Wessex Fertility - Consultation Booklet

Risks of Coronavirus and Fertility Treatment

Risks of Fertility Treatment

with IVF especially if there is already a problem with the fallopian tubes. The incidence of ectopic pregnancy with IVF is approximately 1-3%. The symptoms are usually pain on one side of your abdomen with vaginal bleeding at around 6-8 weeks of pregnancy. Ectopic pregnancies can rupture and cause internal bleeding requiring urgent medical attention in hospital. Very rarely an ectopic can also occur in conjunction with a uterine pregnancy where more than one embryo has been transferred. If you are thought to be at a high risk of an ectopic pregnancy an early ‘location’ scan will be performed at 6 weeks to check the location of your pregnancy(ies). If you have any of ectopic symptoms described above, please contact Wessex Fertility. WHAT ARE THE RISKS ASSOCIATED WITH A MULTIPLE PREGNANCY? Having a multiple birth is the greatest health risk associated with fertility treatment. The HFEA has imposed restrictions on the number of embryos that can be transferred in IVF treatments to reduce the number of multiple births. We also restrict ongoing treatment if more than two follicles have developed in an ovulation induction or intrauterine insemination (IUI) cycle. Multiple births carry health risks to the health of the mother and the unborn baby. The babies are more likely to be premature and to have a below normal birth weight. The risk of cerebral palsy is also higher in twins than in singletons. Please read Wessex Fertility’s Patient Information Sheet – Embryo Transfer Policy for further information on current statistics and our advice and policy. A useful website for you to visit prior to deciding on the number of embryos to transfer is www.oneatatime.com POSSIBLE BIRTH DEFECTS FOR BABIES BORN FOLLOWING ASSISTED CONCEPTION Some research has suggested that fertility treatment may be associated with an increased chance of birth defects. It’s not yet clear whether the birth defects are a result of the fertility treatment itself or fertility problems in the parents. The main thing to know is that birth defects in the general population are low: two per cent of children in Europe are born with birth defects. If fertility treatment is associated with an increased chance of birth defects, the risk is still very low. Research in this area is ongoing and we will continue to review and update our information as more evidence becomes available. Damage to other organs in the pelvis during fertility treatments The ovaries lie close to blood vessels, bowel, the uterus and bladder. It is extremely rare for there to be injury to any of these at egg collection or drainage of ovarian cysts (estimated < 1/1000). The needle used for collecting the eggs and draining cysts on the ovary, passes through the vaginal wall into the pelvis and ovary. There is a very small risk of infection in the ovary because of this (estimated < 1/1000). The risks are a little higher for women who have endometriosis or previous tubal infection and for this reason we advise giving antibiotics at the time of egg collection.

In view of the Coronavirus pandemic The Fertility Partnership (TFP) want to give you information to help you decide when is the right time to start fertility treatment. All treatment cycles involve travelling to and from the clinic for tests, monitoring and procedures. The Government have published guidelines on hygiene, social distancing and travel (for instance use of public transport) to help reduce the risk of infection when outside your home. We advise all patients to read the up-to-date Government information in order to minimise their own risk. During this period, all consultations will be done via Skype or telephone in order to reduce patient travel and footfall in the clinic. All TFP clinics have policies in place to minimise the risks of patients and staff passing on or catching the virus from others. These measures include questionnaire and temperature screening of everyone (patients and staff) entering the building, social distancing measures, appointment and procedure times spacing, extra hygiene measures and appropriate PPE (personal protective equipment) use. We will also be ensuring that appropriate fertility treatments are used to minimise the risk of complications such as OHSS (ovarian hyper-stimulation syndrome) and multiple pregnancy. We will be tailoring your treatment plan for you based on underlying risk factors, for example suggesting the use of a short antagonist IVF protocol to women at high risk of OHSS. This is because we want to reduce the chance of you developing a complication of fertility treatment which, if you also caught Coronavirus, could worsen your illness. We also want to minimise the chance that you would need to be admitted to a hospital because of a fertility treatment or pregnancy complication at this time, when the NHS is under strain. This may involve delaying fertility treatment if you have severe underlying risk factors. The Royal College of Obstetricians and Gynaecologists (RCOG) have published up-to-date guidance on the risks of Covid-19 to pregnant women and their baby. In summary they state that: • Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop coronavirus • The large majority of pregnant women will experience only mild or moderate cold/flu like symptoms • As this is a very new virus, we are just beginning to learn about it. There is no evidence to suggest an increased risk of miscarriage • Hospital Early Pregnancy Assessment Units (EPAU) may have different policies at this time when looking after patients • Transmission of the virus from a woman to her baby during pregnancy or birth appears possible. However, this does not seem to cause a problem with the baby’s health after birth • It does not seem that the virus causes problems with a baby’s development during pregnancy • Government guidance on hygiene and social distancing should be followed to reduce the risk of catching coronavirus . If you have any questions regarding your situation then please contact us via the Patient Portal, email or telephone and we will be happy to discuss further.

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