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Tania Kowalewski has been trying to get pregnant through in vitro fertilization for four years. Last week, she had an egg retrieval — her 12th — and was waiting to hear from her doctor about when she could start the medication that would help prepare her body for an embryo to go back into her uterus.
On Tuesday, she heard back from her doctor — but it was him calling to tell her that there would be no transfer this month. It’s because of the coronavirus outbreak, he explained. They’d have to reevaluate in a month, though there was no guarantee things would be better by then.
“It’s one thing to delay for a month, but if this keeps going on, then you’ve put all this work in for nothing. I feel like the coronavirus outbreak might only get worse,” Kowalewski, 44, told BuzzFeed News, noting that because of her age, any delay significantly lessens chances of her getting pregnant.
For the 12% of women like Kowalewski who struggle to conceive, procedures like IVF and intrauterine insemination (IUI) are emotionally arduous, physically taxing, incredibly stressful, and usually very expensive. One IVF cycle can take months from start to finish, from diagnostic testing to embryo transfer.
Telling a woman who wants to have a kid they’ll have to wait for any amount of time is difficult enough, but in the midst of the coronavirus pandemic, fertility clinics around the country are advising patients to wait to start new treatments or cancel transfers mid-cycle and freeze embryos. Some clinics attached to hospitals have canceled procedures entirely. And as the outbreak continues with no clear end in sight, many women are left with the heartbreaking realization that they don’t know when or if they’ll be able to start trying for a family again.
There’s not a lot of information about babies born to women diagnosed with COVID-19, and there are big unanswered questions about the risks. In China, several babies were born to women with COVID-19 without complications.
On Monday, the American Society for Reproductive Medicine was recommending that clinics suspend “most” procedures.
“This is not going to be easy for infertility patients and reproductive care practices. We know the sacrifices patients have to make under the best of circumstances, and we are loath to add, in any way, to that burden,” Ricardo Azziz, the CEO of the ASRM, said in a statement.
“But the fact is that given what we know, as well as what we don’t, suspending non-urgent fertility care is really the most prudent course of action at this time,” he added.
Some clinics are adopting these recommendations while others are instead allowing patients to decide. A doctor at a DC clinic told BuzzFeed News that roughly 20% of their patients were declining treatment at this point.
There’s a lot of timing involved with every treatment cycle, and women, injecting themselves with medications daily in advance of a transfer or egg retrieval, require a daily blood test and ultrasound. Only when hormone levels reach a certain (and exact) point can doctors do a procedure.
Some offices that have stayed open are screening patients before they go into waiting rooms and are practicing social distancing while there.
But still many clinics are recommending that if a patient can, they should absolutely wait.
L.J., 34, told BuzzFeed News she transferred the one embryo she’d been able to get about a week and a half before clinics started recommending women pause procedures.
“If it does work then what? Then I’m in the early stages of a risky pregnancy in the middle of a global pandemic?”
“I might have postponed it if I realized this was going to blow up,” she said. “We don't have any other embryos, this is it. I’m trying to be positive but it’s so hard. If it does work then what? Then I’m in the early stages of a risky pregnancy in the middle of a global pandemic? Cool, that’s cool,” she said.
There’s also the advice that women have better outcomes when they reduce their stress — a near impossible task at the moment.
“I’m so anxious about this. Is that going to mean that it won’t work when it otherwise would have?” L.J. asked.
Samantha, 35, decided early that moving forward just wasn’t worth the risk.
She completed an egg retrieval early in the month and had been waiting for some test results before moving forward. It seemed like a natural place to take a break.
“They are saying that they are canceling cycles for anyone who might be at risk but continuing ahead for people who are healthy and feel comfortable,” she said. “We’re paying out of pocket for everything, so if they cancel in a few weeks would we get our money back?”
Jana Gold, 35, had been waiting for six months for her new insurance to kick in to cover fertility treatments. It never dawned on her that when it came time to transfer one of the two embryos she was able to create via in vitro fertilization, a pandemic would be taking its toll on the world.
“Even if it had dawned on me, I would have moved forward. There’s nothing getting in the way of this,” she said. “Friends are telling me to not move forward. Unless you are in this situation right now, you cannot understand the feeling of needing to move forward. If it means shacking up in my house for 9 months with muffins and rice, then that’s what I am going to do.”
Gold was days ahead of a transfer when she and I spoke, and on Thursday she was ultimately able to move forward despite a recommendation from her doctor that she delay.
“Quite frankly if it doesn’t work for me, that gets me one step closer to this process being over,” she said. “I said at the end of the year I need to be pregnant, have a baby, or move on with my life.”