HFEA Coronavirus (COVID-19) guidance – current status as of 18 March 2020
Coronavirus (COVID-19) update 18 March 2020: Updated statement for clinics
As the coronavirus pandemic escalates, we are closely monitoring its impact on the UK fertility sector. Our advice to clinics remains to refer to UK professional guidance when making decisions about whether to offer treatment. Only professional guidelines, not the HFEA, can inform local medical decisions.
The British Fertility Society and the Association of Reproductive and Clinical Scientists updated their guidance on 18 March. This is designed to help UK fertility clinics decide how to prioritise and organise their services during the outbreak, whilst complying with their clinical, ethical, regulatory and social duties. The Royal College of Obstetricians and Gynaecologists have also updated their guidance.
We expect clinics to follow the advice from the British Fertility Society and the Association of Reproductive and Clinical Scientists. The guidance calls on clinics in both the private sector and the NHS to consider their wider responsibility in any decision making, including the need to promote social distancing and the potential effects of their work on local NHS services which are likely to be stretched to an unprecedented extent.
The guidance assumes that as coronavirus spreads, clinics will stop fertility treatments over the coming weeks. This may be for several reasons: redeployment of staff, reduced anaesthetist cover, or staff being unable to work due to self-isolation or illness. The guidance also carries a call to cease treatments to minimise the spread of the virus and reduce the impact on the NHS due to the common complications of IVF such as OHSS.
We will be writing to all clinics to seek assurances that they intend to follow this guidance and to remind the Person Responsible of their duty to provide a safe environment for patients, gametes and embryos.
Where clinics remain open either to continue treatment, or to provide a skeleton service, they must work within safe limits, including safe staffing numbers, and ensure stored gametes and embryos are not put at risk. If treatment services are disrupted clinics should put measures in place to keep patients informed of any changes and the reason for these, as well as have adequate cover to support patents who have concerns or require support.
Coronavirus (COVID-19) update 17 March 2020: Guidance for patients
We understand that some patients are concerned about the current situation with COVID-19 and whether this should be a reason to stop IVF treatment.
We cannot provide patients or clinics with medical guidance or make medical decisions. However, our current advice to clinics is to refer to UK professional guidance for advice when making decisions about whether to offer treatment. Patients should discuss their individual circumstances with their clinic before considering starting treatment. British Fertility Society and the Association of Reproductive and Clinical Scientists issued joint guidance on 16 March and we are in regular communication with them. We have also shared guidance from the Royal College of Obstetricians and Gynaecologists to all clinics.
However, we are aware that there are different opinions among professional bodies globally and your clinic should be aware of this, but we reiterate our advice for clinics to follow UK professional guidance only and depending on the individual clinics circumstances they can continue to treating patients at the current time.
We are also aware that some clinics have had to stop treatments for other reasons such as low staffing levels due to staff being redeployed to other areas and emergency planning measures in their hospital. These decisions are taken locally by the individual clinic and are not something that the HFEA is involved in. We have not issued guidance which says all clinics should cease providing treatment at this time.
We are closely monitoring the situation and will share any new information that we receive via our website and social media channels.
Coronavirus (COVID-19) update 17 March 2020: Guidance for professionals
We are aware that there is a confusing picture of the effect of COVID-19 on fertility treatment with advice and guidance coming out from several different sources. Our current advice to clinics is to refer to UK professional guidance for advice when making decisions about whether to offer treatment. Only professional guidelines, not the HFEA, can inform local medical decisions.
The British Fertility Society and the Association of Reproductive and Clinical Scientists issued joint guidance on 16 March and we are in regular communication with them. We have also shared guidance from the Royal College of Obstetricians and Gynaecologists to all clinics.
However, we are aware that there is a difference of opinion among professional bodies globally and clinics should be aware of this. This guidance includes:
- The American Society for Reproductive Medicine (ASRM) has advised that as of 17th March suspension of all new, non-urgent fertility treatments in the midst of a public health emergency. They aim to review their recommendations no later than 30 March 2020 with the aim of resuming usual patient care as soon as possible.
