My clinic is offering immunosuppressive treatments. What does this mean?
Immunosuppressive treatments are not recommended because they are of unproven benefit and carry risks (some of which are serious). They are marked as ‘red’ on our traffic light system. There remains an additional risk in using such treatment during the COVID-19 pandemic. These treatments make patients more susceptible to the virus and put them at high risk for developing serious complications from COVID-19.
The professional advice from the British Fertility Society, the Association of Reproductive and Clinical Scientists and the Royal College of Obstetricians and Gynaecologists is that the use of empirical immunosuppressive treatments should be avoided. There is insufficient evidence of benefit from these treatments, and they may increase the risk of severe infection. Although the pandemic is easing, it is still with us. The UK Chief Medical Officers have determined that the COVID-19 alert level is currently Level 3 (a COVID-19 epidemic is in general circulation) on the basis of advice from the Joint Biosecurity Centre.
Shielding remains in place at the moment, although a relaxation of the shielding guidance came into effect on 6 July and people in clinically extremely vulnerable groups have been advised that they no longer need to shield from 1 August unless the number of COVID-19 cases in the community starts to rise significantly. The guidance remains that people in these groups may still be at risk of severe illness if they catch coronavirus, so they should stay at home as much as possible and continue to take precautions when they do go out. People on immunosuppression therapies sufficient to significantly increase the risk of infection are considered clinically extremely vulnerable according to the most recent UK government guidance.
We note that in the changes to the shielding advice and in other areas of medicine, there has been some use of steroid and other treatments in specific circumstances. However, our advice remains that immunosuppressive treatments should not be offered as there is no evidence that these are effective, and that their use increases the risk to patients during the ongoing pandemic.