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

Updated 1 October 2020

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?

From May 2020, clinics were able 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 are clinics keeping patients safe?

Our priority and that of the clinics is the safety of patients, their gametes and embryos and of clinic staff. Before reopening, clinics needed to satisfy our requirements. 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 For example, centres have to record how they will comply with Government guidance on social distancing.

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.

Before clinics were approved to reopen, they had to write a COVID-19 Treatment Commencement Strategy. This means clinics have measures in place to ensure they comply with specified guidance on safe and effective working practices during the pandemic. Your clinic will need to assess whether these measures are sufficient to be able to protect patients in light of any new lockdown restrictions.

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.

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. The current guidance from the BFS/ARCS is that before starting treatment, consideration should be given to antigen testing (or an equivalent test if available, validated and approved. We have not stated clinics must test all patients as it is not a current recommendation made by Government. If you’d like more information on COVID-19 testing, please refer to the Government guidance.

Can my partner attend fertility appointments? (new)

The updated guidance from The Association of Reproductive and Clinical Scientists (ARCS) and the British Fertility Society (BFS) says that centres should minimise the number of accompanying persons, and should carry out risk assessments to ensure the attendance of a partner at appointments is safe.

The Royal College of Obstetricians and Gynaecologists have introduced a framework to allow partners to be able to attend maternity services in England, including fertility treatments. They recommend using a stepwise approach, following a documented risk assessment. Policies on permitting access to partners should be regularly reviewed by centres. The policies should also be tailored to the local context and take account of current risks and government policy.

What are the risks of COVID-19 and pregnancy?

Patients may be anxious about coronavirus infection and its potential effects on pregnancy. Present experience is limited and does not indicate that the severity of infection is any worse in pregnancy. At this stage, there is no evidence of an increased risk of foetal anomalies or adverse pregnancy complications. The Royal College of Obstetricians and Gynaecologists have provided guidance about the risks of the impact of COVID-19 on pregnancy. 

Clinics should counsel patients on the potential risks, taking into account the patient’s individual clinical situation and risk profile, as well as the likely persistence of the virus in the local community in the medium term. Patients need to actively consent to having treatment while there is a risk of contracting COVID-19 either during treatment or, if successful, during pregnancy.

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.

Are clinics prioritising particular groups of patients as part of their Treatment Commencement Strategy?

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 treatments of uncertain efficacy and safety, including immunosuppressive treatments, should be avoided. There is insufficient evidence of benefit from these treatments, and they may increase the risk of severe infection.

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). Some clinics may be operating 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.

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.

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.

If you think you may be eligible for this extension, we would advise that you contact the centre where your gametes or embryos are being stored.

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Review date: 2 October 2022