If you asked me right now if I wanted more kids, I would have a good laugh — and then probably start to cry, because I am on the brink of losing my damn mind being cooped up in the house with the three kids I already have. But if you had asked me this question 12 years ago, my heart would have burst with longing.
My ex-partner and I were a two-uterus couple, unable to conceive a baby without fertility help. I hesitate to call either one of us infertile, but the infertility clinic is where we went multiple times a month for several months to determine the best time to inseminate my then-partner with frozen sperm we purchased from a cryobank. It was exhausting, expensive, and time-consuming, but we were happy to be working toward our dream.
Now, COVID-19 has taken away access to infertility treatments; individuals and couples are being asked to wait on their dream or watch it disappear altogether. While I understand the need to exercise extreme caution during this pandemic, my heart breaks for the folks who have had their family-planning impacted by these measures.
The American Society for Reproductive Medicine (ASRM) released a statement recommending the suspension of most fertility treatments, including oocyte (immature ovum) retrievals, embryo transfers, and diagnostic tests. Anyone seeking IVF or other forms of infertility help is being asked to wait to start cycles, or pause their efforts until further notice. The reasons for this are to stop the spread of the coronavirus by practicing social distancing and to wait until we have a better understanding of the effects of COVID-19 on pregnancy.
When folks are actively pursuing fertility treatments they are not only in and out of the office several times an ovulation cycle, but they are exposed to a number of different doctors, nurses, receptionists, and billing advisors. Assisted conception is not a one-on-one process, and there are too many variables to try to control social distancing while in the clinic.
ASRM admits that while they are not saying people shouldn’t get pregnant during a pandemic, they won’t say there isn’t risk involved. The potential risks of being infected with the coronavirus during the first trimester of pregnancy are not known, and won’t be known for many months. But some pregnant people are more susceptible to complications from respiratory infections like the flu or COVID-19. ASRM reports that some infected people had difficulty breathing post-delivery.
Trying to conceive at home, if possible, is not being discouraged, yet ASRM is hesitant to advise medical assistance in baby-making in medical facilities. Fertility treatments are important and necessary, but not considered an emergency; there are only a few situations that are exceptions to ASRM’s guidelines.
Director of the Columbia University Fertility Center, Dr. Zev Williams, MD, PhD, notes that “patients who are about to start chemotherapy, patients who are at an advanced maternal age, or patients who have low ovarian reserve” are significantly impacted by a delay in treatments. The recommendation for these patients is to make a plan with their doctor and freeze eggs or sperm for future use. In this way, embryos, eggs, and sperm can be preserved during the pandemic.
But for older folks trying to conceive, each month is a lost opportunity. There is a chance that all opportunities to conceive will be lost by those who have a low egg supply. Single woman Shelly Kudrov told NPR, “I’m not going to lie — being 44 and still wanting to get pregnant with my own biological baby, using my own eggs, this timing is critical. Every month feels like an egg wasted.”
Infertility and the need to seek treatments causes emotional, physiological, and financial stress that lead to depression, anxiety, and hopelessness. I felt out of control and panicked when my ex-partner and I were trying to conceive our first child, and then what turned out to be twins from the second pregnancy. Not only was I unable to contribute anything from my body to try to make a baby, but we were at the mercy of appointments, procedures, nature, luck, and time. When my ex began fertility drugs to see if that would increase our chances at conception, the wait during those couple of months was excruciating, especially when it seemed so easy for other couples to conceive.
Dr. Zev Williams and colleagues at Columbia University Fertility Center recognized the additional impact the pandemic would have on patients who were forced to stop fertility treatments. They conducted a study to examine the emotional impact of cancelled cycles. Of the 518 patients who completed the survey, 22% rated ASRM’s recommendations equivalent to the loss of a child.
An indefinite hold on infertility treatments is an absolute loss of conceived children. For some folks, their time to achieve a pregnancy will come. For others, the window is closing quickly. People don’t know when they will get their chance to try again, or if they will become parents at all. Nothing in this life is guaranteed, certainly not having children — but when every cell in your body tells you that becoming a parent is as vital to your life as air, it’s a punch to the gut when your plans are taken away from you. There is no definitive timeline when these restrictions will be lifted and routine care can resume.
COVID-19 is playing wrecking ball on so many aspects of our lives, and it is breaking the hearts of those who need support in conceiving.
ASRM’s latest statement can be read here; there are updates, but previous recommendations are still in place. They recommend folks impacted by this loss of treatments use RESOLVE, an online support group that can connect others in similar situations.
As someone who has had their fair share of frustrations and worry with fertility cycles and clinics, I can’t offer a lot of advice. It sucks. But if you are a friend of someone going through this, just listen and hold space for them to feel whatever it is they need to process. And please don’t offer alternative plans or try to fix the situation. Your friend likely knows and has already thought about all of the other paths to parenthood, but nothing is an option until we get through the pandemic. Be the constant they need right now.
Elissa Sheppard is married to a woman and has been doing fertility treatments for almost a year. She and her partner have already experienced a miscarriage and are part of the many suffering over the recommendations to stop treatments. She told NPR, “It’s like my brain agrees, but emotionally I feel very devastated or heartbroken.”
Fertility treatments provide a glimmer of hope to those who are struggling to conceive, but with those options coming to a screeching halt, it deals a major blow to a process where hope counts for so much.