Coronavirus Covid-19: Statement from ReproMed Group incorporating ReproMed Ireland and Galway Fertility Clinic. Dated: March 15, 2020
Due to the the ongoing Coronavirus (CV-19) pandemic we have taken the decision, in consideration of our medical ethical duties and our social responsibility, to curtail the following range of our clinical services over the coming weeks:-
- We will no longer be starting new IVF/ICSI cycles for the foreseeable future.
- IVF/ICSI cycles currently on stimulation will be brought as far as egg collection and embryos frozen. If the situation changes these patients will be directly contacted by clinic staff.
- We will not be implanting either fresh or frozen thawed embryos to our patients. This is to reduce the possibility that if a woman becomes pregnant with our help she may require hospitalisation in the coming months when the hospitals are expected to be under severe pressure to treat very unwell citizens;
- Or if she becomes very unwell due to CV-19 she may need drugs to treat her which are in fact contraindicated in pregnancy.
- We will not be carrying out partner or donor sperm IntraUterine Inseminations (IUIs) as this could again lead to pregnancy with the above mentioned potential risks.
- Routine diagnostics such as semen analysis, hormone profiling blood tests, endometrial biopsies, diagnostic ultrasound scans.
- Clients attending the clinic for the IVF/ICSI treatment cycle currently ongoing will be asked to maintain a distance of 2 meters from other patients.
- Please do not attend if you feel unwell with Flu-like symptoms.
- Please attend alone for appointments without your partner (unless otherwise instructed), or friend, and without any children (despite childcare issues prevailing).
- Pregnancy scans will not be carried out by ReproMed or Galway Fertility Clinic. Instead they can be facilitated at our sister clinics at BabyScan who will perform the fetal heart viability ultrasound scan for you.
Coronavirus Covid-19: European Society for Human Reproduction and Embryology (ESHRE) statement on pregnancy and conception
In view of the increasing incidence of infection from the coronavirus Covid-19 and widespread initiatives to limit its spread, ESHRE reaffirms its recommendation that Society members follow local and national government advice, particularly national daily advice updates, with compliance encouraged where feasible.
Pregnancy and conception
There is no strong evidence of any negative effects of Covid-19 infection on pregnancies, especially those at early stages, as indicated by the latest updates from the Centers for Disease Control and Prevention (CDC) in the USA and others in Europe.(1,2)
There are a few reported cases of women positive for Covid-19 who delivered healthy infants free of the disease.(3) There have been reports of adverse neonatal outcomes (premature rupture of membranes, preterm delivery) in infants born to mothers positive for Covid-19 during their pregnancy, but the reports were based on limited data.(4) Similarly, one case report has been published of an infected infant, but again there was no strong evidence that this was the result of vertical transmission.(5)
These data, although encouraging, only report small numbers and must be interpreted with caution. They refer to pregnancies in their final stages, but we have no information on the possible effect of Covid-19 infection on pregnancies in their initial stages.(6)
However, in view of the above considerations and the maternal and neonatal outcomes reported in cases of other coronavirus infections (such as SARS), ESHRE continues to recommend a precautionary approach.(7) It is also important to note that some of medical treatment given to severely infected patients may indicate the use of drugs which are contraindicated in pregnant women.
As a precautionary measure - and in line with the position of other scientific societies in reproductive medicine - we advise that all fertility patients considering or planning treatment, even if they do not meet the diagnostic criteria for Covid-19 infection, should avoid becoming pregnant at this time. For those patients already having treatment, we suggest considering deferred pregnancy with oocyte or embryo freezing for later embryo transfer.
ESHRE further advises that patients who are pregnant or those (men and women) planning or undergoing fertility treatment should avoid travel to known areas of infection and contact with potentially infected individuals.
ESHRE will continue to monitor the scientific literature, especially in relation to ART and pregnancy. And reaffirms the view that all medical professionals have a duty to avoid additional stress to a healthcare system that in many locations is already overloaded.
