THE NEW NORMAL: PATIENT PROGRESSION TO FERTILITY TREATMENT IN A COVID-19 WORLD

ABSTRACT

OBJECTIVE: The coronavirus (COVID-19) pandemic reshaped access to assisted reproductive technology (ART) treatment. Following ASRM's March 2020 recommendation to halt all ART treatments, many patients were unable to pursue parenthood until resumption of clinical care. Our study assesses patient progression to reproductive care before, during and after the declaration of the COVID-19 pandemic. MATERIALS AND METHODS: The study includes patients who sought ART treatment from January 1, 2018 to October 1, 2020. Only patients who underwent an initial consultation were included in the study. Patients were grouped by month in the years of 2018, 2019, and 2020. Patient progression to treatment was confirmed only if the ART procedure occurred within 90 days after initial consultation. RESULTS: A total of 27,626 initial consultations from patients who sought ART treatment were evaluated in the study. Treatment progression rates for 2018 and 2019 showed high correlation with nearly identical rates per month from March to July [Table 1]. Patient progression declined to 47.9% starting in January 2020 compared to 57.3% in 2018 and 59.4% in 2019 of the same month. Thereafter, progression to treatment dropped to an all-time low (February-March 2020 (32.0-33.0%)). Progression rate increased by late April 2020 (47.7%);and then surged in May 2020 (55.7%) superseding treatment progression rates between the same months during 2018 (47.4%) & 2019 (47.9%). By the end of August and throughout September 2020 progression to treatment restored itself to rates in 2018 & 2019 [Table 1]. CONCLUSIONS: As compared to cohorts in 2018 and 2019, our study demonstrated a marked decline in progression to ART treatment that coincided with the onset of the COVID pandemic and when many regions of the country restricted all but urgent medical procedures. As COVID-related restrictions lifted, treatment progression rates sharply rebounded and then stabilized by September 2020. The recovery to treatment progression displays fertility care as essential to patients and reaffirms a strong desire to have children. IMPACT STATEMENT The barriers related to the onset of the COVID pandemic were short-lived for patients who sought ART treatment. Even with COVID's introduction of new normal, patients can be reassured that they have the ability to access reproductive care and achieve parenthood.