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Patient notice - Novel Coronavirus

Patient notice - Novel Coronavirus

The current COVID-19 crisis can be an unsettling time for many of you. To avoid any needless worry and stress, we wanted to update you on the evidence-based scientific facts regarding fertility treatment and COVID-19 virus and to reassure you that we are following the latest advice from the government, our regulator (HFEA) and the Royal College of Obstetricians and Gynaecologists (RCOG). The RCOG guidance on COVID-19 infection in pregnant women, which can be accessed here.

The current guidance from UK professional bodies is that pregnant women do not appear to be any more susceptible to the consequences of COVID-19 than the general population, or that women can pass the infection onto their baby while pregnant. The UK's Chief Medical Officer, Professor Chris Whitty has said there is currently no evidence to suggest the existence of any coronavirus-related complications in pregnancy and the UK's IVF regulator, the HFEA, has advised that clinics follow UK professional guidance and depending on the individual clinics’ circumstances, clinics can continue treating patients at the current time.

As we know, timing is often a key factor when it comes to fertility treatment, therefore if you have any concerns, we can agree a treatment plan best suited to your individual fertility needs. We pride ourselves in using individualised and safer drug protocols that are aimed at reducing OHSS and related complications for women in order to protect the health and safety of the mother and baby.

Please see below further details of the assistance we can provide.

To access the full government advice, please visit here.

The public are being advised to stay at home (self-isolate) without any testing for COVID-19, regardless of travel history or contact with confirmed cases, if they have:

a. A new continuous cough OR

b. High temperature (of 37.8 degrees centigrade or higher)

  • • if you live alone and you have symptoms of coronavirus illness (COVID-19), however mild, stay at home for 7 days from when your symptoms started.
  • • if you live with others and you or one of them have symptoms of coronavirus, then all household members must stay at home and not leave the house for 14 days. The 14-day period starts from the day when the first person in the house became ill
  • • it is likely that people living within a household will infect each other or be infected already. Staying at home for 14 days will greatly reduce the overall amount of infection the household could pass on to others in the community
  • • for anyone in the household who starts displaying symptoms, they need to stay at home for 7 days from when the symptoms appeared, regardless of what day they are on in the original 14 day isolation period.
  • • if you can, move any vulnerable individuals (such as the elderly and those with underlying health conditions) out of your home, to stay with friends or family for the duration of the home isolation period
  • • if you cannot move vulnerable people out of your home, stay away from them as much as possible
  • • if you have coronavirus symptoms:
    • do not go to a GP surgery, pharmacy or hospital
    • you do not need to contact 111 to tell them you’re staying at home
    • testing for coronavirus is not needed if you’re staying at home
    • plan ahead and ask others for help to ensure that you can successfully stay at home and consider what can be done for vulnerable people in the household
    • ask your employer, friends and family to help you to get the things you need to stay at home
    • wash your hands regularly for 20 seconds, each time using soap and water, or use hand sanitiser
  • • if you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online coronavirus service. If you do not have internet access, call NHS 111. For a medical emergency dial 999

 

What does self-isolating mean?

If you have been told to self-isolate, you will need to get to the place you are going to stay using your normal mode of transport, once there remain indoors and avoid contact with other people. This will prevent you from spreading the disease to your family, friends and the wider community. In practical terms, this means that once you reach your residence you must:

  • • stay at home
  • • not go to work, school or public areas
  • • not use public transport like buses, trains, tubes or taxis
  • • avoid visitors to your home
  • • ask friends, family members or delivery services to carry out errands for you - such as getting groceries, medications or other shopping

In addition to the self-isolation guidelines, the advice for anyone in any setting is to follow these main guidelines:

1. Wash your hands more often than usual, for 20 seconds using soap and hot water, particularly after coughing, sneezing and blowing your nose, or after being in public areas where other people are doing so. Use hand sanitiser if that’s all you have access to.

2. To reduce the spread of germs when you cough or sneeze, cover your mouth and nose with a tissue, or your sleeve (not your hands) if you don’t have a tissue, and throw the tissue away immediately. Then wash your hands or use a hand sanitising gel.

3. Clean and disinfect regularly touched objects and surfaces using your regular cleaning products to reduce the risk of passing the infection on to other people.