- The Fertility Society of Australia suggests there is no evidence to recommend contraception or cessation of attempts to conceive, either unassisted or assisted. The FSA has in place guidance for those with symptoms or at risk which is similar to the ASRM.
- The European Society of Human Reproduction and Embryology (ESHRE) has stated that there is no strong evidence of any negative effect of COVD-19 on pregnancy, especially at the early stages. They have taken a precautionary approach and have advised all fertility patients to avoid becoming pregnant at this time and suggested consideration of deferred pregnancy with oocyte of embryos cryopreservation
We appreciate that this difference of opinion does make individual treatment decisions difficult, but we reiterate our advice is for clinics to follow UK professional guidance only. We are aware of the limitations of the evidence that is currently published, and we advise clinics to be cautious when interpreting it and that those clinics proceeding with treatments should discuss this with patients, so they fully understand the situation.
In addition, we are aware that some clinics have had to stop treatment cycles for other reasons such as staffing levels and emergency planning measures in their hospital. These decisions are taken locally by the individual clinic. We have not issued any guidance to advise that treatments should not continue.
We are closely monitoring the situation and will share any new information that we receive.
Coronavirus (COVID-19) update 17 March 2020: Clinic inspections
Following UK government’s updated guidance on COVID-19 yesterday, we’ve decided to cease clinic inspections starting from today until the end of August 2020.
The HFE Act requires that all clinics must have a licence from us to offer services and we will put measures in place that allow clinics to continue to operate lawfully.
- Clinics that are due renewal inspections between now and August will have their inspection date deferred
- Where clinics have a four-year licence (at their previous renewal) and where compliance has been demonstrated, we will issue a one-year extension to the licence.
- Where there is evidence of issues some clinics may be asked to provide information to enable a desktop analysis to be conducted before any extension can be granted.
- Clinics that have a four-year licence and are due an interim inspection between now and the end of August will not be inspected.
- Clinics with licences of less than 4 years or where a targeted inspection is required may either be asked to provide information for a desktop analysis and/or will be inspected as soon as possible after the inspection schedule restarts.
- Research centres that have a licensed research project that is due for renewal between now and the end of August will have a desk-based renewal inspection with a decision on the renewal of the licence taken by an HFEA committee (by paragraph 3(8) of Schedule 2 a research licence cannot be granted for a period exceeding 3 years).
Coronavirus (COVID-19) update 16 March 2020: UK professional guidance
We are carefully following the coronavirus pandemic and UK government measures to contain and mitigate the spread of the virus. We are monitoring updates issued by the Department of Health and Social Care, Public Health England and the NHS.
Our priority is the health and safety of patients, clinic staff and our staff. We’re taking the following actions to deal with any potential implications of the coronavirus outbreak. These include:
- Following official government guidelines and advice
- Monitoring clinics who are due inspections and will ensure continuity of licence is maintained if we are unable to inspect before a licence period runs out
- Provided advice for our staff. We have a business continuity plan in place to ensure we can respond efficiently to serious business disruption
We expect clinics to have their own business continuity and contingency plans to respond to official advice or cope with specific local effects of coronavirus in their own hospitals and clinics.
As the regulator, we are unable to provide advice on individual medical questions. Patients who are currently undergoing fertility treatment or are pregnant should contact their clinic for advice and questions about their treatment.
Coronavirus (COVID-19) update 05 March 2020: Donation
Patients or donors who have travelled to a country that is deemed to have a high risk of Coronavirus should speak to their clinic about how this may impact on their treatment or donation.
Guidance issued by the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) states:
Must not donate if:
- a) Less than 28 days from a donor’s return from a Coronavirus risk area. This includes transit through an airport in a Coronavirus risk area, even if the traveller has not left the airport.
- b) Less than 28 days from the last contact with a person with Coronavirus infection.
- c) Less than 28 days since recovery from Coronavirus infection or possible Coronavirus infection.
The Department of Health and Social Care have issued guidance and advice on Coronavirus and an action plan, which may also be helpful for donors and patients to refer to. The NHS has also issued guidance.
Publication date: 23 March 2020
Review date: 23 March 2022