Implications of COVID-19 on fertility treatment

Absolutely, this is the best time to start preparing for the reopening, as we’re all aware it may take quite a few weeks for all the tests to be completed before IVF. If an issue is identified then, the treatment may be required f. e. some vitamin deficiency or some thyroid or hormonal problem, that needs to be corrected and so forth. So start talking to your clinic team now, just start making a plan, asking questions, getting answers, making a plan, understanding a situation and also getting all the energy you need, not just physically but also emotionally and spiritually. This is the best time to use the lockdown as an opportunity for empowerment and preparing yourself for the next step.

I don’t know what is the answer. I hope there’s going to be a vaccination soon, this is not a 100% certain. The word has not discovered vaccines for every single disease, f.e. there is no vaccine for HIV, hepatitis C, and there’s no vaccine for SARS etc. , so it’s not certain that the vaccine will be available anytime soon. In the last couple of months, all of us, in the medical profession we’ve been under a heavy scientific bombardment as to what is the effect of this new situation into our specialities and our everyday practices. We don’t know the answers, I don’t know how it will affect the treatments. I would hope that vaccine is similar to the seasonal flu vaccine, hopefully, it will be available before the end of the year, but even if it’s available at the beginning of next year, that’s still good news, and that will transform the pandemic into an epidemic.

I am afraid it is another I don’t know. I don’t think this is an issue, definitely in our clinic, we haven’t come across here so we will have to discuss it. In general, the feeling is that we’re partners in this amazing loss, so the general feeling of the clinics is that we would try to be as understanding as possible. However, one has to realize that apart from the immense psychological stress of most patients, families, siblings and carers, there’s been an amazing emotional and psychological and also financial stress on clinics as well. This situation is not nice to anyone, and I don’t think anyone has escaped any of those consequences. I understand that all clinics have a lot of understanding, and we’re very happy to discuss in individual situations, so there are no concrete decisions in place.

Sure, I mean in our clinic, my team and I, we’ve always been traditionally offering free online consultations to our patients. Free initial Skypes are still available. We also offer proper full online consultations for patients who wish to get on with their treatment without initial appointments. I think most clinics are doing the same, there’s a lot of work that could be done online, and I encourage patients to take advantage of that.

It depends on the type of treatment and depends on individual requests. Since the borders will not open before the 15th of June, we have prioritised all the patients who had to cancel because of COVID-19, they will be on top of our priority list, so we’re hoping to work with the local patients, the Greek patients. From the middle of June onwards, we will allow going all international patients, starting from the ones who cancelled the treatment for the planned treatment and then going further to the ones who are 48,49 and so forth. A good piece of news is that, although the age limit in Greece like in most European countries, is 50 for the female partner. We had a letter issued by our regulatory body in Greece that this limit could be extended to 50 plus a few months if treatment has been cancelled because of COVID-19. I think this is only the beginning because there’s a lot of talks in Greece in the last couple of years, to extend the upper limit for the patients to the age of 53. And, to answer your question, if you would require egg donation, and if you would have standard characteristic requests, then the normal egg donation waiting list is no longer than 6 weeks.

It depends on individual countries legislation. The institution in the UK is the HFEA. In Greece, we have a similar institution which is in line with the European Society of Human Reproduction. A related body of each country has the absolute responsibility to decide on timings and decide on conditions under which we reopen, and the General Medical Council of each country has a huge say in this.

I would hope that no donor and no patient would be misdiagnosed as negative, and I would be quite confident in that. I mean, at the moment in Greece the overall case rate is 1 in 300, so there are about 3,000 declared cases, even if the actual cases are about 30,000 that’s about 1 in 300 which is very low, however, if we will be also performing the PCR, which can be very accurate, even in a simplification, I think the absolute chance is extremely slim if not non-existent.

I wouldn’t worry too much about it, because Greece and the UK have very strong ties. The governments are communicating and collaborating and so forth, and Greece has been the first country that declared that there is not going to be a difference in the status of either Greek citizens in the UK or UK citizens in Greece and so forth. With regards to IVF and egg donation treatment, there will be no effect whatsoever. The only slight issue may be in the case in which embryos or genetic material needs to be transferred between the countries, as you probably know transportation of genetic material, so if you have sperm or embryos in the UK and you wish to transfer them before Brexit, the official Brexit, then within Europe, you don’t need any special license, so you do that as if you’re transferring between a London clinic and the Manchester clinic. After Brexit, we would need to have a special license by the authorities, but that again shouldn’t be an issue.

As I said before, there is a likelihood that some sort of testing might be required before you travel and there’s a lot of talks between the governments, at the moment, before they allow international travel, so that would be either PCR antibody testing. Once someone has landed and they are attending for treatment, ideally I would want you to do PCR before you start treatment and one before the egg collection or the embryo transfer. Because of the cost implications, we are now in discussions with our scientific authorities, and with the scientific board of our hospitals, in order to identify which is the best time to do it. I think, at the moment it seems that the best time to do the PCR testing, is just before the egg collection, results come out in about 12 to 24 hours. Maybe, the day of the trigger might be the ideal time. PCR testing is maybe valuable for asymptomatic patients. If somebody has symptoms, they would definitely have the full check, the antibody screening and the PCR testing, and if there is any suspicion, the treatment will not go ahead.

If you’re transferring the embryos within the UK, then there’s no deadline, you can do it at any time. My suggestion is that you should trust the clinics involved, so if you’re transferring embryos within UK clinics, just ask the clinic’s, the receiving clinic or the clinic of origin within the European Union, I would do it as soon as possible because it’s going to be much less complex before the official Brexit. Courier companies, they do work as far as I’m aware, again ask for the advice from your clinics, I mean, we all have some associated genetic transportation companies, and you can find them on the Internet as well.