Before attending the clinic;
All patients should follow HSE guidelines and not attend the clinic if they have been to an affected area and are symptomatic. We kindly ask at this time that children not be brought to the clinic for your appointments. For critical appointments patients should bring at maximum one partner/companion. For less critical appointments we would ask that you attend alone. Our team will advise in any case.
Do not attend if you have travelled to or from the affected regions outlined above in the last 14 days
the following regions in Italy - Lombardy, Veneto, Emilia-Romagna or Piedmont
If you have been in contact with someone who has the virus
If you have flu like symptoms such as:
shortness of breath
fever (high temperature)
If you have any other reason to believe you have the virus
Please note the following important information from the HSE;
Symptoms of coronavirus
It can take up to 14 days for symptoms of coronavirus to appear.
The most common symptoms of coronavirus are:
- a cough - this can be any kind of cough, not just dry
- shortness of breath
- breathing difficulties
- fever (high temperature)
If you have these symptoms and have been to a place where there is spread of coronavirus, read this advice.
When you may need to call a doctor
For most people who have these symptoms now, it is more likely to be an infection that is not coronavirus.
You only need to phone a doctor if you have symptoms and any of the following apply to you:
- they are the type of symptoms you would usually contact a GP about
- you have travelled from an affected area
- you are a close contact of a confirmed case in Ireland - if you are, the Department of Public Health will contact you
This is only a guide but close contact can mean:
- spending more than 15 minutes face-to-face contact within 2 metres of an infected person
- living in the same house or shared accommodation as an infected person
Anyone with symptoms of coronavirus who has been in close contact with a confirmed case in the last 14 days should:
- isolate themselves from other people - this means going into a different, well-ventilated room alone, with a phone
- phone their GP, or emergency department
- in a medical emergency (if you have severe symptoms) phone 112 or 999
When you may need to be tested for coronavirus
You will need to be tested for coronavirus if you have symptoms and have in the last 14 days been:
- in close contact with a confirmed case of coronavirus
- to a place where there is spread of coronavirus
Your doctor may also suggest you are tested for coronavirus if you have a severe lung infection.
If your doctor thinks that you need a test for coronavirus, they will tell you where the test will be done. They will also tell you when to expect your results.
Risk of catching coronavirus in Ireland
There are confirmed cases of COVID-19 (coronavirus) in Ireland.
The risk of catching coronavirus in Ireland is still low to moderate. This may change. However, most people may continue to go to work, school and other public places, as usual.
How coronavirus is spread
Coronavirus is spread in sneeze or cough droplets.
You could get the virus if you:
- come into close contact with someone who has the virus and is coughing or sneezing
- touch surfaces that someone who has the virus has coughed or sneezed on
As it's a new illness, we do not know how easily the virus spreads from person to person. Spread is most likely from those who have symptoms.
The virus may only survive a few hours if someone who has it coughs or sneezes on a surface. Simple household disinfectants can kill the virus on surfaces. Clean the surface first and then use a disinfectant.
Treatment for coronavirus
There is no specific treatment for coronavirus. But many of the symptoms of the virus can be treated.
Supportive treatments, like oxygen therapy, can be given while your own body fights the virus. Life support can be used in extreme cases.
If you get the virus, your healthcare professional will advise treatment based on your symptoms.
Antibiotics do not work against coronavirus or any viruses. They only work against bacterial infections.
There is currently no vaccine to treat or protect against coronavirus.
The flu vaccine does not protect against coronavirus.
Avoid all non-essential travel to China and Northern Italy
Follow the up-to-date travel information from the Department of Foreign Affairs for travel advice on countries and regions affected by coronavirus.
The Department of Foreign Affairs has advised people to avoid all non-essential travel to China and Northern Italy.
There is a high risk of getting coronavirus if you travel to a place where there is spread of the virus.
COVID-19 updates - how the health service is responding to the global spread of coronavirus
Department of Foreign Affairs – updated travel information and advice
The Health Protection Surveillance Centre – information for health professionals