Objective
The COVID-19 pandemic is an unprecedented health crisis that has affected IVF practices globally and recommendations by local health authorities and reproductive medicine societies vary widely. Hence, the purpose of this study was to compare regional responses to the COVID-19 pandemic among infertility clinics and gain insight into the extent of practice modifications.
Design
Self-administered online survey.
Materials and Methods
Between March–June 2020, a multiple-choice 11-question survey was distributed through the IVF-worldwide online network (https://ivf-worldwide.com/survey/infertility-treatment-during-covid-19-pandemic.html). Responses were screened for completeness and duplicate clinics.
Results
Responses from 299 clinics representing 228,500 IVF cycles were received, with respondents distributed across all 5 continents (34.8% Europe, 25.1% Asia, 18.1% South America, 15.4% North America, 5.3% Africa, and 1.3% Australia/New Zealand).
86.6% of respondents reported that their reproductive medicine society released pandemic-specific recommendations for a complete (53.8%) or partial shutdown (23.7%), which was higher than limits imposed by health authorities (32.5 and 19.7%, respectively). With respect to changes in IVF case volume, 76.6% and 80% of clinics reported a ≥75% reduction in fresh and frozen cycles, respectively, while 73.6% reported a ≥75% IUI case reduction. 3.7% of clinics reported no reduction in case volume.
Among clinics that stopped or reduced services, 69.5% cited government-mandate as a reason for closing, 31.1% due to employer concern for the health and safety of staff, 35.4% due to patient concerns, and 34% due to concerns regarding possible effects of COVID-19 on pregnancy. Lack of PPE was only acknowledged by 5.3% as a reason for closure. The most cited provisions planned prior to re-opening include increased hand sanitization (87%), spacing between appointments (86%), COVID symptom screening (84.3%), and temperature checks (71.6%). Among clinics that continued operations, the most cited provisions that were implemented included hand sanitizing (63%), symptom screening (60.4%), spacing between appointments (56.9%), and temperature checks (52.7%). Interestingly, 37% of clinics that stayed open did not report additional hand sanitization measures and 39.6% did not screen patients and staff for COVID symptoms.
Finally, 93.6% of respondents supported additional provisions for patient counselling including risk of cycle cancellation if a patient or provider tests positive for COVID-19 (85.6%) and possible risks of COVID-19 on adverse pregnancy outcomes (69.9%), miscarriage (67.2%), and fetal anomalies (58.9%).
Conclusions
COVID-19 resulted in a substantial reduction in IVF cycles, despite significant implications for such a delay on the probability of having a child. Data suggests that there remains room for improvement among clinics that remained open to decrease transmission using accepted procedures. Interestingly, clinics that stayed open were less aggressive at implementing protective provisions than clinics that closed.
P-933 3:30 PM Wednesday, October 21, 2020