Covid-19 UPDATE February 12, 2020
Information for patients who would like to become pregnant and would like to know about the vaccine and Covid testing
Update #12 ASRM (January 18, 2021)
A new antigen test can be done for Covid but false negative rates tend to be higher than traditional PCR tests, so PCR tests are still recommended. If you decide to do antibody testing, Covid antibodies can be detected within two weeks of infection but symptomatic people should not be tested for antibodies (too early to test). If anyone is exposed to somebody with Covid they can quarantine for 10 days now without testing and resume normal activity after 10 days if they are without symptoms. Patients undergoing elective procedures should wait 4 weeks after a Covid infection if they have no symptoms and are healthy, or 6-8 weeks if they have symptoms, Diabetes or are immunocompromised.
At this time the known benefits of the vaccine outweigh the disadvantages. Common side effects from the vaccine include pain and swelling at the injection site, fever, chills, headaches and tiredness. The vaccine is not thought to cause infertility and according to a Pfizer trial a similar number of patients conceived after receiving the vaccine as those who got no vaccine (a placebo). The mRNA vaccines (Pfizer & Moderna) vaccines do not cross the placenta. Therefore, the vaccine is recommended for those patients contemplating pregnancy or who are pregnant to minimize the risks associated with Covid infection. Also, the Covid vaccine will not give you a positive PCR or antigen test.
ACOG Recommendations (December 20, 2020)
Women who are pregnant or plan to become pregnant should follow the same guideline for vaccination as everyone else when deciding if the vaccine is appropriate. Women who have had reactions to prior vaccinations should discuss with their healthcare provider. At this time there is not one vaccine that is considered better than the other for women who are pregnant or plan to become pregnant. If women develop a fever after receiving the vaccine they can take Tylenol. Vaccines should not be taken within 14 days of another vaccine like Influenza or Tdap, but patients can still receive Rhogam if they need it (Rh negative status). Pregnant women who decline the vaccine should have their decision respected. If a woman becomes pregnant after the first dose of the vaccine, they should still get the second dose and are encouraged to follow up in the CDC’s V-SAFE program (to monitor outcomes). You do not need to take a pregnancy test prior to vaccination with an approved vaccine.
Covid Update November 17, 2020
Covid-19 infections rates continue to rise in all states except Hawaii. As rates rise we may see the hospital and medical system become overwhelmed with new cases. Patients and the population at large are encouraged to continue risk reducing strategies as approximately 50% of transmission is from asymptomatic persons carrying the infection. There has not been much new information on pregnancy and Covid-19. Pregnant women are less likely to show fever and muscle pain than non-pregnant patients but more likely to need intensive care and have preterm labor if they become infected. Currently it is unknown when pregnant patients will become candidates for the Covid-19 vaccine. In mid-November Pfizer announced a vaccine that is 90% effective and Moderna announced a vaccine that is 94.5% effective.
Covid Update October 06, 2020
The American Society for Reproductive Medicine reaffirmed that patients should follow the guidelines in Update #3. At this time antibody testing is not considered sufficient for Covid-19 testing. Rapid testing has been approved by the FDA and is recommended for people at high risk and those who have symptoms of Covid-19 infection. A positive rapid test should be followed up by a routine (nucleic acid) testing. The following tests have been approved by the FDA for rapid testing:
|Abbott Diagnostics Scarborough, Inc.||BinaxNOW COVID-19 Ag Card
|LumiraDx UK Ltd.||LumiraDx SARS-CoV-2 Ag Test||Sensitivity 97.6%
|Becton, Dickinson & Co.||BD Veritor System for Rapid Detection of SARS-CoV-2||Sensitivity 84%
|Quidel Corp.||Quidel Corp. Sofia SARS Antigen FIA||Sensitivity 96.7%
(Sensitivity = the chance of detecting infection if it is present; Specificity = the chance that the person who tests negative does not have the virus).
As of October 05, 2020 there were 42 candidate vaccines and 9 that are in Phase 3 testing (Moderna, Pfizer and Astra Zeneca). The National Academy of Sciences recommended that when the vaccines become available they should be distributed first to healthcare and frontline workers, then older adults with comorbid medical conditions then young healthy adults. Since reproductive patients fall into the last group they are strongly encouraged to continue prevention strategies (mask wearing, hand washing, social distancing etc). Approximately 51-55% of Americans are willing to become vaccinated. As of yet, there is no safety data for pregnant patients taking the vaccine. Currently ASRM encourages pregnant women to participate in vaccine trials. Patients are encouraged to remain vigilant during this time as they start to experience “caution fatigue” as infection rates are rising we are entering the flu season.
