Mothers-to-be Matter: Learning From Fertility Treatment COVID-19 Policies

Happy Mother's Day Flower WreathWe have heard so many stories about the handling of the current pandemic that we all are getting a little tired of it. As Mother’s Day is upon us, there is one story that needs to be told. Like many other COVID-19 stories, this one is alarming and frustrating but hopefully something that we can learn from.

Infertility care is not elective

On March 17, 2020 the American Society for Reproductive Medicine (ASRM) recommended all infertility clinics adhere to a policy that banned all treatments to assist patients struggling with infertility to conceive except for those who were about to undergo chemotherapy or have their ovaries removed. Essentially the reason given was that the consequences to a mother or her fetus from an infection with COVID-19 are not known and out of an abundance of caution, infertile patients should not be allowed to try to conceive.

This unleashed a dramatic backlash from reproductive specialists around the country who felt that these recommendations compelled them to comply and were extremely paternalistic and completely insensitive to patients who struggle to conceive.

Infertility patients vs. those who have the choice to try getting pregnant

The desire to have a child when you cannot was not felt to be essential enough to allow pursuing treatment. This was by the very society that for years had claimed they supported the idea that infertility is not “elective” but is a fundamental medical problem that deserves insurance coverage, research funding and emotional support.

Opponents of this policy argued that if the pregnancy concerns cited by ASRM were so compelling that it justified completely removing the right to choose to continue treatment or not from the couple suffering from the heartache of infertility, then that same standard should be applied to all people contemplating a pregnancy.

In stark contrast, no policy statement was put forth recommending that all reproductive aged people initiate reliable contraceptive measures to prevent pregnancy. There was no recommendation that all reproductive health care providers educate their patients about the potential dangers of allowing a pregnancy to occur or recommend reliable contraceptive measure be adopted by all of their patients.

On March 30, 2020 ASRM doubled down and did not concede any of the points brought up by opponents of the policy but rather reaffirmed, “all of the stated recommendations of March 17, 2020 as timely and appropriate.…” They attempted to affirm that they did not feel that infertility care was elective but to many this fell on deaf ears because the level of care necessary to assist infertile couples is a far cry from that required in most elective surgeries that were being banned at the time.

The fact of the matter was – and still is – that every argument for not treating infertility patients based on utilization of resources and protection of patients and staff could have been solved in ways other than a moratorium on allowing patients the right to choose for themselves whether to try to get pregnant during the pandemic or not.

Are Infertile couples different?

One of the unfortunate consequences of all of this was the unmasking of a bias held by many, even the very leaders tasked with protecting the rights of couples to pursue their dream of a family: That infertile couples are “different.” The people who decided to impose the moratorium might have a hard time or not be comfortable articulating exactly why they think infertile couples are different but the precedent has been set. They are different. And as such their desire to have a child is not felt to be as compelling as people who are not suffering from infertility or are suffering from other more “important” illnesses.

Well I agree. I agree that infertile couples are different from the fertile couples who were “permitted” to conceive during this trying time. And since it is Mother’s Day, let me focus on my “mothers-to-be” though I believe that their partners also have similar differences.

Mothers-to-be: grieving infertility and the right to try

I think the difference is their eyes. If you look closely, you will see something different. You will see a grief that transcends what those who have not experienced infertility can ever understand.

Research that quantifies grief has shown that a woman experiencing infertility experiences the same “grief score” as a person who experiences the death of a mother, father, sibling or child. Our world leaders have felt that the prevention of the loss of a loved one from COVID-19 and the grief that those that survive experience is worth lockdown policies that will probably cost society over 20 TRILLION dollars.

We will all probably experience the loss of a loved one at least once in our lives. COVID-19 has accelerated that experience for tens of thousands of our neighbors. Imagine the amount of grief an infertile woman carries with her when she has experienced this level of grief month after month for years. I see the eyes of these beautiful women staring back at me every day.

It is inconceivable to me that I would be so presumptuous as to think I have the right to take away their right to try one more time, at the time of their choosing – adding yet another month of grief to a well that must be overflowing.

Mothers-to-be Matter.

They are different, but not in any way that would justify taking from them their right to try. And that is the miracle. That they try. That despite physical, emotional, and financial pain they still try. Because there is something different about cherishing the experience of motherhood. Something selfless, courageous, ennobling and yes, beautiful.

Mothers-to-be matter.

Keeping your dreams alive

ARMS has implemented infection control protocols to provide our patients with the maximum amount of protection while allowing patients to continue to pursue their dream of having a family.

COVID-19 Measures