COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management

DOI: https://doi.org/10.1186/s12958-020-00605-z

COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management

Carlo Alviggi^1*, Sandro C. Esteves^2,3,4*, Raoul Orvieto^5,6, Alessandro Conforti¹, Antonio La Marca⁷, Robert Fischer^8, Claus Y. Andersen9, Klaus Bühler^10,11, Sesh K. Sunkara¹², Nikolaos P. Polyzos¹³, Ida Strina¹, Luigi Carbone¹, Fabiola C. Bento², Daniela Galliano¹⁴, Hakan Yarali¹⁵, Lan N. Vuong^16,17, Michael Grynberg¹⁸, Panagiotis Drakopoulos^19,20, Pedro Xavier²¹, Joaquin Llacer²², Fernando Neuspiller²³, Marcos Horton²⁴, Matheus Roque²⁵, Evangelos Papanikolaou^26,27, Manish Banker²⁸, Michael H. Dahan²⁹, Shu Foong^30,31, Herman Tournaye¹⁹, Christophe Blockeel ¹⁹, Alberto Vaiarelli³², Peter Humaidan^4,33, Filippo M. Ubaldi³² and on behalf of the POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) group.

Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
ANDROFERT, Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1463, Campinas, SP, 13075-460, Brazil
Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, Brazil
Faculty of Health, Aarhus University, Aarhus, Denmark
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel
The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
Fertility Center Hamburg, Hamburg, Germany
Laboratory of Reproductive Biology, University Hospital of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
Center for Gynecology, Endocrinology and Reproductive Medicine, and Stuttgart, Ulm, Germany
Scientific-Clinical Centre for Endometriosis of the University Hospitals of Saarland, Saarbrücken, Germany
Department of Women’s Health, Faculty of Life Sciences, King’s College London, London, UK
Dexeus University Hospital, Barcelona, Spain
Instituto Valenciano de Infertilidad (IVI), Rome, Italy
Anatolia IVF, Ankara, Turkey
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Clamart, France, Université Paris Saclay, Saint-Aubin, France
Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
Department of Obstetrics and Gynecology, Medical School, University of Crete, 71110, Heraklion, Crete, Greece
Unit of Reproductive Medicine, Department of Gynecology and Obstetrics, Hospital Center São João, Porto, Portugal
Instituto Bernabeu, Alicante, Spain
Instituto Valenciano de Infertilidad (IVI), Buenos Aires, Argentina
Pregna Medicina Reprodutiva, Buenos Aires, Argentina
MaterPrime, São Paulo, Brazil
Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
Nova IVF Fertility, Ahmedabad, India
Department of Obstetrics and Gynecology, McGill University, Montreal, Canada
Department of Obstetrics & Gynecology, University of Calgary, Calgary, Canada
Regional Fertility Program, Calgary, Canada
Fertility Clinic Skive, Skive Regional Hospital, Skive, Denmark
GENERA, Center for Reproductive Medicine, Rome, Italy

Abstract

The prolonged lockdown of health services providing high-complexity fertility treatments –as currently recommended by many reproductive medicine entities– is detrimental for society as a whole, and infertility patients in particular. Globally, approximately 0.3% of all infants born every year are conceived using assisted reproductive technology (ART) treatments. By contrast, the total number of COVID-19 deaths reported so far represents approximately 1.0% of the total deaths expected to occur worldwide over the first three months of the current year. It seems, therefore, that the number of infants expected to be conceived and born –but who will not be so due to the lockdown of infertility services– might be as significant as the total number of deaths attributed to the COVID-19 pandemic. We herein propose remedies that include a prognostic-stratification of more vulnerable infertility cases in order to plan a progressive restart of worldwide fertility treatments. At a time when preventing complications and limiting burdens for national health systems represent relevant issues, our viewpoint might help competent authorities and health care providers to identify patients who should be prioritized for the continuation of fertility care in a safe environment.

KEYWORDS:

COVID-19, Assisted reproductive technology, Infertility, In vitro fertilization, Intracytoplasmic sperm injection, Poseidon criteria, Viewpoint

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