Covid Update September 08, 2020
It is recommended that all patients, family members and the population at large get the flu vaccine early this year to minimize the risk of becoming infected with the flu and Covid-19 at the same time. The most current information can be found on the CDC websites https://www.cdc.gov/coronavirus/2019-ncov/index.html and https://www.cdc.gov/coronavirus/2019-ncov/faq.html).
Covid-19 UPDATE August 11, 2020
In the past 4 weeks cases have continued to increase and phase III trials for the Covid vaccine are widespread but a vaccine in months away. Many patients are beginning to feel an increased sense of anxiety, depression and other mental health issues compared to the beginning of the pandemic, and should reach out to us as we have resources that can help . ASRM states that patients who are planning embryo transfer who were previously experiencing Covid symptoms wait until at least 10 days after symptoms pass to undergo transfer. At Inovi Fertility & Genetics Institute, we test prior to starting and prior to the completion of treatment for the safety of patients and their pregnancies.
ASRM also reiterates that when it is possible, patients can reduce their risk by:
- Seeking care using telehealth whenever possible
- Reducing risk of exposure to potentially infected individuals
- Avoiding large gatherings of people
- Maintaining social distancing
- Ensuring universal masking
- Practicing frequent hand hygiene
- Ensuring surface decontamination
- Avoiding travel by air
- Avoiding travel to areas with high disease prevalence
- Working remotely to the extent possible
Covid-19 Update July 10, 2020
While much has transpired since the original recommendations, the American Society for Reproductive Medicine (ASRM) once again reinforced the original recommendations from the April 24, 2020 Update #3 (see below) for clinics providing fertility care.
More information about Covid-19 during pregnancy has been gathered from different studies done around the world and are summarized below:
- Approximately 1/3 of asymptomatic pregnant women with Covid-19 may become symptomatic when admitted to the hospital when admitted for delivery
- Severe medical illness, including Covid-19, could lead to premature labor or early delivery
- Covid-19 Pneumonia may make pregnant patients more likely to develop preeclampsia
- Pregnant women affected by Covid-19 may be more likely to require care in an ICU but did not have different rates of survival compared to non-pregnant patients
- A small series of patients undergoing Cesarean section did not have Covid-19 virus in the breast milk, cord blood or amniotic fluid
- Neonatal transmission is still unclear and/or uncertain
- Babies rarely develop Covid-19 and if they do, they do very well during the newborn period
Covid-19 Update June 08, 2020
In this update ASRM focused on the procedural aspects of fertility treatment including reproductive surgery. It was recommended Covid-19 testing prior to reproductive surgery and recommended that patients where surgical masks during IVF related procedures.
Covid-19 Update May 11, 2020
ASRM suggested that oocyte (egg) and sperm donors or intended parents take into consideration the local Covid-19 status of the places they were considering travel to. It was also suggested that in situations in which oocytes or sperm could be shipped to the location of the intended parents that it would be preferable instead of donors and intended parents travelling between different cities, states or countries.
Covid-19 Update April 24, 2020
Today is a great day and time for a new beginning! On April 24, 2020 the American Society for Reproductive Medicine provided guidance on how fertility practices should proceed during the Covid-19 pandemic. We know many of you have been eagerly awaiting the opportunity to move forward in your fertility journey.
We are pleased to say that we will be seeing patients in the office for fertility evaluations and treatments starting May 1, 2020. Patients who would like to have their new patient consultation or follow-up consultation conducted by are still able to do schedule a telemedicine visit if they choose.
