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Frequently asked questions for patients on Coronavirus (COVID-19)

We have produced these questions and answers to help to explain how clinics are resuming fertility treatment during the ongoing COVID-19 pandemic. If you have specific questions regarding your medical treatment or the reopening of your chosen fertility clinic, you will need to speak to your clinic directly.

We will update these FAQs as needed and we will keep you informed via our website, Twitter and Facebook.

What is the current situation?

In May 2020, we issued a new General Direction to clinics allowing them to apply to reopen. A full list of clinics that have been authorised to resume treatment is available on our website. Some of these clinics may be operating on a reduced service. 

How will clinics keep patients safe?

Our priority and that of the clinics is the safety of patients, their gametes and embryos and of clinic staff. We need to be assured that clinics have processes in place to ensure all of these before they reopen. Clinics will need to satisfy the requirements set out in the revised General Direction 0014. These requirements include that clinics record the measures the centre will be taking to comply with current guidance on safe and effective treatment during the COVID-19 pandemic published by professional bodies and UK and devolved governments.

Do I need to be tested for COVID-19 prior to treatment?

Some clinics may choose to include testing for COVID-19 as part of their treatment strategy for all patients having treatment including patients who are asymptomatic. We have not stated clinics must test all patients as it is not a current recommendation made by Government or the Professional Bodies (BFS/ARCS). If you’d like more information on COVID-19 testing, please refer to the Government guidance. You can request also request a test on the NHS website.

Will clinics implement social distancing?

The revised guidance from professional societies and UK and devolved governments set out ways in which services can be reconfigured to allow patients to be treated safely and clinic staff to work safely during the current situation with COVID-19. Clinics will need to outline in their COVID-19 Treatment Commencement Strategy how they will comply with Government guidance on social distancing.

Can my clinic charge for a COVID-19 test and/or Personal Protective Equipment (PPE)?

Some clinics may choose to include testing for COVID-19 as part of their treatment strategy for all patients having treatment, including those who are asymptomatic. Our regulatory remit does not include the ability to stop clinics charging for these tests or PPE, but we expect patients to be treated fairly and safely at all times.

If your clinic  requires you to take a test before starting treatment, they should inform you that you can access a free test using the NHS website, if you have symptoms. If your clinic requires you to have a test and you don’t have any symptoms then we have advised clinics that they should consider what a reasonable charge is for that test. 

Some clinics may also require patients to use PPE. We know that clinics have to cover their costs which is acceptable, but we expect clinics to charge patients a fair price for any PPE they are required to use.

What will happen if there is a localised lockdown due to COVID-19?

If there is a localised lockdown, it will be the responsibility of any affected clinics to assess the risk locally and decide whether they can safely continue treatment. This would involve looking at the risks to patients, the local ‘r’ rate, and any restrictions in place locally.

For a centre to be approved to reopen they must have a written COVID-19 Treatment Commencement Strategy.  This means clinics will have measures in place to ensure they comply with specified guidance on safe and effective working practices during the pandemic. 

We will continue to monitor national and devolved government advice as well as that of the professional bodies and will react in an appropriate manner, should the situation change at any time.

When clinics reopen will they prioritise particular groups of patients?

It is up to individual clinics to decide which treatments are to resume and when. Clinics will be holding waiting lists of patients whose cycles had to be cancelled or who could not start planned treatment during the closure. We understand that unless there are exceptional circumstances, most clinics will be carrying on where they left off in terms of who they will offer treatment to and will be in touch to let those people know what to expect.

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.

My clinic is not responding to me. What can I do?

Many clinics have been operating with reduced staffing levels (where employees may have been redeployed, furloughed or are unwell). As clinics begin to reopen, they may be doing so on a reduced service and therefore may take longer to reply than usual. We have encouraged clinics to communicate with patients about their current status and it might be helpful to check on your chosen clinic’s website or social media pages for any updates they have provided.

We are unable to answer medical questions or questions related to your specific treatment. If your question is related to either of these, you will need to wait for a response from your clinic. We know that clinics are eager to resume treatment as soon as possible, but safety must remain their priority.

I’m not on any clinic’s waiting list but was hoping to start treatment soon. What can I do?

