International patient process during COVID-19 safety measures

We are resuming all the treatments now that needed to be put on hold, as it was advised and we are contacting all of our patients and going ahead with all the treatments. For people who have not yet started treatment, it is possible to book an online consultation with us and start with the pre-diagnosis, start preparations and start the treatment already and so hope to be able to come to Spain in a very short term.

From the perspective of patients who need to go with safety measures, 4-5 aspects need to be taken into account. The first one is if you’re about to start treatments, we will check this together with you that you do not have any symptoms at present. If you do have symptoms, we will have to check with a PCR test that it is negative. If your PCR test is negative or you do not have any symptoms and we can start the treatment, it is important that you then monitor your own condition, so that you can proactively let us know if there is any change in your condition, and we can take the necessary measures. It is also important to foresee if you can do a PCR test where you live and if not, tell us in advance whether this is the case. We will see if we can send you a kit if we have the contacts which we are working on and if not, we will together redesign your strategy so that we can make it work and you can take the test here. Then you have to take into account that every time you come for a visit to the clinic, you have to be prepared, we will remind you about it, a nurse will call you but you will have to prepare for the visit by wearing the mask, wearing gloves, being on time, this is very important to minimize everyone’s presence, and to be able to be efficient with the procedures and to maintain the distance and once you’re at the clinic you need to be aware of not touching unnecessarily surfaces f.e. Those are the things that we have to to take into account from the perspective of the patient and lastly it is important that once you start the process, you also maintain as best as possible all the safety measures wherever you live, so distancing, wearing masks when you go outside, it said also said to avoid coming into contact while on the process.

For the preparation of the treatment, from our part, you can do all the necessary tests at your home country. The test, that we usually need is pretty straightforward blood examinations such as serologies and blood groups and preparation for the surgery sometimes karyotype, and in specific cases, we might ask for more specific blood testing and to assess the uterine factor, we also quite often request for a pelvic MRI and a hysterosalpingogram. If you can do all of these tests at your home country, then we are happy with that, and we will only need to get the results back from you.

In most cases, two to three times will be enough up to the embryo transfer, but it will always depend on each strategy, whether we need to repair the uterus or to do any tube burgery. In that case, it might take one or two more visits, but I would say on average two to three times would be enough in most cases.

We have at the moment two addresses here in Valencia for accommodation for our patients during the state of alarm. So we will provide patients with this contact and address and help whenever necessary to make a booking, and there should be coming more of those. We are associated with sanitary clusters, and we try to keep informed of any advances with regards to travelling, flight and accommodation.

At this moment, yes, we are issuing certificates to all the patients that need to come to the clinic. In this certificate, we explain the medical reasons, and we highlight the need for the patient or the couple to come, to the clinic. Indeed, we cannot assure patients that this will be valid in every situation because part of these requirements also depend on the Home country legislation or the requirements that they need. It would be helpful if patients can gather some information in advance on what it is that they exactly need but we provide this certificate and we can make any amendments necessary, that is not a problem.

We are relying on the PCR test, which is the test that tells us if a person is infected now. If you can first monitor if you have any symptoms, then it would be helpful to do the PCR test and to confirm that it is negative before travelling. If you are thinking about whether there is a requisite of being tested before travel, I would have to check that, as far as we know, it is not. For our patients abroad, if they are able and this PCR test is accessible to them, then it would be helpful to do it beforehand to make sure that that there is no problem.

The PCR stands for a polymerase chain reaction, and it is a type of test where the information shows if someone is infected at present, and this is why we rely on this type of test. There are other tests to check for antibodies, but since that may take a while before a person can make antibodies and we need to ensure that someone is not infected while they are going on treatment or if they are about to go for the procedures, will rely on this test. So this test gives the results in 48-72 hours and it will tell us whether someone is infected, at that moment.

Indeed, it is a difficult question because it is something that we don’t have clear information on. This is up-to-date information from yesterday. We are associated and in contact with several sanitary clusters. There has been a study of about 600 flight planners, and the expectancy is that by the end of May some flights may restart and probably June, July we might be at a level of good accessibility of flights. It is also a good idea to start any preparation now because, by the time we need to get going, the expectancy is that there would be flights and that people will be able to fly and as you know these are also medical reasons. As for the frozen eggs, I think you mean frozen embryos that you have to transfer from the UK, several conditions have to be met to accept frozen gametes from another country. At present, I’m not sure whether there is any specific ban or any specific requirement during the COVID-19, I think this is something that we can look up for you, so feel free to contact, and we can look into this.

Getting medication in your home country will make it easier for the process, in the sense that you do not need to travel to Spain before you start the treatment. There are a number of possibilities, and there’s also the possibility of getting them through some providers that are specialized in getting medication for IVF patients. So, if you want me to get this information, you can contact us through the information on the website and I’d be happy to send you any specific addresses and contacts that we know help patients when the regular way through the doctor proves to be a little bit more difficult.

From the beginning of the stimulation, if we need to treat a uterine factor, we might be thinking at a time range of baby between 4 to 6 months. When we have a uterine or a tubal factor, we need to take care of to ensure that the ‘house’ is as prepared, as perfect as possible before an embryo transfer. Then this is what we should be thinking of. It will depend on each case, sometimes we might speak of 3-4 months and then sometimes we need to extend it to 5 or 6 months.

There’s no scientific evidence that the virus can inhabit in the embryo. The babies that have been born from mothers who had the COVID-19, there was no trace from the placenta to the embryo and there was no trace in the amniotic liquid or the umbilical cord, so therefore as far as the scientific evidence goes it is not necessary to test embryos for COVID- 19.

EMMA test that will really depend on each particular case, and it will be the doctor that will have to assess whether it is necessary to do it or not.

We would have to follow up on your medical condition. If you were to contract the virus on the plane normally, it takes a couple of days until the symptoms would show and if you think that there has been any contact which is one of the questions on the questionnaire or that something has happened around you that makes you suspect or think, we can always check but remember that before we go ahead with the actual procedures, we will have every patient tested so nobody will go ahead with any of the procedures, that I mentioned earlier egg retrieval or an embryo transfer or a surgical procedure without a negative PCR, so we will always check up to the last moment and this way everyone will be reassured that we’re doing the things as best as possible, and we are sure to preserve the safety of everyone.

We perform a PCR test COVID-19 for medical staff if necessary and always when they show symptoms, so like I said our first filter is a clinical symptom, checkup every day. We know that 82% of infected patients will show symptoms, and if we need to perform PCR tests because of the showing symptoms, all of the tests that are necessary will be performed. I am not someone who is an expert in all the lab procedures, I cannot explain to you exactly what these safety measures are for biological materials of HIV-positive patients. I can assure you that we can treat HIV-positive patients. We always have to look into every personal file, but this is possible, but I will be more than happy to provide you with every specific measure that our lab performs in such case, so please send us an email so that I can fully answer your question.

No, fallopian tubes cannot be replaced, I am afraid.

In most cases, we’re talking about visits that are roughly about 2 to 3 days. In some cases, maybe a little bit more f.e. the ones related to the transfer may be between 3 to7 days because we might need to see you at the time that you might be prepared, but sometimes we need a couple of days longer, but this is roughly what you would have to think about.