Thankfulness for Our Fertility Patients in the Time of COVID-19

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Our thankfulness is based on your beautiful voices and twinkling eyes that tell the story of human triumph, giving us at RSC purpose and hope

Diverse group of female fertility patients, who have our thankfulness | Reproductive Science Center | Dan Francisco Bay Area CADear RSC Family,

At this time (and especially when we have a little extra time at home during COVID-19), I love the opportunity to think about the past year and about all that I am grateful for. You, our fertility patients, come to the top of the list of our thankfulness!

Why, you may ask? Well, it is you that gives us purpose and hope. It was your desire to keep going that motivated us in the darkest days of COVID-19. And it is your beautiful voices and twinkling eyes that tell the story of human triumph despite tragedy.

At RSC we have always felt it was our supreme duty to continue to serve infertile and not-yet-fertile patients no matter the challenge. The challenge was (and still is) formidable – a virus that none had seen before and that moved in mysterious ways. And so we met, and met, and met again to come up with a strategy that would allow us to continue to serve you and keep you safe.

Mother kissing little baby at home

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We’ve seen some of our best pregnancy rates during the coronavirus pandemic, more cause for thankfulness

It has worked! And we have seen some of our best pregnancy rates ever, which has added to our thankfulness. We have begun to study the reasons why. Was it that people were more focused on their personal health? Less junk food from restaurants? More time to sleep? Less stress from the daily commute? Was it that we shored up protocols and cleaned and cleaned and cleaned again?

It is still too soon to know for sure, but we are happy to see the positive hCG (human chorionic gonadotropin) reports daily and to know that means nine months from now – likely when there is a vaccine – those babies will be born, and families will celebrate. And there’s no better reason for thankfulness than that.

And so, you may ask what the new guidelines from Governor Gavin Newsom will mean to your care? And what the new studies are showing about COVID-19 in pregnancy? Both are areas we promised to update you on as the information became available.

As for RSC’s COVID-19 guidelines

We will continue to see patients and perform fertility treatments like we have the last eight months.

That means:

  • Only the patient will be allowed into the office, masked and with hands sanitized (no partners of family members).
  • Temperature checks and questions about risks will still be implemented.
  • Appointments will be kept short when in person and done by teleconference as much as possible.
  • All county guidelines on occupancy rates will be followed.

As much as possible, staff will be working remotely to minimize exposure to patients.

  • Staff will be screened and tested as per county and CDC guidelines.
  • Out of region and out of state travel will be discouraged or delayed.
  • We have learned that this works to stop the spread of COVID-19!
“All this new data points to the fact that it is acceptable to allow and even encourage women to conceive during this time.”
– Dr. Mary Hinckley

Thankfulness for the studies on COVID-19 and pregnancy

Data continues to emerge, especially from the United States. While we expected a number of studies on COVID-19 exposure in early pregnancy to surface from China, we have not seen that. Instead, what has guided our decisions have been the studies published on women who tested positive for COVID-19 in peer-reviewed journals. We recognize that there are many more pregnant women who have had the coronavirus and been asymptomatic and therefore are not included in the data.

  • The majority of studies have been reassuring and show no greater risk of severe COVID-19 than the general population.
  • The risk factors for COVID-19 in the general population appear to be the same as for pregnant women – asthma, hypertension, diabetes, obesity, and being a member of a Black or ethnic minority.
  • We have not seen any increase in first trimester miscarriages, but the lack of data cannot be assumed to mean that there is no effect.
  • One study out of New York showed a higher rate of hospitalization and ICU admission for pregnant women with COVID-19.
  • The vast majority of maternal deaths from COVID-19 (124 deaths out of the 146 TOTAL deaths of pregnant women thus far reported) has come from Brazil in a lower socioeconomic group, with what appears to be limited access to ICU care or ventilators.
  • The chance of passing on SARS-CoV-2 in utero to the fetus has been almost zero. However, a few case reports have suggested it is possible.
  • Neonates have almost uniformly done well if SARS-CoV-2 was identified. There have been only 3 reported deaths, but the cause of death was unclear from the studies.
  • Some data out of Europe has shown that there are fewer preterm deliveries, perhaps due to a more sedentary lifestyle and lower work-related stress. This is an unexpected bonus!

Many women can conceive now, some may want to wait or do egg freezing

All this new data points to the fact that it is acceptable to allow and even encourage women to conceive during this time. Care should be taken to avoid getting COVID-19 as much as is reasonably possible. For those with underlying health risk factors who are able to wait to conceive, it may be preferable to do egg freezing or embryo freezing in anticipation of a day when the risk of contracting the virus is less or a vaccine has been made available.

Our stance on the COVID-19 vaccine

And so, this may lead you to ask what RSC’s stance is on the SAR-CoV-2 vaccine. Well since we don’t even know which vaccine will be offered and when, it is a little premature to have a medical stance at this time.

However, just as with all vaccines, we must weigh the risk of contracting the illness against the potential risk of the vaccine. Since the early data released to the public show the vaccine to be highly effective (70%-94%), we only need to better know the risk of negative consequences of getting the vaccine. Hopefully, that will be forthcoming.

I hope that this update has come at a helpful time as you navigate your next steps in your fertility path. We are here to answer questions and help you solve problems. We have so much thankfulness for your loyalty and trust in us.

Sincerely,

Mary Ramie Hinckley, MD, on behalf of Reproductive Science Center

Pregnancy and COVID. Elizabeth A. N. Wastnedge, Rebecca M. Reynolds, Sara R. van Boeckel, Sarah J. Stock, Fiona C. Denison, Jacqueline A. Maybin, and Hilary O. D. Critchley, American Physiological Society 20 NOV 2020.