About more than 5 lakh couples opt for IVF, but is experiencing the procedure safe during this pandemic? We talked to two known IVF specialist to know their views.
Approximately 30 lakh people in India undergo infertility treatment annually, and of these, about 5 lakh couples opt for IVF. However, The COVID 19 pandemic has given rise to innumerable apprehensions of the effect of the virus on fertility.
Although there is no specific restriction by the Government of India on fertility /IVF treatment, many couples opt to postpone the treatment. Many hospitals opt to reduce the “elective “ cases to provide the extra workforce for use in the pandemic.
Various studies from the West conclude that the COVID-19 virus does not affect IVF outcome. All IVF processes must be initiated by proper screening, and the centres must follow risk mitigation methods to prevent infection transmission.
A careful balance must be maintained as suspension of treatment can result in psychological distress in some women and COVID-19-related anxiety while keeping the policy of reducing “elective cases” and avoiding overburdening the healthcare system.
We contacted two IVF specialist to get some more information about the same. First, we talked to Dr. Arati Rama Rao, a consultant - Ivf and fetal medicine in Manipal Hospital Whitefield. Another is Dr. Arveen Vohra, one of the popular infertility specialists in Bangalore working in Milann - The Fertility Center.
IS IVF SAFE DURING COVID 19 SITUATION GOING ON?
Dr. Arati Rama Rao: Currently, there is no evidence to conclude that COVID-19 negatively affects the outcome of IVF treatment or suggests that the virus can be transmitted through the procedures of Assisted Reproduction.
While undergoing IVF is safe during the COVID-19 pandemic, the fertility centres must follow all the COVID-19 protocols and guidelines for managing the patients. Because of lockdown, several hospitals have chosen to discontinue IVF treatment to prevent further stress on the healthcare system.
Dr. Arveen Vohra: This pandemic caused by the SARS CoV 2 virus stopped the world last year, and the impact of Covid 19 on physical and mental health has been extraordinary.
All fertility centres across the globe had shut down during the beginning of this Sars-Cov-2 or COVID19 pandemic last year as this was a new condition of which we had no scientific knowledge.
Another debatable reason was that fertility services were not considered essential even by fertility societies all over the world. This added stress for patients is already suffering from infertility because time is crucial for fertility treatment.
As the research data started to come in, it was understood that it was safe if IVF was started in the select group of patients with low-risk factors or the ones who really were pressed for time, such as women with advanced maternal age, low egg reserve and women with conditions known to decrease fertility like endometriosis. In fact, most couples who turned to IVF had already endured a huge emotional turmoil due to infertility.
With COVID-19 pandemic added on top, it became more overwhelming for such couples. We cannot forget the impact on the mental health of couples who are undergoing treatment for fertility issues. And a lot of them, though because of young age or other factors, would be able to endure the stress of infertility, but the add on of COVID-19 actually made it challenging. A patient's mental health also has to be considered while offering or denying. And most of the patients in the reproductive age group are not in the high-risk group.
With the knowledge available today, there is no need to delay IVF treatment just because of Covid 19. There have been many recommended safety measures that have been implemented in IVF clinics like minimising contact by teleconsultations. Most blood investigations are also being offered at home itself. Even if a couple is going to the clinic, the only important parameter is ensuring that you're practising social distancing masks and sanitisation. And of course, the clinics also have to be responsible for sanitisation and air cleaning techniques, both in their outpatient and inpatient operation theatres and labs.
WHEN IS THE RIGHT TIME TO CONCEIVE THROUGH IVF?
Dr. Arati Rama Rao: There are no current guidelines that restrict you from taking the infertility treatment during this pandemic. However, you and your healthcare facility must follow all the COVID-19 protocols. There is no need to discontinue your treatment after having the COVID-19 vaccine.
The chance of successful treatment is unlikely to be affected by a short delay, for example, up to 6months, particularly if you are 37 years of age or younger.
However, delays of several months may affect your chance of success once you are over 37, especially if you are 40 years of age or older. Further, there is no effect of COVID-19 on IVF outcome. Thus, you can initiate your IVF treatment when you feel it is safe to move out and your clinic has all COVID-19 precautions in place.
Dr. Arveen Vohra: I think every couple has the right to procreate, and whenever you think you're ready to have a baby, that would be the right time. The existing covid 19 situation is no reason alone to postpone having a family. Many spontaneous conceptions had happened in the last year for couples who were already undergoing fertility medications when the lockdown started. And that tells us that life always finds a way.
A couple of mental health also needs to be considered while deciding treatment strategies. So if there are no risk factors, I think a couple can continue with their fertility treatment. Where time is of paramount concern like age or low egg reserve and high-risk factors, it's better to collect the eggs and the sperm, make the embryos and freeze them. After covid vaccination, embryo transfer can be planned.
Watch this space; we will update you with more information on the same topic.
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