Communication with fertility patients during the COVID-19 pandemic- let's talk about it

Abstract

ObjectiveTo assess the impact of the COVID-19 pandemic on the activity of a tertiary fertility service and compare telemedicine and face-to-face meetings during this time. MethodsThis was a retrospective cohort study conducted in a university affiliated tertiary medical center. Included were patients scheduled for an appointment in the in-vitro fertilization (IVF) unit between March 18th and April 15th. A comparison was made between patients who chose telemedicine as opposed to face-to-face meetings. Additionally, the population of patients who chose to cancel their appointment was characterized. IVF cycle outcomes were additionally compared between the groups. ResultsOverall, 90 IVF clinic appointments were scheduled during the study period. Thirty-four (37.8 %) patients chose to arrive to the clinic in spite of the COVID 19 pandemic and partial quarantine, 27 (30.0 %) patients chose to avoid in person meeting and scheduled a telemedicine appointment and 29 (32.2 %) patients cancelled their appointment. On comparison between patients who chose telemedicine vs. face-to-face meeting, the telemedicine group had lower prevalence of primary infertility (20.0 % vs. 47.1 %, p = 0.037) and higher rates of preimplantation genetic testing indication for in-vitro fertilization (48.2 % vs. 20.6 %, p = 0.026). Rate of a first-ever clinic visit was higher in patients that arrived for a face-to-face meeting, as compared to telemedicine encounter (55.9 % vs. 28.0 %, respectively; p = 0.036). Patients that opted to avoid attending the clinic or meeting via telemedicine had higher rates of medical comorbidities compared to patients who chose to attend their appointment (51.7 % vs. 29.5 %, p = 0.016). Rate of appointments that led to fresh or frozen-thawed embryo transfer and these transfers' outcomes (clinical pregnancy rate) were similar in the telemedicine and face-to-face meeting groups (72.2 % vs. 88.0 % and 30.8 % vs. 31.8 %, p = 0.73 and p = 1.00; respectively). ConclusionTelemedicine is a valuable tool for delivering fertility care during the COVID-19 pandemic. There is need to determine which patients will benefit most from this modality.