Fertility Providers’ Alliance (FPA) reframes ASRM’s reaffirmation of COVID-19 guidelines

CHR’s COVID-19 Bulletin, April 6, 2020 #2

[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 5, 2020 and published on April 6, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.]

To fully understand the significance of this news item, we have to refer readers to this month’s CHR newsletter, VOICE, where we in detail reviewed background of a new organization founded by some of the largest investor-owned provider organizations in IVF, the so-called Fertility Providers Alliance (FPA). We dedicated a big part of the newsletter to describing who founded the FPA, what the organization’s declared purpose was and what CHR felt the real reason for the FPA’s sudden creation was. 

The FPA announced itself through a news release from a financial advisor corporation in Chicago. It identified as point person for the FPA the CEO of a company that described itself as “the largest IVF provider in the U.S.” The news release further stated that the FPA was founded to counteract what the organization considered inappropriate guidelines published by the American Society for Reproductive Medicine (ASRM) COVID-19 Task Force. FPA further announced in a lengthy open letter the creation of its own COVID-19 task force to enter into discussions with the ASRM on modifying its initial guidance.

In the VOICE article, we reprinted the FPA’s open letter and expressed the opinion that the creation of the FPA by a group of investor-owned  IVF centers represented the beginning of the stage II of the industrialization of IVF practice in the U.S., since it reflected a blatant attempt by investor-controlled IVF centers to usurp decision-making powers within the IVF field, either from within the ASRM or, if that did not work, by creating a competing organization that could issue its own professional guidelines.

Two professional organizations working together for a shared goal, or one threatening the other?

Though we do not know what transpired out of view and behind the scenes, as we noted in a prior Bulletin, the ASRM response to the public FPA letter was a firm reaffirmation of its prior Position Statement. The FPA, in turn, followed up with the following press release on April 3, 2020:

Fertility Providers Alliance Applauds ASRM for Revised Recommendations on Fertility Care During COVID-19 Pandemic

Newest recommendations give fertility providers greater autonomy in making fertility care decisions in the midst of the global pandemic

NEWS PROVIDED BY The Fertility Providers Alliance (FPA) 

Apr 03, 2020, 10:30 ET

HOUSTON, April 3, 2020 /PRNewswire/ — The Fertility Providers Alliance (FPA), a newly formed industry organization that represents over 400 fertility specialists who provide care to tens of thousands of patients each year in the United States, today applauds the American Society of Reproductive Medicine (ASRM) for its efforts in communicating its latest guidance on fertility care during the COVID-19 pandemic.

Earlier this month, the ASRM released a set of recommendations, suggesting that fertility providers suspend all non-urgent and elective surgeries.  In an effort to continue providing patients with care during this COVID-19 epidemic, while at the same time keeping patients, physicians and staff safe, the FPA launched the FPA COVID-19 Task Force, who shared with ASRM its concerns over those initial recommendations.  In its latest guidance document, which will be reassessed on April 13, 2020, the ASRM gives fertility providers greater autonomy, affirming its trust in the physicians to consult with their patients and decide together on the best course of action during these challenging times.

“The FPA is very appreciative to the ASRM and its COVID-19 Task Force for hearing our concerns, being responsive to those concerns and communicating this updated document first with its physician members so that we can, in turn, have important conversations with our patients,” says William Schoolcraft, MD HCLD, Founder and Medical Director of CCRM Fertility and a member of the FPA COVID-19 Task Force.  “We also praise the ASRM for reiterating that infertility is in fact a disease and infertility care is not elective.  Most importantly, we thank ASRM for entrusting in us the ability to determine, alongside our patients, which procedures are urgent and require immediate action in the presence of the coronavirus.” 

The FPA and the fertility community are deeply committed to the safety of its patients, staff, and the families it seeks to build, and the organization will continue to evaluate its safety protocols as the COVID-19 pandemic evolves. The FPA is also committed to strictly adhering to CDC guidelines for infection prevention and control, to reduce or eliminate the risk of virus transmission between individuals and to promote the creation of a safe environment for the continuation of fertility care.

 “The Coronavirus pandemic is here and affecting us all and as fertility providers, we have been making preparations since it was first reported and throughout its initial worldwide spread,” says James A. Grifo, MD, PhD, Program Director NYU Langone Prelude Fertility Center/Chief Executive Physician Inception Fertility and FPA COVID-19 Task Force Member. “We are thankful to the ASRM for hearing and acting on the concerns of its physician members, and the FPA remains committed to helping patients build their families, while protecting our patients, staff and preparing to make any necessary changes to assure safety and good outcomes.” 

About the Fertility Providers Alliance 
The Fertility Providers Alliance (FPA) represents over 400 fertility specialists who provide care to tens of thousands of patients per year in the United States. As leaders in the fertility industry, the members of the FPA have come together to reshape the delivery of fertility care. We believe the voices of the patient and the provider should be heard in all policy conversations in the field of reproductive medicine, and our collaboration across the fertility industry will promote better outcomes for all.  

Media Contact: 
Mia Humphreys 
Krupp Kommunications 

We, frankly, fail to understand the message of this FPA communication because, as the ASRM specifically noted in its reaffirmation, it has not changed its Position Statement. As CHR has repeatedly noted in these Bulletins and in different monthly issues of the VOICE, CHR’s interpretation of the original ASRM Policy Statement has always been that it permitted “urgent” infertility care.

The change in tone from the FPA is, however, acknowledged and appreciated. Hopefully, it also represents an abandonment of all further attempts to impose the organization’s will on the ASRM.

