Infertility Treatment on Hold: Managing Treatment Delays due to COVID-19

by Dr. Rashmi Kudesia

With COVID-19 spreading throughout the U.S., governmental and professional directives caused many medical treatments deemed necessary, but not emergent, to transition into an indefinite holding pattern. With guidance from the American Society for Reproductive Medicine in mid-March, nearly all infertility treatment fell into this category, much to the dismay of the 15% of U.S. couples who face infertility, as well as the single or LGBT patients using fertility treatment to build their families. Some folks pursuing treatment may already have children but are battling secondary infertility or planning for the transfer of previously-frozen embryos. The numbers are sizeable. In 2018, more than 300,000 cycles of in vitro fertilization (IVF) were completed, with about a third of these being for fertility preservation, and the rest resulting in the birth of more than 80,000 children (nearly 2% of all infants born in the country)! Nearly 8,000 of those cycles were completed in Houston-area clinics.

Though we hope that treatment can resume, at least in gradual fashion, over the next weeks to months, here are my tips to make the most of this unanticipated treatment delay:

First, prioritize mental health. Life during a pandemic is anxiety-provoking on top of the stress of struggling with infertility. Shifts in work lives, self-quarantining and social distancing have abruptly changed our routines, and those who are already mothers are shouldering the brunt of changes to childcare and education routines. So, be kind to yourself! Create a loose structure to guide your days without being overly ambitious or a perfectionist. Reestablishing some control by setting daily goals such as taking a walk, reconnecting with a loved one, meal-planning or cooking, taking a leisurely bath, stretching, or pursuing a hobby (even if for 15 minutes!) are all great ideas for self-care.
Second, craft a game plan. Patients often have prior bloodwork or treatment records that we would like to review before prescribing a new course of treatment. Obtaining these records can take weeks even under ordinary circumstances. By completing a telehealth consult now, I can help patients start completing all the steps required prior to treatment. Couples may have more time now to discuss and jointly decide upon treatment options. Many of us will feel a financial impact from the pandemic as well, so the opportunity to speak with a financial consultant to understand insurance benefits, cost of treatment and initiate monetary planning is also critical.
Finally, it’s a great time to discuss diet, exercise habits, supplements and management of other medical issues, all of which can influence the success of infertility treatment. We recommend a Mediterranean diet, focusing on fresh vegetables and fruits, lean poultry and fish, nuts, lentils and healthy fats, along with hydration and moderation or elimination of red meat, caffeine, alcohol and other substances. Working up to medium-intensity, interval-style workouts a few times weekly is a workout plan that fits most lifestyles, but work with your physician on this one because your starting fitness level and other medical history do matter. We may recommend vitamins, supplements or other ancillary treatments, such as acupuncture, many of which takes weeks to have an impact.

COVID-19 and the pause on infertility treatment are creating a lot of anxiety. However, we are not only ready to help our patients make the most of this current delay, but eager to help those individuals seeking fertility preservation or family-building to feel informed and prepared to resume care as soon as the time is right. We are truly #inthistogether.

About the author

Dr. Rashmi Kudesia is the Director of Patient Education and Sugar Land Site Director for CCRM Fertility Houston. She and her husband (a born-and-bred Sugar Land native!) are parents to 6-month-old Amara and 2-year-old puppy Bowser. Follow her on Instagram @rkudesia for much more content on family-building and women’s health!