Prepared by the ARCS/BFS COVID working group* on behalf of the Executive Committees of ARCS and the BFS.

Published on the ARCS and BFS websites on 4th August 2021

 

Covid-19 remains a challenge to the health system. At the time of this update, the number of new infections in the UK has been declining, but significant numbers of patients, including pregnant women, are still being admitted to hospitals with serious illness. It is likely that the effects of the pandemic will continue to affect the UK, and other, health services for some time to come. In this situation, the ARCS/BFS Covid working group believes that its guidelines concerning Covid-19 remain relevant. However, we encourage practitioners and clinics to interpret the guidance in the light of changes in transmission rates, national guidance concerning healthcare and local factors. The safety of patients and staff, alongside the maintenance of service viability and resilience remain our key priorities.

 

Emerging data for mRNA Covid vaccine is encouraging in terms of its effect on sperm parameters (1), IVF cycle outcome (2) and miscarriage risk following frozen embryo transfer (3). No obvious safety signals have been identified by the V-Safe surveillance system and pregnancy registry (4). Clinicians should feel able to discuss and encourage the uptake of vaccination among patients planning to conceive and may find the updated ARCS/BFS FAQ useful as a support tool for this.

 

Centres may wish to review their triage processes for patients who have received two doses of the COVID-19 vaccine.

 

Centres should take into account evolving national rules for self-isolation of staff in the event of exposure, or contact by NHS Test and Trace, in order to maintain services, ensuring that these processes are appropriately risk assessed.

 

It is appropriate for centres to consider which of the measures introduced in response to the pandemic are suitable in the longer term to build in resilience. Virtual consultations have been widely adopted, and centres may decide to continue with these based on their assessment of safety, confidentiality and patient acceptability. Research is lacking on the use of virtual consultations for fertility.

 

Patient support remains vital. Staff should be aware that there remains heightened anxiety among patients around Covid-19, and centres should ensure appropriate self-help and counselling provision in order to cater for this. Centres should signpost to and assist patient support groups where they exist.

 

 

References

 

  1. Gonzalez DC, Nassau DE, Khodamoradi K, et al. Sperm Parameters Before and After COVID-19 mRNA Vaccination. JAMA. 2021;326(3):273–274. doi:10.1001/jama.2021.9976

 

  1. Orvieto, R., Noach-Hirsh, M., Segev-Zahav, A. et al. Does mRNA SARS-CoV-2 vaccine influence patients’ performance during IVF-ET cycle?. Reprod Biol Endocrinol 19, 69 (2021). https://doi.org/10.1186/s12958-021-00757-6

 

  1. Morris RS. SARS-CoV-2 spike protein seropositivity from vaccination or infection does not cause sterility [published online ahead of print, 2021 Jun 2]. F S Rep. 2021;10.1016/j.xfre.2021.05.010. doi:10.1016/j.xfre.2021.05.010

 

  1. Shimabukuro, Tom & Kim, Shin & Myers, Tanya & Moro, Pedro & Oduyebo, Titilope & Panagiotakopoulos, Lakshmi & Marquez, Paige & Olson, Christine & Liu, Ruiling & Chang, Karen & Ellington, Sascha & Burkel, Veronica & Smoots, Ashley & Green, Caitlin & Licata, Charles & Zhang, Bicheng & Alimchandani, Meghna & Mba-Jonas, Adamma & Martin, Stacey & Meaney-Delman, Dana. (2021). Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. New England Journal of Medicine. 384. 10.1056/NEJMoa2104983.

 

*The ARCS/BFS COVID working group: Raj Mathur & Jason Kasraie (co-chairs), Gwenda Burns, Alison Campbell, Debbie Evans, Nicholas Macklon, Jane Stewart.