Fertility choices, the holidays and COVID-19

I had just arrived back from a medical mission to Africa where we set up a cervical cancer screening program for women in a rural area of Africa and young women rescued from the sex trafficking trade. While we were there the world blew up with COVID-19. It was early March 2020. My family almost did not make it back as our flights were cancelled and countries were locking down. It was my first day back at work and I was meeting with a patient who had done everything she could to have a successful pregnancy and had just suffered her second failed embryo transfer. That same day, the American Society for Reproductive Medicine (ASRM) recommended all infertility clinics adhere to a policy which 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. Still a little jet-lagged and not exactly sure what to counsel her, I recommended that she not have her transfer until “the coronavirus infection level had dropped to pre-pandemic levels.” She was very discouraged but agreed to the plan.

Trusting fertility patients

The encounter was unsettling, and I soon made the realization that this was not really my decision. I have always tried to follow a policy that if I want my patients to trust me, I need to trust my patients. They are the ones in charge of creating their family. My job is to be honest, give them the best information I can and the best treatment I can and let them make their own choices.

I soon put together the limited information available about pregnancy risks and COVID-19 and began giving patients the option of proceeding with treatment or waiting until the pandemic was over. I was surprised to see that with few exceptions, patients were choosing to proceed with treatment. Most patients would share their reasoning for proceeding and usually behind it all was a strong feeling that it was the right thing to do and that they had faith that everything would be ok.

Importance of family

Quickly something very unusual began to happen. My practice became busier than it has ever been! My schedule was booked out and I could barely keep up with the people wanting to move forward with their plans for a family despite the waves of COVID-19 spikes. In addition, a higher percentage than ever before were being successful, including the patient I met with on that first day back from Africa!

I often wondered what was going on? Usually when the future looks bleak, infertility treatment is the first thing to go as people focus more on feeding their family and paying their rent than having children. Not this time. Something was different. It is probably a combination of many things, but I like to think that it is because, as we have collectively faced such a difficult year, we have become more aware of what really matters in our lives – Family. When disease, violence, and uncertainty raged around us, we turned to each other and the hope that a single baby can bring.

At this special time of year, we remember a young couple that had to make difficult choices and ultimately take a difficult journey over two thousand years ago. They arrived in a crowded town that had no rooms for them. They ended up in a stable where they were forced to bring a little baby into the world under the humblest of circumstances. But on that special night they and some shepherds came to the realization that when God wants to fix something, he usually sends a baby.

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