The Coronavirus

Keeping your dreams alive

The coronavirus pandemic has introduced a significant degree of uncertainty into our daily lives (see our recent blog). What has not changed are your dreams of having a family. ARMS has implemented the following protocols to provide you with the maximum amount of protection recommended and still allow you to continue pursuing your goals.

New patients

The first step in your fertility journey is a consultation with an ARMS physician. For your convenience and safety, this visit will be conducted virtually using WhatsApp or simply using the telephone. Everything that we normally do during a first visit can be accomplished during this virtual visit. We will review your medical history and make recommendations on how to pursue appropriate diagnostic testing and treatment.

Follow-up visits

All follow-up visits will be conducted virtually using WhatsApp or simply the telephone. During these visits we typically review past tests or treatment and discuss plans for the future.

Office visits

If you feel healthy and are without symptoms, you may continue pursuing your dream of a family. We have instituted policies that will minimize your risk of contracting an infection while in our office.

Treatment

We are a highly successful practice. This means that when we treat you, we need to plan for what happens when you get pregnant. The question now is, “How is that planning impacted by the coronavirus pandemic?”

IVF with “freeze all” policy for embryos

First of all, depending on what treatment you choose and where you are in the process, it is quite probable there are things that need to happen before you actually get pregnant. Patients who are interested in doing an in vitro fertilization (IVF) procedure can proceed with this treatment despite the coronavirus. This is because we practice a “Freeze All” policy, which means that we create the embryos, grow them to an advanced stage called a blastocyst and then freeze them. This is because studies and a review of our own experience has shown that pregnancy rates are highest using this approach. The result of this approach is that there is a separation in time between when the embryos are created and when they are transferred.

Embryo transfer & egg freezing

At this point, our normal process of embryo creation and preparation for embryo transfer is likely to place an embryo transfer after the expected time of the current precautions against coronavirus infection. If those expectations are prolonged, the embryo transfer can simply be postponed further. For patients who need to freeze eggs, for the past two years ARMS has been recognized as having the highest success rate in the nation at one of the largest and most successful egg banks in the world, Donor Egg Bank USA. This treatment can be pursued with confidence at ARMS during this period.

Continue preliminary fertility preparations, but postponing pregnancy during the coronavirus outbreak

Postponing getting pregnant until the risk of contracting the coronavirus has decreased is advisable because not much is known about the severity of infection during pregnancies. Other respiratory infections such as the common flu are often worse during pregnancy, including a higher risk of death. Preliminary data on the coronavirus suggest that the severity of illness does not increase in pregnancy, but there are not yet enough reported cases to draw definitive conclusions.

As a result, ARMS is recommending continuing preparations and preliminary stages of advanced treatments, such as egg retrieval and embryo creation. When it is time to consider proceeding with a procedure to actually conceive in a given month, consideration should be given to the availability of the vaccine and the level of infection in the community. For patients requesting IVF treatments, we have made special arrangements to protect you from the consequences of a cancellation of your cycle due to your illness, ARMS staffing shortages, or government mandates that force us to close the office. There currently is no restriction to proceeding with an embryo transfer or an insemination. It is ultimately a personal decision between you and your doctor. The following bulletin from the American Society for Reproductive Medicine is helpful to review before making a decision.

Staffing

We have confirmed that all of the outside entities that support us in providing care to you such as anesthesiologists and registered nurses are continuing to provide services during this time. At ARMS we anticipated the coronavirus situation and obtained appropriate CDC recommended personal protective equipment (PPE). We have approximately an 8 week supply of these products, which will hopefully get us past the current shortages and hopefully the infection in general. In order to protect critical staff from infection and therefore the inability to provide services at ARMS, we are able to provide them with this equipment to mitigate the risk of obtaining an infection while at ARMS.

Patients

Our infection control policies minimize the risk of contracting an infection at ARMS. Of course they do not protect our patients from contracting it elsewhere and then, upon the development of symptoms, needing to cancel their treatment. This makes it incumbent on us that any treatments we initiate at ARMS need to protect you from the physical and financial consequences of cancellation of a cycle at any point in the process.

Physical consequences

ARMS has been a leader in the development and implementation of treatment protocols that would make your treatment safe regardless at what point in the process your treatment would be cancelled.

Financial consequences

If your cycle is cancelled at any point in the process because of your illness, ARMS staffing issues or government mandates, the financial consequences of use of medications or services at ARMS will be absorbed by ARMS and its partners.

Services rendered by ARMS

If your cycle is cancelled for the above reasons, you my reinitiate a cycle with no additional payment to ARMS.

Medication costs

If you obtain your medications at our recommended sources and your cycle is cancelled for the above reasons, we will replace the medications we have documented that you utilized at no cost to you.