contact your primary care physician.
• We will ask you to wash hands upon arrival.
• To the best of your ability, please keep social distancing and refrain from touching the countertops of the front desk. IHR staff will wipe them down regularly. 
• Once available, you will be directed to an ultrasound/blood test room. We hope to complete all tests within 15-30 min.

What are your new office hours?

• Office visit hours are from 06:00 am to 02:00 pm. Phone calls are from 08:00 am to 5:00 pm. Hours are by appointment only, and may vary as needed. No walk in appointments will be seen. Please call (312) 288-6420 to schedule. 
• Personal consults with the physicians will be conducted for now only by telemedicine. Both phone and video consultations are available by appointment only. 

IVF Lab

The IVF Lab has revised and adjusted it’s policies and procedures according to the SART/ASRM recommendations and our embryologists are prepared to take care of your oocytes, sperm and embryos, in the safest way possible, without any compromise to the success of your treatment.

Our Physicians as well as the staff of the IVF lab are required to wear a mask and keep social distancing as possible. When you come for an oocyte retrieval or embryo transfer you will not see laboratory personnel as previously, but they will continue to work extremely hard for the success of your treatment.

Future Considerations

• IHR will monitor, reassess and modify clinic operations as conditions change, knowledge of the disease increases, and additional resources to mitigate, test for, and combat the disease become available. 
• IHR will continue to monitor and follow the most recent regulations provided by professional groups and government agencies. 

IHR physicians and staff wish you success with your treatment. Your success is our success. Best wishes and stay safe.

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