[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 31, 2020 and published on April 2, 2020. For a list of all COVID-19 articles, scroll to the bottom.]
"What can I do while waiting for my IVF center to reopen?" This is probably the most frequent question we are hearing today, as so many IVF centers have closed their doors temporarily and, often, quite suddenly in response to the COVID-19 pandemic. And here, we've put together what we have instructed our staff to tell patients.
Dr. Gleicher explains what fertility patients can do to get ready for IVF during the COVID-19 pandemic.
Don’t get upset and don’t be depressed. For most infertility patients, 2-3 months of delay makes absolutely no difference. For those patients, usually it is not worthwhile to start looking for another IVF center that may still be open because the delays caused from transferring medical records, hopefully, will take longer than the current closure of most IVF centers.
Circumstances may be different for a small minority of fertility patients, in whom a delay of 3 or more months in their treatments may adversely affect pregnancy chances. Who are these patients in the so-called “urgent group?”
First and foremost, women and men who face imminent threats of losing their ovarian or testicular function from medical interventions, like surgery, bone marrow transplants, chemotherapy or radiation therapy.
Older women who, because of advanced age, have very low functional ovarian reserve (LFOR).
Younger women who, for a variety of causes, have advanced LFOR.
Women with poor ovarian reserve who are already in the midst of egg or embryo banking for fertility preservation purposes.
Everybody who is not in these 4 groups of patients, has nothing to worry about if treatments are delayed by a few months.
If you are in what we call the “urgent group,” contact your IVF center and ask them for a referral to a center still open in your neighborhood. If your center is not cooperating, simply go on Google and find an alternative IVF center that you feel meets your expectations.
If you are in the much larger “non-urgent” group,use the time to prepare your body for your upcoming treatments. What do we mean by that? The better a shape you are in, the better will be your chances with IVF. If you were planning to lose a few pounds or kilograms, this may be the time to do it. A recently published study claimed improved IVF outcomes after a period of eating the Mediterranean Diet. While we were not particularly impressed by that study, it can never hurt to eat healthy, work out and, in general, to try to face your next IVF cycle in the best possible shape.
Don’t stop your medications and supplements: If your doctors started you on medications and supplements to prepare your ovaries, do _not_stop those, unless specifically instructed by your physicians to do so. Patients often stop medications and supplements on their own, not realizing that this may push them to the very back of the line, once IVF centers reopen their labs because treatments and/or supplementation will have to start from scratch.
Preparing your ovaries never hurts and steady readers of these pages probably know that CHR recommends pre-supplementation with DHEA and CoQ10 for at least 6-8 weeks prior to IVF cycle starts in older women after age 40 and younger women with LFOR. Though we usually recommend that such supplementation be done only under medical supervision, this could be a worthwhile way of making good use of the time. You can probably discuss this with your physicians, even if your IVF center has closed [CONFLICT NOTICE: CHR holds a number of U.S. patents claiming treatment outcome benefits from supplementation with DHEA. CHR and CHR’s physicians also receive license fees from a number of DHEA manufacturers and hold shares in Fertility Nutraceuticals LLC, one such manufacturer.]
Remember that, once your center reopens, there will be considerable pent-up demand from patients who, like you, faced interruptions in their treatment schedules. Those patients who are the most ready to get started in a cycle will, likely, be the ones who are pushed toward the front of the line. Therefore, make sure that you have everything lined up, including your medications.
If you purchase your fertility drugs from a reputable source, you do _not _have to worry about expiration dates for your medications. Most medications’ shelf life should exceed a year. But it never hurts looking at the expiration dates for all medications you purchase and, if they are shorter than the likely time in which you will use them, ask your purchasing source for a different batch. While talking about this subject, a recent paper in a prominent medical journal actually questioned expiration dates on many, if not most, medications, suggesting that most medications can, actually, safely be used for a few good months beyond their expiration dates.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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