Gone is the obvious representative of the finance community as source of this new press release and gone is the CEO of the “largest provider of IVF services in the U.S.” as featured contact person for the FPA. 

The press release came instead from a professional PR company and features two prominent physicians, Drs. Schoolcraft (CCRM, Colorado) and Grifo (NYU-Langone, New York), as spokespersons. Both, however, still represent the investor class in IVF, as both of these physicians’ organizations are controlled by outside investors (for details, please see this article in the April 2020 VOICE). Since the FPA, judging from the initial press release announcing its creation, was founded only to enter discussions with the ASRM in an attempt to modify the ASRM’s COVID-19 Position Statement, and since this matter per second press release now appears resolved, these circumstances raise the question: Why has the FPA not yet been dissolved as quickly as it was created?

The answer to this question is, unfortunately, likely not a very promising one and would support CHR’s initial suspicion about the FPA’s intent, as expressed in the April 2020 VOICE. If correct, then the change in tone in the above-reprinted second press release from the FPA is only tactical, and the purpose of forming the FPA has remained the same, i.e., to control the clinical practice policies in IVF

CHR’s COVID-19 Bulletins

  1. COVID-19 accelerating the changing practice of assisted reproduction (published on October 16, 2020)
  2. [Preprint by Norbert Gleicher, MD] COVID-10 pandemic through the eyes of a New York City fertility center (published on August 20, 2020)
  3. News you, likely, will not find in the media (Published on July 6, 2020)
  4. Notable reports in medical literature and the media on COVID-19 and immunity against it (Published on July 6, 2020)
  5. COVID-19 cases rapidly increase in South and Western U.S. states but that will help build herd immunity (Published on June 29, 2020)
  6. Are we witnessing a second wave of COVID-19 outbreak? (Published on June 22, 2020)
  7. WHO was wrong about asymptomatic patients being contagious & other COVID-19 fake news (Published on June 10, 2020)
  8. Updated COVID-19 precautions at CHR (Published on June 9, 2020)
  9. What we now know about COVID-19 and what it means for mitigation strategies (Published on May 22, 2020)
  10. COVID-19 response in retrospect, as well as going forward (Published on May 7, 2020)
  11. The essence of the COVID-19 pandemic (Published on May 7, 2020)
  12. Practical consequences of COVID-19 for CHR’s fertility patients (Published May 7, 2020)
  13. IVF after COVID-19: ASRM and SART release reopening guidelines for IVF centers (Published on 4/29/2020)
  14. One medical expert, missing from all COVID-19 task forces, who should be listened to (Published on 4/29/2020)
  15. Governments worldwide should have let herd immunity develop rather than cause one of the worst recessions on wild guesses of “experts” (Published 4/27/2020)
  16. Reciprocal collaboration among IVF centers for cycle monitoring may be on the wane (Published 4/22/2020)
  17. Is embryo freezing better than IVF during COVID-19 outbreak? (Published on 4/17/2020)
  18. When to restart fertility treatments after COVID-19 (Published on 4/17/2020)
  19. “Reopening” of fertility centers after COVID-19: How that may look like (Published on 4/17/2020)
  20. Some IVF centers may never reopen (Published on 4/17/2020)
  21. Skepticism warranted for “expert opinions” on COVID-19 (Published on 4/13/2020)
  22. Fertility Providers’ Alliance tries to reframe ASRM’s reaffirmation of COVID-19 guidelines as FPA victory (Published on 4/6/2020)
  23. States in the Northeast may see first signs of “flattening the curve” (Published on 4/6/2020)
  24. Reported death rate exaggerated by the media, shelter in place or herd immunity, first COVID-19 antibody test approved, and more (Published on 4/3/2020)
  25. What can I do to continue on my fertility journey? [VIDEO] (Filmed on 3/26/2020, published on 4/2/2020)
  26. “Controversy” over ASRM recommendation hints at investor interest’s power grab amid COVID-19 pandemic (Published on 4/2/2020)
  27. Pregnant women concerned over delivery and babies during COVID-19 pandemic (Published 4/1/2020)
  28. ASRM’s COVID-19 Task Force reaffirms previous recommendations (Published 4/1/2020)
  29. To stay open or not: IVF centers argue over ASRM guidelines on COVID-19 and fertility treatments (Published 3/27/2020)
  30. Concerning news on COVID-19’s effects on pregnancy and newborn (Published 3/27/2020)
  31. What’s urgent is urgent and what’s not urgent isn’t: Explaining ASRM recommendations on fertility treatments during COVID-19 pandemic (Published 3/26/2020)
  32. Patient autonomy and “do no harm” principles mean CHR continues to offer fertility diagnosis and treatments during COVID-19 crisis (Published 3/23/2020)
  33. ASRM and SART’s recommendations on fertility treatment during COVID-19 outbreak (Published 3/18/2020)
  34. CHR’s response to the COVID-19 outbreak: What we are doing to protect our patients, staff and community (Published 3/13/2020)
  35. Does COVID-19 have an effect on fertility? (Published 3/13/2020) 
  36. What happens if I get quarantined during an IVF cycle? (Published 3/13/2020)
  37. What happens if CHR is closed for quarantine during my IVF cycle? (Published 3/13/2020) 
  38. What should fertility patients do during the coronavirus outbreak? (Published 3/13/2020) 
  39. Should international patients of IVF do anything differently during the outbreak? (Published 3/13/2020) 
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.