COVID-19 FAQs

Monash IVF FAQs relating to COVID-19

Updated 27.04.2020

1) Am l able to start, or resume my fertility treatment now that the Government has lifted the suspension on IVF?

Yes, all of our services are resuming. If you want to start treatment and have not yet seen a fertility specialist, please call 1800 628 533 to make a telehealth appointment. If you are continuing treatment, call your fertility nurse to determine what this means for you.

2) Should I attend my appointment if:

• I have had close contact with someone who has positively tested for Coronavirus; or
• I have respiratory and / or viral symptoms

If you are sick and think you might have COVID-19, please do not attend our clinic. Check your symptoms using Healthdirect's Coronavirus (COVID-19) Symptom Checker and follow their instructions. Please let our team know, so that they can talk you through the potential impact on your cycle. If your symptoms are only mild "cold" like symptoms (runny nose and sore throat) and you have no fever (your temperature is not 37.4 degrees C or higher) we may still proceed with treatment. This decision will be made on a case-by-case basis. Please do not attend any appointments before discussing your symptoms with us.

3) Will my consultation or appointment be in person? What are the alternatives?

Wherever possible, consultations with your fertility specialist, counsellor or nurse will be done as a phone or skype consultation. If some circumstances you care will not be able to be conducted remotely. Where you do need to attend our facilities, we will do everything we can to maintain social distancing, which may include:

• a. Offering the option of waiting in your car or outside the clinic until your appointment timeb. Floor markings to indicate the 1.5m distance between you and the next personc. Re-configured waiting rooms

Your clinic will discuss the best option with you before making an appointment.

If you have any viral symptoms or a fever you must not attend in person consultations – please call and discuss your situation with the clinic instead.

For treatment consent forms and other documentation that need to be signed, we may be able to arrange that at your next in-person appointment, such as oocyte retrieval or embryo transfer. Your clinic will advise this on a case by case basis.

4) I live overseas, are you accepting overseas patients?

If you have travelled from overseas from any country you will be required to complete a Government mandated isolation for 14 days after travel. You would need to factor this into any travel plans that you make. Further information is available here.

5) What is Monash IVF doing to minimise transmission in clinics?

Monash IVF have introduced a series of initiatives to reduce the risk of spreading COVID-19, including:

• Temperature screening of patients and support people entering Monash IVF clinics
• Modifying waiting rooms and reception areas to accommodate social spacing distance of 1.5m per person
• Telehealth appointments with doctors, unless a face-to-face consultation is required
• Staggering face-to-face appointments to minimise traffic in the clinics
• Patients who have a planned treatment that requires attending a day surgery unit (eg. egg collection or surgical sperm retrieval) may be required to be tested for COVID-19 and return a negative result
• Personal Protective Equipment will be worn in clinic, to meet Droplet Precaution requirements as indicated

6) What happens if I have already commenced a stimulated IVF cycle or am booked in for a frozen embryo transfer, intrauterine insemination or ovulation induction and become unwell with flu like symptoms and/or a fever?

Please take your temperature, self-isolate at home and contact your clinic or Monash IVF on 1800 628 533. If your symptoms are only mild "cold" like symptoms (runny nose and sore throat) and you have no fever (your temperature is not 37.4 degrees C or higher) we may still proceed with treatment. This decision will be made on a case-by-case basis. Do not attend any appointments before discussing your symptoms with us.

Please note that medications such as paracetamol (Panadol) and other anti-inflammatories (Nurofen etc.) may hide a temperature for four hours. Please take your temperature at least 4 hours after taking these types of medications.

If the symptoms remain, or you have developed a fever, we will cancel the cycle and delay treatment. If your symptoms have gone we may still be able to proceed with treatment, once we are able to in accordance with Australian Government guidelines.

7) Could COVID-19 have any negative effect on my chance of pregnancy?

There is no evidence at this stage of the impact of COVID-19 on fertility treatment and little is known about the effect of COVID-19 in pregnancy.

However, the Royal Australian New Zealand College of Obstetricians and Gynaecologists statement on this topic is the best authoritative resource. The full statement can be found at RANZCOG. An outline of their statement is contained below in italics.

1. Are pregnant women at increased risk of becoming infected with COVID-19?

Pregnant women should be considered a vulnerable or at-risk group.

2. Are pregnant women at increased risk of developing severe disease/complications from COVID-19?

At this time, pregnant women do not appear to be more severely unwell if they develop COVID-19 infection than the general population. It is expected that the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.However, detailed information regarding the impact of COVID-19 infection on pregnant women and their babies is limited by the recency of the disease emergence. Therefore, our pregnancy advice is based on learnings from influenza infection, and also the medical response to the SARS epidemic in 2003. Influenza is a potentially serious disease for pregnant women, the fetus and newborn babies. A number of changes occur to a woman’s body during pregnancy. These changes include reduced lung function, increased cardiac output, increased oxygen consumption, and changes to the immune system. Due to these changes, pregnant women have an increased risk of severe complications from influenza.