At the current time and based on our understanding of what is known of COVID-19 and other similar respiratory viruses, it is likely that older people and those with chronic medical conditions may be vulnerable to severe disease. As more information emerges, recommendations may change.

Further information can be accessed on the NHS advice website.

HFEA Coronavirus (COVID-19) guidance – current status as of 18 March 2020

Coronavirus (COVID-19) update 18 March 2020: Updated statement for clinics

As the coronavirus pandemic escalates, we are closely monitoring its impact on the UK fertility sector. Our advice to clinics remains to refer to UK professional guidance when making decisions about whether to offer treatment. Only professional guidelines, not the HFEA, can inform local medical decisions. 

The British Fertility Society and the Association of Reproductive and Clinical Scientists updated their guidance on 18 March. This is designed to help UK fertility clinics decide how to prioritise and organise their services during the outbreak, whilst complying with their clinical, ethical, regulatory and social duties. The Royal College of Obstetricians and Gynaecologists have also updated their guidance.

We expect clinics to follow the advice from the British Fertility Society and the Association of Reproductive and Clinical Scientists. The guidance calls on clinics in both the private sector and the NHS to consider their wider responsibility in any decision making, including the need to promote social distancing and the potential effects of their work on local NHS services which are likely to be stretched to an unprecedented extent.

The guidance assumes that as coronavirus spreads, clinics will stop fertility treatments over the coming weeks. This may be for several reasons: redeployment of staff, reduced anaesthetist cover, or staff being unable to work due to self-isolation or illness. The guidance also carries a call to cease treatments to minimise the spread of the virus and reduce the impact on the NHS due to the common complications of IVF such as OHSS.

We will be writing to all clinics to seek assurances that they intend to follow this guidance and to remind the Person Responsible of their duty to provide a safe environment for patients, gametes and embryos.

Where clinics remain open either to continue treatment, or to provide a skeleton service, they must work within safe limits, including safe staffing numbers, and ensure stored gametes and embryos are not put at risk. If treatment services are disrupted clinics should put measures in place to keep patients informed of any changes and the reason for these, as well as have adequate cover to support patents who have concerns or require support.

Coronavirus (COVID-19) update 17 March 2020: Guidance for patients

We understand that some patients are concerned about the current situation with COVID-19 and whether this should be a reason to stop IVF treatment.

We cannot provide patients or clinics with medical guidance or make medical decisions. However, our current advice to clinics is to refer to UK professional guidance for advice when making decisions about whether to offer treatment. Patients should discuss their individual circumstances with their clinic before considering starting treatment. British Fertility Society and the Association of Reproductive and Clinical Scientists issued joint guidance on 16 March and we are in regular communication with them. We have also shared guidance from the Royal College of Obstetricians and Gynaecologists to all clinics.

However, we are aware that there are different opinions among professional bodies globally and your clinic should be aware of this, but we reiterate our advice for clinics to follow UK professional guidance only and depending on the individual clinics circumstances they can continue to treating patients at the current time.

We are also aware that some clinics have had to stop treatments for other reasons such as low staffing levels due to staff being redeployed to other areas and emergency planning measures in their hospital. These decisions are taken locally by the individual clinic and are not something that the HFEA is involved in. We have not issued guidance which says all clinics should cease providing treatment at this time.

We are closely monitoring the situation and will share any new information that we receive via our website and social media channels.

Coronavirus (COVID-19) update 17 March 2020: Guidance for professionals

We are aware that there is a confusing picture of the effect of COVID-19 on fertility treatment with advice and guidance coming out from several different sources. Our current advice to clinics is to refer to UK professional guidance for advice when making decisions about whether to offer treatment. Only professional guidelines, not the HFEA, can inform local medical decisions. 

The British Fertility Society and the Association of Reproductive and Clinical Scientists issued joint guidance on 16 March and we are in regular communication with them. We have also shared guidance from the Royal College of Obstetricians and Gynaecologists to all clinics.

