A Fertility Doctor’s Take on The Impact of COVID-19, And How One Patient Is Coping

By Kristyn Hodgdon

If you are reading this, you are probably acutely aware that the American Society for Reproductive Medicine (ASRM) recently issued guidance for its members as they manage patients in the midst of the COVID-19 pandemic.

The ASRM’s recommendations urge healthcare providers to suspend the initiation of all new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF), and egg freezing, and to consider the cancellation of all embryo transfers, whether fresh or frozen.

The ASRM is advising Reproductive Endocrinologists to continue to care for patients who are currently ‘in-cycle’ or who require urgent stimulation and cryopreservation, but to suspend elective surgeries and non-urgent diagnostic procedures. They are also encouraging doctor’s offices to minimize in-person interactions and increase the use of telehealth.

While postponed cycles and canceled surgeries are undoubtedly frustrating to all who are involved, I recently had the pleasure of sitting down with Dr. Brian Levine, founding partner and medical director at CCRM Fertility New York to get a fertility doctor’s take on this unprecedented situation and its impact on the infertility community.

Dr. Levine has been a practicing Reproductive Endocrinologist and Fertility Specialist at CCRM Fertility New York for 5 years.

As someone who has been with CCRM Fertility, a global pioneer in fertility science, research and treatment, for his entire career, he prides them on being a data-driven practice. CCRM Fertility leverages its own data, as well as a dedicated team of in-house reproductive endocrinologists, embryologists and geneticists in order to deliver consistent, successful results, which directly relates to how they deal with their patients. What that means when it comes to COVID-19 is that CCRM Fertility is using all of the available data out there in order to make an informed, data-driven decision on how to treat, or not treat, their patients.

So what’s the deal on the ASRM guidance surrounding the pandemic?

Dr. Levine said that, in his opinion, ASRM did a great thing by taking a stance in such an uncertain time. Since there is still so much unknown surrounding COVID-19, they decided to recommend that clinics take a pause and use data to figure out what the right approach is before moving forward with treatments. Basically, they used an abundance of caution, which Dr. Levine thinks was the right call.

So then why are some fertility clinics still moving forward with treatments?

Well, the ASRM guidance was a recommendation, not a rule. ASRM did not say clinics would be penalized for going ahead with planned treatments, which is why there are some patients who have not had their cycles put on hold like everybody else. When asked about the clinics who are continuing to cycle patients, Dr. Levine said, “I hope they’re doing it in a meaningful way, and in a way that reduces the risk to all involved.” As for CCRM Fertility New York and the rest of their locations Nationwide, they are adhering to the ASRM guidance until they have enough data to learn how to practice in this new normal.

But what about the patients?

Many who have had their cycles canceled or postponed feel that the ASRM guidelines are robbing them of their chance to become parents by putting their plans on hold yet again—something that anyone going through infertility is already all too familiar with.

I had the opportunity to chat with one of Dr. Levine’s current patients, Alyssa, whose first frozen embryo transfer was supposed to be scheduled for this week, until it was canceled due to COVID-19.  Alyssa started trying to conceive exactly one year ago. She got pregnant twice, but unfortunately lost both pregnancies. Following a D&C, she learned that the embryo showed genetic abnormalities, and subsequent testing showed that she had low AMH and Endometriosis. At only 30 years old, she was diagnosed with Diminished Ovarian Reserve (DOR) and was advised to go right to IVF.

Alyssa says she originally wasn’t worried about doing IVF in order to start her family, but she quickly learned—the hard way—that IVF doesn’t always work. After four IVF cycles, she and her husband currently have one healthy, genetically normal embryo and were finally awaiting transfer when all of this happened.

How can I cope with a canceled cycle?

Alyssa says she’s having a really hard time digesting the fact that “someone else” is making the call as to when she and her husband are able to start their family. And the part that she feels is really unfair is that she has no idea when they can start trying again.

In the meantime, she says she’s doing all she can to control what she can during this time. She is currently on an anti-inflammatory diet, which she very accurately calls the “no fun diet,” and is taking a prenatal vitamin, a vitamin D supplement, and a probiotic. She has also been visiting the ASRM website daily looking for updates as to when treatments might resume, which she says is hard not to do. When I asked Alyssa what her advice would be to other fertility patients dealing with canceled or postponed cycles, she said:

For now, she is doing yoga and meditation, and says she feels lucky to have one healthy embryo waiting to be transferred as soon as things go back to normal.  

So what can I do with all of this extra time in between cycles?

Dr. Levine actually thinks this is an exciting time for fertility patients, who can focus on making positive lifestyle changes to prepare for their next cycle, whenever that may be. He says, “You have much more control over your diagnosis than you recognize, and you can limit your chances of having a negative outcome by making healthy choices.”

For women, Dr. Levine recommends adopting a Mediterranean diet and taking supplements such as a prenatal vitamin, fish oil DHA/EPA, Coenzyme CoQ10, and Vitamins C & D while preparing to conceive. For men, he suggests limiting alcohol and sugar content and increasing exercise and Vitamin D, all of which can have a dramatic improvement on your cycle. It’s also a way to add structure to your day and a great way to cope mentally.

Above all, Dr. Levine recommends using this time to talk to your provider. This situation is fluid and dynamic, and things are changing very quickly. Chances are by the time you’re reading this, treatments might already be starting back up!

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