Upon arrival to our office we will provide all measures to make sure you have a safe visit including:
- Limiting patients in the office to one patient or couple every hour
- Eliminating overlap of patients visits as much as possible
- Providing each patient with their own private waiting room
- Providing a mask to patients who do not bring one to their appointment
- Providing hand sanitizer
- Minimizing the number of staff that you have contact with during your appointment
- Providing our staff with the most current education, practices and PPE for your safety
- Use of electronic communication for collecting and sharing information
- Education about your personal safety and safety during pregnancy
- Contactless check-in, check-out and payment
- Temperature & symptom screening at each appointment
- Providing testing for Covid-19 as it becomes available
We know that you probably have many questions related to Covid-19 and undergoing fertility treatments. At each appointment that you attend we will provide you with the most current information available as it is constantly evolving. We are constantly reviewing and practicing the latest recommendations from major medical societies & government agencies including the:
- American Society for Reproductive Medicine (ASRM)
- Society for Assisted Reproductive Technology (SART)
- American College of Obstetricians & Gynecologists (ACOG)
- Society for Maternal Fetal Medicine (SMFM)
- Center for Disease Control (CDC)
- Food & Drug Administration (FDA)
- Occupational Safety and Health Administration (OSHA)
- Texas Medical Board (TMB)
We advise you to continue to practice healthy habits as you prepare for pregnancy which includes a healthy diet, regular exercise, avoiding smoking and limiting alcohol intake. Please make sure that as life is slowly returning to normal that you continue to practice safe social distancing, limit trips to public spaces, wear a cloth mask (at a minimum) in public and wash your hands frequently for at least 20 seconds each time.
Prior to your appointment, if you are experiencing a temperature greater than 100.0 F, fever or chills, coughing, body aches or abdominal symptoms prior to your appointment please let us know beforehand. We may request that you conduct a telemedicine appointment and see your primary care provider prior to coming to the office again.
We look forward to seeing you in person (or video) soon! Take care and be safe!
COVID-19 APRIL 14, 2020 UPDATE
We hope all of you are doing well and maintaining a positive outlook. You are all in our thoughts during this challenging time and we understand that the current Covid-19 adds another level of uncertainty to fertility treatment. We wanted to provide you the most recent update from the American Society for Reproductive Medicine (ASRM) from April 14, 2020 but also to let you know that discussions are actively taking place within our community as to how to begin evaluating and treating fertility patients in the office again. Currently ASRM recommend limiting fertility treatments and diagnostic procedures to emergencies only until they reevaluate on April 27, 2020. Their prior recommendations are to remain in place as previously stated:
- Suspending initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
- Strongly considering cancellation of all embryo transfers whether fresh or frozen.
- Continuing to care for patients who are currently “in-cycle” or who require urgent stimulation and cryopreservation.
- Suspending elective surgeries and non-urgent diagnostic procedures.
- Minimizing in-person interactions and increasing utilization of telehealth.
Please do not hesitate to reach out to us if you have any questions or concerns about the above guidelines, about your care or anything else on your mind.
The Inovi Fertility & Genetics Institute Team
Covid-19 March 18, 2020 Update
Dear Patients and Friends of Inovi Fertility & Genetics Institute,
As you know Covid-19 is having a profound affect worldwide and in our daily lives here in the United States and Houston. As the number of cases grows and the situation evolves rapidly, we are urging everyone to be safe, take the recommended precautions and avoid unnecessary activity in public spaces that could result in exposure to Covid-19.
According to the Center for Disease Control, the best way to avoid getting sick is to avoid exposure to those who have the Covid-19 or are exhibiting symptoms (coughing or sneezing, fever and/or flu-like symptoms) that suggests they may have the virus. The virus is usually spread through respiratory droplets (coughing or sneezing) or close personal contact (standing within 6 feet of others). It is also recommended that you wash your hands frequently for at least 20 seconds each time, use hand sanitizer containing at least 60% alcohol and avoid touching your face, eyes or nose.
On March 17, 2020 the American Society for Reproductive Medicine (ASRM), the largest fertility society nationally and internationally, released a statement with recommendations regarding fertility practices. They recommended that any non-urgent evaluations (ultrasound, HSG) or procedures be postponed until further notice. The procedures include ovulation induction with Clomid or Letrozole, insemination, IVF procedures (egg retrieval or embryo transfers), and surgeries performed in the office or hospital. In the interest of the safety of our patients and staff, in order to limit their exposure to Covid-19, we will be limiting patient care and consultations to telemedicine (phone calls). Follow up recommendations will be released by ASRM before the end of March and we will update our patients accordingly. We respect the recommendations of our society and strive to provide fertility care at the highest level while providing the best care for our patients. We look forward to resuming normal practices soon and hope that all of you stay safe. Your safety is paramount to us.