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1.
Fertility and Sterility ; 114(3):e179, 2020.
Article in English | EMBASE | ID: covidwho-880478

ABSTRACT

Objective: To evaluate a protocol of universal symptom and viral screening prior to initiation of controlled ovarian hyperstimulation among patients receiving care in New York City. Design: Prospective cohort study. Materials and Methods: Prior to initiation of controlled ovarian hyperstimulation for oocyte cryopreservation or in vitro fertilization cycles, patients were screened by phone for symptoms of fever, cough, sore throat, recent travel or contact with confirmed COVID cases. If negative, patients were scheduled for nasopharyngeal swabs at our center the following day, with visits spaced at 15 minute intervals to avoid crowding. Upon presentation for swab testing, patients were again screened for symptoms and fever. Nasopharyngeal swabs were collected in accordance with the Center for Disease Control (CDC) guidelines, and delivered to the university’s clinical microbiology laboratory. The swabs were tested using the Roche Cobas 6800 SARS-CoV-2 test, a qualitative assay, using real-time reverse transcriptase polymerase chain reaction (RT-PCR) test (Roche Diagnostics, USA), with results delivered in the same day. A negative test result was required prior to patients' baseline ultrasound and bloodwork the following morning. This study was conducted from April 21- May 21, 2020, Results: The study sample included 151 asymptomatic patients who were tested for SARS-CoV-2 via nasopharyngeal swab. Overall, 149 (98.68%) tested negative for COVID-19, 1 (0.66%) tested indeterminate, 2 (1.32%) tested invalid, and 0 (0%) tested positive for COVID-19. Of the 149 patients who have tested negative, 81 have successfully undergone oocyte retrieval without complications. One patient screened positive for symptoms at the time of swab presentation and was instructed to return for testing in 2 weeks. Conclusions: The incidence of COVID-19 infection among asymptomatic patients seeking fertility treatment in NYC is low. We have demonstrated that fertility care can safely resume in a way to limit risk to our patients, staff, and our physicians working in the epicenter of infection.

2.
Fertility and Sterility ; 114(3):e63, 2020.
Article in English | EMBASE | ID: covidwho-880461

ABSTRACT

Objective: To survey fertility patients’ agreement with ASRM recommendations during the COVID-19 pandemic and the emotional impact on them. Design: An online survey was sent to current fertility patients at a New York City academic fertility practice at the epicenter of the COVID-19 pandemic. Materials and Methods: Patient agreement with the ASRM recommendations during the COVID-19 pandemic and the emotional impact rated on a Likert scale. Ordinal data such as responses rated on a Likert scale were analyzed using Mann-Whitney Wilcoxon testing and responses were compared using Fisher exact or chi-square test as appropriate, with significance at p<0.05. Results: A total of 518 patients completed the survey for a response rate of 17%. Fifty percent of respondents had a cycle canceled due to the COVID-19 pandemic. Of those who had a cycle cancelled, 85% of respondents found it to be moderately to extremely upsetting with 22% rating it to be equivalent to the loss of a child. There was no difference on the emotional impact based on the type of cycle cancelled. Fifty-five percent of patients agreed that diagnostic procedures such as hysterosalpingograms should be cancelled while 36% of patients agreed all fertility cycles should be cancelled (22% unsure, 43% disagreed). Patients were slightly more likely to agree with the ASRM guidelines if they have an upcoming cycle cancelled (p = 0.041). Of all respondents 82% would have preferred to have the option to start a treatment cycle in consultation with their doctor. Conclusions: Given the severity of the COVID-19 pandemic, the physical, financial and emotional impact of this unprecedented threat cannot be underestimated in our fertility patients.

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