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It's crucial to listen to patients' perspectives as fertility clinics prepare to reopen

26 May 2020
By Dr Zeynep Gurtin
Lecturer in Women's Health at University College London (UCL)
Appeared in BioNews 1048

Fertility clinics are currently preparing to reopen their doors following their nationwide closure in April, enforced by the coronavirus pandemic. As Sally Cheshire chair of the Human Fertilisation and Embryology Authority (HFEA) told BioNews last week, 'Our priority throughout the pandemic has been to consider how treatment could resume quickly and safely for as many patients as possible and our clear plan sets out how clinics can treat and care for patients safely during the continuing COVID-19 pandemic.' However, as with every aspect of easing lockdown measures, these potential clinic reopenings have also been fraught with questions and uncertainties, especially for patients.

While many patients have warmly welcomed the news of clinics reopening, and are eager to restart their treatment cycles, some have raised concerns regarding a variety of practical, medical, financial and emotional matters. For example, what will be the impact on waiting lists if clinics are required to comply with social distancing measures and thus need to reduce the numbers of patients they can safely see in a given day or week? How will clinics decide which patients take priority? What about the safety concerns regarding patients who rely on public transport to attend their clinic appointments several times a week? Or the financial concerns for patients relying on NHS funding who are approaching the upper age limit for eligibility to treatment on the NHS? Patients may also fear implications to their treatment if someone in their household starts to show symptoms of COVID-19, forcing the patient to self-isolate midway through a cycle. These are all valid concerns, and no doubt more will arise as patients, doctors, nurses and embryologists negotiate the challenges they face providing fertility treatments amidst a global pandemic.

Ms Shirin Khanjani, a consultant in reproductive medicine and surgery at University College Hospital, (UCLH), underwent retraining to be redeployed to the NHS COVID-19 frontline. Khanjani is now looking forward to returning to her fertility patients in the near future and knows that many have found the clinic closures heart-breaking. She is concerned about the impact the pause will have had on them: 'They have waited for months, if not years, to have their treatment and this break in proceedings may have had a damaging impact on their emotional and physical wellbeing,' she says.

Philomena da Silva, a psychologist working in a fertility clinic, has continued to offer support over the telephone, and has witnessed first-hand the heightened stress many fertility patients have been under during lockdown. She said, 'The possibility of losing NHS funding, the wait to be contacted, and the worry about the impact of the aftermath of this period, to name just a few of the concerns, have been sources of anxiety for many patients at this time.'

Fertility counsellor, Carmel Dennehy, adds that while a few patients have been 'relieved' to have an enforced break from IVF, many have felt frustrated. Those actively about to commence treatment or whose treatment was abruptly paused have found the reminders of treatment around their home, such as boxes of prescriptions and injection packets, particularly distressing. Right now, a key worry for many patients, she says, is 'how soon can they start', with some worried that their fertility profile will have declined and that they might miss their opportunity to create a family.

It seems clear that clinics are going to have to build robust support systems as part of their new operating protocols, and in order to do this, it is extremely important to listen carefully to patients' voices and perspectives. For this very reason, we at the Institute for Women's Health at UCL have teamed up with fertility clinicians and counsellors from UCLH to launch a new research study exploring fertility patients' experiences of clinic closures, their worries and concerns around the coronavirus pandemic, and their opinions and anxieties regarding the reopening of clinics.

The anonymous questionnaire is open to all male and female fertility patients, at any stage of fertility treatment (including those who were waiting to begin or consult at a clinic), and can be completed anonymously online in approximately 20 minutes. We hope that this research will give us a better understanding not only of the impact of the coronavirus on the feelings, relationships and lives of fertility patients, but will also enable us to inform clinics about how best to support their patients during these challenging times.

If you would like to get involved with this research, we would love to hear from you. We would like to hear from as many fertility patients as possible and ask for your help to spread the word and forward our questionnaire.

The online questionnaire is available here.

To find out more about this research or to contact the lead researcher, please email.

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11 May 2020 - by Dr Imogen Goold 
Following the cessation of all fertility services on 23 March 2020, fertility patients have been waiting to learn when they will be permitted to recommence treatment...
11 May 2020 - by Dr Joanne Delange 
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