COVID Update: Treatment

23 March 2020

As the Government escalates COVID-19 to Alert Level 4 restrictions in the community we want to provide as much certainty as we can at this stage.  Below is an update for our patients on treatment next steps.     Endocrinology COVID instructions here. 

New Cycles

  • No new treatment cycles - At this stage we will stop accepting new treatment cycles/ Day 1's - except for fertility preservation before cancer treatment referred by a cancer specialist.

For people who have started a treatment cycle: 

IVF

  • People who have started FSH medications will complete their IVF cycle.  Examples of FSH medications are Gonal F, Puregon, Menopur and Elonva. 
  • People who have not started FSH medications will not complete their cycle at this time.  They should stop taking medications and hold the medication they have left in the fridge for a later date.  They can then phone in with their Day 1, when the Alert Level 4 restriction is lifted.  Our team will be in touch during this time. 

  • We will be freezing all embryos now for an embryo transfer at a later date.  We will adjust your transfer price so there is no difference between your fresh and frozen embryo price.
  • This has also been the approach taken in the UK, Europe and USA

Thawed embryo transfer

  • People who have started Utrogestan or Crinone will complete their embryo thaw cycle
  • If you are on a natural cycle, we will go ahead with an embryo transfer if we have already given a date and time
  • This means we will thaw and transfer embryos in these cycles
  • Other transfer cycles will be cancelled until a later date

IUI

  • We will go ahead with insemination if we have already given you an insemination time
  • Other IUI cycles will be cancelled until a later date

Monitored Ovulation with Clomiphene or Letrozole

  • We will go ahead with a scan if we have already arranged a scan for Tuesday 24th March or Wednesday 25th March
  • Other cycles will be cancelled

What about costs if I have to stop? 

  • We understand that some people may want to stop their IVF or thawed embryo transfer cycle even though we are able to finish it.
  • An occasional person may need to stop because they are unwell. We’ll stop your IVF medications – this is quite safe to do
  • If you stop before egg collection, we will waive the usual costs associated with stopping a cycle. Please store any unused medications in the fridge in case they can be used for your next IVF cycle
  • For patients having a freeze-all due to COVID-19, the cost of the first embryo transfer will be reduced, so the total cost would have been the same as having a fresh embryo transfer.

What about doctor consultations?

  • Our doctors will do consultations already scheduled on Tuesday 24th, unless we make other arrangements
  • We will offer telephone consultations from Wednesday 25th March, but we may have to reschedule existing appointments

What about nursing and other support?

  • Our nursing team will still be available to support you through treatment, although many will be working from home with access to your medical records online.
  • We will be able to answer your questions, get advice from our doctors and arrange any urgent investigations or medical care throughout this time.

What about pregnancy scans and antenatal care?

  • These are essential services that will continue
  • We will contact you, or you can contact us, for details

What are the implications of freezing all embryos?

  • Modern embryology means nearly all embryos grown to the blastocyst stage (day 5 to 7 after egg collection) can be frozen and thawed without any disadvantage
  • Birth rates from thawed embryos are very similar to those from fresh embryos
  • The freeze-all approach is already standard for people who respond briskly to IVF medications or have increased levels of the progesterone by the time of egg collection, being 30-40% of all patients

What happens if I need to stop treatment because I get COVID-19 or become unwell before egg collection?

  • We’ll stop your IVF medications – this is quite safe to do
  • If you are paying for treatment yourself, we’ll discount the cost of the medications you have already used and refund the monitoring fees

What happens if I have been exposed to a person with COVID-19 while I’m on treatment?

  • Please call us for medical advice about your specific situation

What are the risks in pregnancy if I contract corona virus?

  • While little is known on Covid-19 and pregnancy so far, we can expect it to have similar effects as other types of corona virus, which range from the flu to SARS
  • Corona viruses don’t appear to affect the chance of miscarriage, pregnancy loss or congenital abnormalities.
  • While infection from the mother to the baby in the uterus may be possible from a recent case in the UK, evidence from China suggests that it is uncommon
  • Pregnant women who develop Covid-19 don’t seem to be more severely affected than others
  • Corona-type viruses may increase the chance of pre-term birth, so pregnancy women are advised to take extra care to minimise exposure in the last third of pregnancy

Keep an eye on our website for updates!

We are looking forward to being able to offer full patient services again!  Keep an eye on our website, Facebook and Instagram pages for the latest information.

We anticipate being able to start new treatments when NZ goes back to Level 3 or lower.