When will WFI resume treatments?

We will be required to undertake a phased introduction of patients into WFI.  Our aim is to contact patients from the week commencing 29th June to start re-engaging our both our IVF and andrology patients into the service.  We have comprehensive lists of all patients that we need to make contact with and our staff will ensure that all patients are contacted in the following weeks.  If you do not receive immediate contact please be assured that we will contact you as soon as we can.

 

What effect has the Coronavirus pandemic had on WFI?

The most obvious effect of the pandemic was that WFI was unable to continue treating our patients. Some were unable to start whilst others had treatments cancelled before they could have an embryo transfer.

The majority of our staff were deployed to other duties in the fight against coronavirus with many only returning to WFI very recently. As a service, we are incredibly proud of the contribution everyone made to fighting COVID19.

Because we had to suspend treatments it is inevitable that we will have a backlog of treatments to work on as we start up. We intend to pick up where we left off as much as we can as we restart and will prioritise those patients who had treatments cancelled or were about to start their treatment with us.

As with the rest of Wales and the UK, we all have to bide by the coronavirus guidance issue to us by government and our professional societies. This has brought a great many challenges and changes to restarting our services. To allow for social distancing we will be conducting most of our outpatient activity in WFI Cardiff with treatments being done at our centre in Neath. We have reconfigured our service so that the majority of our outpatient appointments will be done via secure video conferencing rather than face to face. You will only attend our units to have scans and blood tests as well egg collections and embryo transfers. Despite these and many other changes our staff are determined to offer you the safest possible care and support you throughout your treatment with us.

 

Is it safe to have fertility treatment now?

Coronavirus is still at large in the community and we have designed robust and comprehensive protocols to provide treatment in a way that is safe for you and for our staff. Please be aware that other fertility and pregnancy related services may also have undergo changes due to COVID19.

 

Am I at increased risk of infection because of treatment during the pandemic?

All the patients attending hospital need to understand that they are at increased risk of contracting the infection, although we cannot quantify what the increased risk may be. We are currently not operating under normal conditions and everyone must still adhere to government advice.

Please be assured, we are making every effort to keep you and our staff safe. We have adapted our pathways and practices to minimise the risk. The adaptions include but are not limited to, requesting our patients to:

Abide strictly by Welsh government’s social distancing guidelines before, during and after your treatment. The time from start of treatment to embryo transfer is critical and minimum essential outside contact is advised.

Be tested for coronavirus prior to the start of treatment and prior to egg collection.

Answer a screening questionnaire that will be conducted prior to each visit to the unit.  If your answers raise any concerns or you have any concerns regarding symptoms of COVID19 then as a precaution and in line with recommendations, your appointment will need to be cancelled

Wear a face covering whilst attending any appointment at WFI

Maintain strict hand hygiene

Whilst undergoing treatment we will be advising patients to self-isolate if possible during their treatment cycle and if this is not possible to ensure that they comply with all social distancing guidance
 

Is there a risk to pregnancy?

The present experience with COVID19 is limited and evidence (RCOG - Royal College of Obstetrics and Gynaecology, UK) currently does not indicate that the rate of infection in pregnancy or death is higher but because of changes in immunity during pregnancy, more so towards to end of pregnancy, the severity of an infection may be worse. It is also recognised that there may be a significant cohort of pregnant women carrying the virus who are have no or very minor symptoms.

A recent update to RCOG guidance based on a recent UK based study by UKOSS (UK Obstetric Surveillance System) recognises that most women in the study required only ward treatment and were discharged home well, around one in ten women required intensive care, and sadly five women with coronavirus died. Whether these deaths are a direct result of COVID-19 infection is currently unclear, and these data are likely to be updated in the future. This study also recognises that women admitted to hospital with COVID19 are 4 times more likely to be of BAME background and 1.5 to 2 times more likely to have co-existing medical conditions.

Across the world, emerging reports suggest some babies have been born prematurely to women who were very unwell with coronavirus. In the same study (UKOSS) as above, 27% babies were born premature. It is unclear whether coronavirus caused these premature births, or whether it was recommended that their babies were born early for the benefit of the women’s health and to enable them to recover. The study also states that 2.5% of babies were found to be positive for SARS CoV2 within 12 hours of birth. It therefore possible that the virus can pass from the mother to baby in the womb or during delivery.

Currently there is no definite evidence of an increased risk of miscarriages or abnormalities in babies. However, data is very limited and the evidence is evolving, so risks cannot be confirmed, quantified or ruled out at the present time

 

Should anyone consider delaying fertility treatment?

Everyone is different. There may be factors in your medical history that prompt you to consider delaying your treatment.  We will be on hand to give you as much information as we can to help inform your decision as to whether you want to undertake treatment.

 

How will WFI be minimising the impact of IVF on other NHS services? 

All IVF centres that reopen have a duty of care not to allow treatment to impact negatively on the wider NHS. WFI will carefully consider common side effects of treatments such as ovarian hyperstimulation syndrome (OHSS), which, in a very small number of cases, can result in patients being admitted to hospital for observations and, occasionally, treatment. Much less often, fertility patients could also be admitted to hospital because they have an infection after egg collection or because of an ectopic pregnancy. WFI will also carefully consider any underlying medical conditions (known as co-morbidities) before advising on treatment.

 

Will everything be safe in the laboratory when you reopen your clinics?

We always take every care to look after your valuable eggs, sperm and embryos, and we have never seen an instance of cross contamination in any of our laboratories – even though some viruses are known to be present in body fluids like semen.

 We are not complacent and will always be cautious in our laboratories and wider clinics, so we are confident your embryos are safe, and are safe for your treatment or to freeze and store. We are also confident that our staff are safe when they are working behind the scenes to help you grow your family.

 

What happens if I test positive for COVID-19 during treatment?

If you test positive, we will need to cancel your treatment. If you develop symptoms after egg collection but before embryo replacement, we will ask you to freeze all of your embryos and have an embryo replacement once you are fully recovered. To protect all our patients and staff, we will not treat anyone with an active COVID-19 infection until they are fully recovered.

 We are minimising the possibility of patients developing COVID-19 during treatment by screening everyone for symptoms before visiting our clinics, and by conducting COVID-19 tests. By taking the COVID-19 test before treatment, you can feel confident in starting your treatment and then take informed lifestyle choices to reduce any possible risk of becoming infected while you are having treatment.

 

What emotional support are you offering patients in the meantime?

We know that struggling to conceive is emotional challenging, and that many patients feel their anxiety about fertility treatment has been amplified by the current situation. We want all our patients to be able to access much-needed support during this truly difficult and uncertain time. As always, counselling is free and available to everyone at WFI.

 

Where can I get further information?

 

https://www.hfea.gov.uk/

https://www.hfea.gov.uk/treatments/covid-19-and-fertility-treatment/coronavirus-covid-19-guidance-for-patients/frequently-asked-questions-for-patients-on-coronavirus-covid-19/

https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health/

https://www.britishfertilitysociety.org.uk/2020/05/01/position-statement-on-the-resumption-of-fertility-treatment-in-the-uk-during-covid-19-pandemic/