COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management

Carlo Alviggi, Sandro C Esteves, Raoul Orvieto, Alessandro Conforti, Antonio La Marca, Robert Fischer, Claus Y Andersen, Klaus Bühler, Sesh K Sunkara, Nikolaos P Polyzos, Ida Strina, Luigi Carbone, Fabiola C Bento, Daniela Galliano, Hakan Yarali, Lan N Vuong, Michael Grynberg, Panagiotis Drakopoulos, Pedro Xavier, Joaquin Llacer, Fernando Neuspiller, Marcos Horton, Matheus Roque, Evangelos Papanikolaou, Manish Banker, Michael H Dahan, Shu Foong, Herman Tournaye, Christophe Blockeel, Alberto Vaiarelli, Peter Humaidan, Filippo M Ubaldi, POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) group, Carlo Alviggi, Sandro C Esteves, Raoul Orvieto, Alessandro Conforti, Antonio La Marca, Robert Fischer, Claus Y Andersen, Klaus Bühler, Sesh K Sunkara, Nikolaos P Polyzos, Ida Strina, Luigi Carbone, Fabiola C Bento, Daniela Galliano, Hakan Yarali, Lan N Vuong, Michael Grynberg, Panagiotis Drakopoulos, Pedro Xavier, Joaquin Llacer, Fernando Neuspiller, Marcos Horton, Matheus Roque, Evangelos Papanikolaou, Manish Banker, Michael H Dahan, Shu Foong, Herman Tournaye, Christophe Blockeel, Alberto Vaiarelli, Peter Humaidan, Filippo M Ubaldi, POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) group

Abstract

The prolonged lockdown of health services providing high-complexity fertility treatments -as currently recommended by many reproductive medicine entities- is detrimental for society as a whole, and infertility patients in particular. Globally, approximately 0.3% of all infants born every year are conceived using assisted reproductive technology (ART) treatments. By contrast, the total number of COVID-19 deaths reported so far represents approximately 1.0% of the total deaths expected to occur worldwide over the first three months of the current year. It seems, therefore, that the number of infants expected to be conceived and born -but who will not be so due to the lockdown of infertility services- might be as significant as the total number of deaths attributed to the COVID-19 pandemic. We herein propose remedies that include a prognostic-stratification of more vulnerable infertility cases in order to plan a progressive restart of worldwide fertility treatments. At a time when preventing complications and limiting burdens for national health systems represent relevant issues, our viewpoint might help competent authorities and health care providers to identify patients who should be prioritized for the continuation of fertility care in a safe environment.

Keywords: Assisted reproductive technology; COVID-19; In vitro fertilization; Infertility; Intracytoplasmic sperm injection; Poseidon criteria; Viewpoint.

Conflict of interest statement

CA and SE declare the receipt of unrestricted research grants from Merck, and lecture fees from Merck. RO, AC, RF, FN, and MR have received honoraria for lectures from Merck. ALM has received unrestricted research grants from MSD, Merck, Ferring, Theramex, Beckman Coulter, IBSA, Gedon-Richter, Roche as well as honoraria for lectures from the same companies. KB has received honoraria for lectures from Bayer and Merck, and unrestricted research grant from Theramex. SS declares the receipt of honorarium for lectures from Merck, MSD, and Ferring. NP has received unrestricted grants or lecture fees from Merck, MSD, Gedeon-Richter, IBSA, Besins, Ferring Pharmaceuticals, and Theramex. HY and MH declares receipt of honorarium for lectures from Merck and Ferring. LV has received speaker’s fees from Merck, Ferring, and research grants from MSD. PD declare the receipt of honorarium for lectures from Merck, MSD, and Ferring, and unrestricted research grant form MSD. PX declares receipt of lecture fees from Merck, Gedeon-Richter, Ferring, and MSD. JL has received research grants from MSD and IBSA, Merck as well as honoraria for lectures from MSD, Merck, Ferring, Theramex, and IBSA. CB has received unrestricted grants and lecture fees from Abbott, MSD, Gedeon-Richter, and Ferring Pharmaceuticals. HT has received grants from Roche, MSD, Cook, Ferring, Research Funders of Flanders, Gedeon-Richter, Abbott, and ObsEva, as well as consulting fees from Gedeon-Richter, Abbott, and ObsEva. PH has received unrestricted research grants from MSD and Merck, as well as honoraria for lectures from MSD, Merck, Gedeon–Richter, Theramex, and IBSA. The remaining authors (CYA, FCB, ID, LC, DG, MG, MB, MHD, HT, EP, SF, AV, and FMU) declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

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Fig. 1
COVID − 19 and Assisted Reproductive Technology: proposal for individualized clinical management

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