COVID-19 may alter the way infertility treatment is provided: Doctors

Women with PCOS should bring some lifestyle changes during lockdown, say doctors

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Acknowledging that the lockdown measures have abruptly halted active treatment of infertility, doctors specialising in this field said that they will prioritise cases with advanced maternal age and whose gametes are frozen for long, while also suggesting that an extensive change in protocols will be required once the lockdown is lifted. Speaking at a web summit organised by the IHW (Integrated Health & Wellbeing) Council, a not-for-profit think tank based in New Delhi, the doctors added that the lockdown should be used as an opportunity by women with the polycystic ovary to lower their stress levels and modify diet and exercise to facilitate the treatment.

“Polycystic ovary syndrome (PCOS) is one of the most common conditions in Indian women; one out of 10 suffers from it. The treatment is 70 per cent diet modification and 30 per cent exercise. Ensure your diet is low in trans fat – so say no to junk food and sugar – and increase the share of protein,” said Dr Shivani Sachdev Gour, founder & director, SCI Healthcare, New Delhi.

“The general conception is that women who have PCOS are stressed due to the lack or absence of periods. However, it is the other way round – these women are generally more stressed than others because they are constantly reminded by people around them of their difference, either due to the physical features such as unwanted hair growth or irregular periods," said Dr S. Krishnakumar, secretary-general, Indian Society for Assisted Reproduction (ISAR), Mumbai.

The stress level in women with PCOS varies, so some take more time to respond to treatment than others do. Now with the lockdown, as women remain in the comforts of their home, they must try and focus on things that will keep their stress levels down, such as reading or meditation. “Safety is very important for the patients during this time. So, we avoid going ahead for any treatment for infertility or IVF and advise oral treatment. We advise our patients to utilise the time of lockdown and bring some lifestyle changes, an exercise which will help in improving their PCOD or infertility,” said Dr Sujoy Dasgupta, consultant, Reproductive Medicine, Genome Fertility Centre, Kolkata.

The virtual summit on PCOS and infertility treatment was attended by Dr K.U. Kunjimoideen, founder and managing director, ARMC IVF, president Perinthalmanna O&G Society & Joint Secretary - Indian Fertility Society, Kerala and Dr Sujoy Dasgupta, consultant, Reproductive Medicine, Genome Fertility Centre, among others.

“We do not have enough data to say whether the COVID-19 virus can transmit from mother or father to the child, or whether the child can become a carrier if a woman conceives during the pandemic. The only infertility treatment allowed now is for cancer patients who want to freeze their sperms or eggs. Once the lockdown is lifted, we will prioritise the cases with advanced maternal age or where the gamete has been frozen for a long time,” Gour explained.

A woman’s location has become a crucial factor in providing the treatment as those who are living in an area identified as a hotspot or containment zone not only need to take extra care to prevent infection but also need to ensure they can access antenatal care in a hospital set up, say experts. Women in these areas should try to conceive naturally while high-risk pregnancies need access to good healthcare. Kamal Narayan, CEO, IHW Council, who moderated the session, said, “Just like maternal care cannot wait due to lockdown, couples who are undergoing treatment for infertility also need to continue their regime and decide on the next step based on the specialist’s intervention, which is the same for those undergoing treatment for polycystic ovary. However, the lockdown has restricted their visits to the doctor’s chambers and can disrupt the entire treatment.”

The doctors said that the pandemic may alter the way infertility treatment is provided but once the lockdown is lifted, strict guidelines will be in place as social distancing is likely to become the norm. Protocols will also be put in place to enhance the telemedicine capability, experts said. Extensive guidelines will also have to be put up for the staff who would be in charge of disinfecting labs as the fumes of the sanitisers with 70 per cent of alcohol can cause damage to the gamete.