Abstract
The guidelines, at the time of writing this manuscript, recommend withholding fertility treatments due to fear of the COVID-19. However, many fertility doctors and many patients, especially those with diminished ovarian reserve (DOR), strongly suggest that their fertility treatment including oocyte and/or embryo freezing is a time-sensitive matter due to fear of losing all their ovarian reserve. This report presents a novel approach for ovarian stimulation at home in women with DOR for oocyte/embryo cryopreservation using At-HOME IVF kit mailed to the patients’ home, and without the need for blood hormones and transvaginal ultrasounds monitoring. In this study, women (n = 22) diagnosed with DOR who underwent either oocyte (n = 6) or embryo freezing (n = 16) were included. Each patient took the medications included in the kit without the frequent visits to the office for monitoring and presented only once to the fertility clinic on the day of the oocyte retrieval. Upon presentation on the day of oocyte retrieval, none of the patients had ovulated. All patients underwent oocyte retrieval with 21 out of 22 patients having had at least one or more oocytes collected, with the number of mature oocytes retrieved ranging from 1 to 7. Eight out of 16 patients (50%) who underwent IVF, had embryos cryopreserved at either the cleavage-stage or blastocyst stage. This report suggests that, during the COVID-19 pandemic, At-HOME IVF kit presents a novel solution for women with DOR, or in situations where time is of essence, limiting office visits and thus minimizing the risk of coronavirus infection.
Highlights
The coronavirus disease 2019 (COVID-19), called the severe acute respiratory syndrome corona virus 2(SARS-CoV-2), is rapidly spreading all over the world causing a serious global public health issue [1]
This report suggests that, during the COVID-19 pandemic, At-HOME IVF kit presents a novel solution for women with diminished ovarian reserve (DOR), or in situations where time is of essence, limiting office visits and minimizing the risk of coronavirus infection
On March 17, 2020, the American Society for Reproductive Medicine (ASRM) released new clinical recommendations [2] stating that clinics: 1) do not initiate new treatment cycles — including ovulation induction, intrauterine insemination (IUI), in-vitro fertilization (IVF), and non-urgent oocyte or embryo freezing, 2) strongly consider canceling all embryo transfers, 3) continue caring for people who are “in-cycle,” or have urgent needs for stimulation or cryopreservation, 4) postpone elective surgeries and any non-urgent diagnostic procedures, and 5) prioritize telehealth over in-person contact
Summary
(SARS-CoV-2), is rapidly spreading all over the world causing a serious global public health issue [1]. During this pandemic, access to fertility has been difficult due to fear of transmission of the virus from patient to patient or from patient to clinic staff members (or vice versa). The society for assisted reproductive technology (SART) recommended that anyone who is actively pursuing assisted reproductive technology (ART) and meets the diagnostic criteria for the COVID-19 infection consider freezing all oocytes or embryos and waiting until patients are disease-free to do an embryo transfer [3].
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