However, we are aware that there is a difference of opinion among professional bodies globally and clinics should be aware of this. This guidance includes:

  • The American Society for Reproductive Medicine (ASRM) has advised that as of 17th March suspension of all new, non-urgent fertility treatments in the midst of a public health emergency. They aim to review their recommendations no later than 30 March 2020 with the aim of resuming usual patient care as soon as possible.
  • The Fertility Society of Australia suggests there is no evidence to recommend contraception or cessation of attempts to conceive, either unassisted or assisted. The FSA has in place guidance for those with symptoms or at risk which is similar to the ASRM.
  • The European Society of Human Reproduction and Embryology (ESHRE) has stated that there is no strong evidence of any negative effect of COVD-19 on pregnancy, especially at the early stages. They have taken a precautionary approach and have advised all fertility patients to avoid becoming pregnant at this time and suggested consideration of deferred pregnancy with oocyte of embryos cryopreservation

We appreciate that this difference of opinion does make individual treatment decisions difficult, but we reiterate our advice is for clinics to follow UK professional guidance only. We are aware of the limitations of the evidence that is currently published, and we advise clinics to be cautious when interpreting it and that those clinics proceeding with treatments should discuss this with patients, so they fully understand the situation.

In addition, we are aware that some clinics have had to stop treatment cycles for other reasons such as staffing levels and emergency planning measures in their hospital. These decisions are taken locally by the individual clinic. We have not issued any guidance to advise that treatments should not continue.

We are closely monitoring the situation and will share any new information that we receive.

Coronavirus (COVID-19) update 17 March 2020: Clinic inspections

Following UK government’s updated guidance on COVID-19 yesterday, we’ve decided to cease clinic inspections starting from today until the end of August 2020.

The HFE Act requires that all clinics must have a licence from us to offer services and we will put measures in place that allow clinics to continue to operate lawfully.

These include:

  • Clinics that are due renewal inspections between now and August will have their inspection date deferred
  • Where clinics have a four-year licence (at their previous renewal) and where compliance has been demonstrated, we will issue a one-year extension to the licence.
  • Where there is evidence of issues some clinics may be asked to provide information to enable a desktop analysis to be conducted before any extension can be granted.
  • Clinics that have a four-year licence and are due an interim inspection between now and the end of August will not be inspected.
  • Clinics with licences of less than 4 years or where a targeted inspection is required may either be asked to provide information for a desktop analysis and/or will be inspected as soon as possible after the inspection schedule restarts.
  • Research centres that have a licensed research project that is due for renewal between now and the end of August will have a desk-based renewal inspection with a decision on the renewal of the licence taken by an HFEA committee (by paragraph 3(8) of Schedule 2 a research licence cannot be granted for a period exceeding 3 years).

Coronavirus (COVID-19) update 16 March 2020: UK professional guidance

We are carefully following the coronavirus pandemic and UK government measures to contain and mitigate the spread of the virus.  We are monitoring updates issued by the Department of Health and Social Care, Public Health England and the NHS.

Our priority is the health and safety of patients, clinic staff and our staff. We’re taking the following actions to deal with any potential implications of the coronavirus outbreak. These include:

  • Following official government guidelines and advice
  • Monitoring clinics who are due inspections and will ensure continuity of licence is maintained if we are unable to inspect before a licence period runs out
  • Provided advice for our staff. We have a business continuity plan in place to ensure we can respond efficiently to serious business disruption

We expect clinics to have their own business continuity and contingency plans to respond to official advice or cope with specific local effects of coronavirus in their own hospitals and clinics.

Clinics should follow professional UK guidance from the British Fertility Society and Royal College of Obstetricians and Gynaecologists on treating patients throughout the coronavirus pandemic.

As the regulator, we are unable to provide advice on individual medical questions. Patients who are currently undergoing fertility treatment or are pregnant should contact their clinic for advice and questions about their treatment.

Coronavirus (COVID-19) update 05 March 2020: Donation

Patients or donors who have travelled to a country that is deemed to have a high risk of Coronavirus should speak to their clinic about how this may impact on their treatment or donation. 

Guidance issued by the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) states:  

Must not donate if:

  1. a) Less than 28 days from a donor’s return from a Coronavirus risk area. This includes transit through an airport in a Coronavirus risk area, even if the traveller has not left the airport.
  2. b) Less than 28 days from the last contact with a person with Coronavirus infection.
  3. c) Less than 28 days since recovery from Coronavirus infection or possible Coronavirus infection.

The Department of Health and Social Care have issued guidance and advice on Coronavirus and an action plan, which may also be helpful for donors and patients to refer to. The NHS has also issued guidance.