Fertility clinics across the UK are now officially closed for treatments. This was of course put in place as a result of the lockdown measures that require all of us to play our part by staying at home and preventing the spread of Covid-19. On this, I stand in full solidarity with the Government and echo the call to ensure that we are testing and protecting our NHS staff and all care workers as they work to fight coronavirus.
However, for the thousands of women and couples facing an indefinite suspension on treatment that may have taken them months or even years to arrive at, the trauma and distress caused simply cannot be underestimated. While I understand the current suspension, we must prioritise the re-opening of IVF clinics and provide a clear exit strategy detailing when and how this is going to happen.
There are a number of reasons for this. There is no evidence that pregnant women are more susceptible to infection from coronavirus and should take different precautions to the rest of the population, and there is currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to Covid-19. Most importantly, for women with a low egg reserve, time really is of the essence, and an indefinite delay could ultimately deny many of them the chance to have a biological child.
Much has been written on the effects of the lockdown on mental health, but this will be multiplied hugely for all women denied access to fertility treatment.
Much has been written on the effects of the lockdown on mental health, but this will be multiplied hugely for all women denied access to fertility treatment. At my clinics we have fielded countless calls from those devastated by an indefinite delay, many with depressive and even suicidal thoughts, whom we have had to refer to mental health departments and counsellors for urgent help. Fertility treatment is a process that can take months or years to reach, and so this wait is adding to an already stressful and overwhelming journey.
I urge our government to prioritise fertility services and allow IVF clinics to re-start treatment as soon as possible. Understandably, some NHS fertility clinics may be required to direct resources to the Covid-19 fight, but independent IVF clinics, including those approved to treat NHS patients, are simply standing still and should be allowed to start helping both NHS and self-funded patients.
As medical facilities, we are well placed to employ social distancing and safety measures. There are already scientific papers being published that highlight how an effective and safe exit strategy can be achieved with suitable safety measures. As medical professionals, we can absolutely achieve this to protect our patients, staff and the public – it is in our DNA.
It has also been stated that IVF treatment is to be avoided to reduce the risk of women being hospitalised through OHSS (Ovarian Hyper Stimulation Syndrome – due to over-stimulation with drugs), which could add a burden to our NHS. I have long campaigned for our sector to adopt safer, lower drug approaches to treatment, and this risk can be eliminated by adopting “OHSS-free” drug regimens and the elective freezing of all embryos. It is also possible to identify women at higher risk of infection and bleeding and adopt clinically proven strategies to avoid complications.
The government lockdowns throughout Europe are already being relaxed in phases. In addition, Germany is continuing with some IVF treatments, while Denmark re-started IVF treatments last week. We can learn and adopt approaches from these countries so that the UK could also follow suit once our lockdown is relaxed. Rather than a total ban on IVF, evidence-based clinical protocols can be used to restart treatment safely and responsibly. This should start with a priority given to women with low egg reserve, who are most at risk of losing their chance to become biological mothers.
There is no equivalent ban on natural conception for the fertile, and therefore the indefinite suspension has left women across the country feeling as if they are being unfairly penalised for their infertility. The World Health Organisation classifies infertility as a disease and IVF is an essential medical treatment for many women. Countless couples, single women and same sex partners need fertility treatments to achieve what so many of us take for granted.
At a time when saving lives is the focus, creating life should also remain important. It is a collaborative process that will require all of us working together – professionals, regulators, professional bodies, the department of health and social care, as well as patient support groups. I urge our government to prioritise this vital service and act to protect women’s health across the UK.
Geeta Nargund is medical director of Create fertility and lead consultant for reproductive medicine at St George’s Hospital NHS Trust, London.