Most clinics are offering telephone or video initial consultations and we suggest if you haven’t yet chosen your clinic, you visit the ‘Choose a Fertility Clinic’ section of our website to help you do this. You can then get in touch with your chosen clinic to find out more.

I need further NHS investigations e.g. a laparoscopy or surgical sperm retrieval. What will happen about these procedures?

Currently we don’t have any information about when routine NHS procedures will recommence. Unfortunately, there is likely to be a longer wait for these services as there will be a back log.

What if I don’t want to have treatment because of the risk of contracting COVID-19 or the lack of information on any adverse effects for women who contract the virus during pregnancy?

Any risks about the impact of COVID-19 on pregnancy have been considered by the Royal College of Obstetricians and Gynaecologists (RCOG) who have regularly updated their guidance. This would be taken into consideration by your clinic before treatment is started. Patients would need to actively consent to having treatment whilst there is a risk that they could contract COVID-19 either during the treatment or if successful, during pregnancy.

Will I be refunded if my treatment is cancelled or postponed due to the ongoing COVID-19 pandemic?

Before you begin treatment, consumer protection law states that clinics should explain in writing the circumstances in which treatment may be cancelled or postponed, and explain your rights and obligations should treatment be cancelled or postponed e.g. whether you are entitled to a refund of any prepayments.

The CMA has recently published guidance which sets out its views in relation to cancellations and refunds within the context of the COVID-19 pandemic. This explains the circumstances in which the CMA would expect a consumer to be offered a full refund where no services are provided as a result of COVID-19. This guidance also explains that in circumstances where a patient has already received some services they have paid for in advance, that they would be entitled to a refund of the services not already provided.

Will I still be eligible for NHS funding if my treatment was delayed due to COVID-19?

While we have no remit over funding, we hope that those relying on NHS funding will be allowed to continue their treatment as they expected. We know that the devolved governments of Scotland, Wales and Northern Ireland have committed to ensure that patients are not disadvantaged by the pandemic. The situation has yet to be clarified in England where the patient charity Fertility Network UK is actively trying to ascertain the situation.

We’re nearing the 10-year storage limit for our eggs/sperm/embryos. Will we still be able to use them if we don’t have treatment before our storage expires?

The Government has confirmed that the current 10-year storage limit for embryos and gametes will be extended by two years. This means that patients who have stored sperm, eggs or embryos that are reaching the 10-year storage limit will not be penalised by the current suspension of fertility treatment due to the COVID-19 pandemic.

We will be issuing new guidance to fertility clinics to support them in implementing the new storage limit extension.

What do clinics need to do before they can reopen?

A revised General Direction 0014 has been issued to licensed UK fertility clinics, which sets out conditions that must be met by a clinic in order to reopen for treatment. These new guidelines aim to ensure the safety of patients, their gametes and embryos, and of clinic staff. Clinics must have a COVID-19 Treatment Commencement Strategy that records the measures the clinic will be taking to comply with current professional body and UK and devolved government guidance on safe and effective treatment.

General Directions are issued when we need to change clinic practice in line with new policy or guidance. General Directions are mandatory, meaning that all clinics must follow them. If a clinic fails to do so, it would be a breach of a statutory licence condition, which may have serious implications on their license, including suspending or revoking a clinic’s license.

How long will it take you to process applications from clinics to reopen?

We aim to complete our approval process within 5 working days of receiving the completed clinic self-assessment.

Will some clinics open before others?

The revised General Direction applies to all licensed UK clinics, both NHS and private. It does not require clinics to resume treatment by a certain date and it is likely that some clinics will be in a position to start treatment before others. This is because clinics will need to consider local factors relevant to their service provision and whether they have the resources to be able to offer a safe service at this time. A list of clinics that have been authorised to resume treatment can be found on this page

You can get in touch with your chosen clinic to find out when they will resume treatment. If you are not currently with a clinic you can use our Choose a Fertility Clinic’ service to help you find one.

How will the resumption of fertility treatment impact the NHS?

We have been monitoring this situation closely and believe that circumstances have changed in recent weeks and that fertility treatment can resume without negatively impacting on the NHS. Clinics must have procedures in place to mitigate any complications that might arise from treatment.

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Review date: 14 July 2022