3. Is there an increased risk of miscarriage with COVID-19?

For women who are trying to conceive, or who are in early pregnancy, there is no evidence to suggest an increased risk of miscarriage with COVID-19.

4. Can I transmit the virus to my baby while I am pregnant?

There is no evidence that the virus can pass to your developing baby while you are pregnant (this is called vertical transmission) or that the virus will cause abnormalities in your baby.

5. Can I still give birth in a hospital if I am diagnosed with COVID-19 infection?

The safest place to birth your baby is in a hospital, where you have access to highly trained staff and emergency facilities, if they are required. It is important to emphasise that a woman’s experience of labour and vaginal birth, or caesarean section, should not be significantly impacted and women should be encouraged, and supported, to approach this extraordinary time of their lives without fear or apprehension. Medical intervention, other than that specifically related to infection control, should not differ significantly from usual practice. Active mobilisation, use of water immersion in labour, nitrous oxide and epidural analgesia are not affected.

6. Do I need to have a caesarean section or interventional birth to reduce the risk of transmitting the virus to my baby?

There is no evidence that caesarean section or induction of labour is necessary to reduce the risk of vertical transmission. If a woman has COVID-19 infection, or has had significant exposure, unless there are immediate risks to her health, or other obstetric indications, elective caesarean section or induction of labour should be delayed, if possible.

7. What are the risks to my baby if I am diagnosed with COVID-19 infection?

Some babies born to women with symptoms of COVID-19 in China have been born prematurely. It is unclear whether coronavirus was the causative factor, or the doctors made the decision for the baby to be born early because the woman was unwell. Newborn babies and infants do not appear to be at increased risk of complications from the infection.

8. Can I still go for my routine antenatal check ups and tests, and receive antenatal vaccinations if I am diagnosed with COVID-19 infection?

Routine antenatal investigations, ultrasounds, maternal and fetal assessments should continue as before, allowing for the modifications suggested below.

While it will not influence response to COVID-19 infection, routine whooping cough and influenza vaccination should continue to be administered in pregnancy.

The Fertility Society of Australia has also provided an FAQ for patients who are concerned about having a pregnancy at this time. Read their FAQs.

8) What drugs are safe to take at this time?

Please consult with your fertility specialist or obstetrician as they are best to inform you regarding what medications are safe to take.

9) Can I access donor eggs, donor sperm, or surrogacy services during the pandemic?

Yes, our donor and surrogacy programs continue to be offered.

10) Can I freeze my eggs for medical or elective (social) reasons during the pandemic?

Yes as long as you are well. If you are an existing patient and have any questions about egg freezing, please call your fertility specialist. If you have not yet had a consultation with a fertility specialist and want to learn more about elective egg freezing, please call us on 1800 731 927 (free call) or via enquiries@monashivf.com.

11) Will my eggs / sperm be affected by COVID-19?

There is no evidence at this stage of the impact of COVID-19 on eggs and sperm, however, it is early days. We will continue to review the evidence and provide the most up to date information as we can. Monash IVF recommends that if you are considering starting fertility treatment that you consult with your Fertility Specialist who can advise the best course of action for you.

12) I'm interested in IVF - who can I talk to about my fertility options?

Monash IVF have a dedicated team of experienced fertility nurses who are available to speak to you for free via phone about your fertility options.

They can answer any questions you may have and can help you understand the IVF process in more depth.

You can contact our fertility nurses on 1800 731 927 (free call) or via enquiries@monashivf.com.

13) Are there options to do counselling over the phone?

Yes, to ensure we prioritise the health and safety of our patients and our people, we are currently able to provide telehealth counselling sessions. Please contact your clinic to make a new appointment or to enquire about an existing appointment.

14) What independent mental health support is available?

You can access a range of resources online, in addition to support from your Monash IVF counsellor.

The Fertility Society of Australia has recommended a range of evidence based resources to help patients with their mental health during this time:

• Australian Psychological Society
• Beyond Blue
• Black Dog Institute
• Lifeline
• The Australian government digital health portal, Head to Health. This portal gives suggestions, on how to maintain good mental health during this COVID-19 outbreak and how to support others.
• ACCESS, Australia's national infertility network, can further provide information on ways to keep you connected with others coping with infertility and who may have experienced a delay in their fertility treatment due to disruptions created by COVID-19.

You can also refer to the Fertility Society of Australia's mental health FAQs for more information.

15) Can I access IVF Support Groups during this COVID-19 outbreak?

Face-to-face IVF support groups are not possible during this outbreak because of social distancing rules, however many online support groups are still active. You can contact your IVF clinic or call us on 1800 628 533 to find out more about the available online support communities.

16) Where can I find more information?

The following links are from independent, authoritative bodies and associations, and may be useful for you:

• Fertility Society of Australia (FSA) COVID-19 Information
• Fertility Society of Australia patient FAQs
• RANZCOG COVID-19 Statement
• National Perinatal Association

For further information, please contact our nurse enquiry team on 1800 628 533.