Resuming Assisted Reproduction Services during COVID-19 Pandemic: An Initial Indian Experience
SARS, Coronaviruses, covid-19 pandemic, key performance indicators, Assisted reproduction, resumption of in vitro fertilization
Background: The pandemic of COVID-19 has affected many countries and medical services including assisted reproductive treatment (ART) have been hampered. Aim: The study was conducted to assess the preparedness of ART clinics and staff to resume services; patients' reasons to initiate treatment; and key performance indicators (KPIs) of ART laboratories during the pandemic. Setting and Design: This was a semidescriptive, prospective study in two private in vitro fertilization (IVF) clinics in Maharashtra, India, when COVID-19 testing for asymptomatic people was unavailable. Materials and Methods: Time required for replenishing consumables and clinic preparedness to function under “new norms” of pandemic was documented. Infection mitigation measures and triaging strategy were evaluated. KPIs following resumption were analyzed. The Student's t-test was performed for comparing parameters. Results: Thirty percent of the patients consulted through telemedicine accepted or were eligible to initiate treatment on clinic resumption. Lack of safe transport and financial constraints prevented majority from undergoing IVF, and 9% delayed treatment due to fear of pandemic. With adequate training, staff compliance to meet new demands was achieved within a week, but procuring consumables and injections was time-consuming. Fifty-two cycles of IVF were performed including fresh and frozen embryo transfers with satisfactory KPIs even during pandemic. Conscious sedation and analgesia during oocyte retrieval were associated with reduced procedure time and no intervention for airway maintenance compared to general anesthesia. Self-reported pain scores by patients ranged from nil to mild on a graphic rating scale. Conclusions: This study provides practical insight for the resumption of IVF services during the COVID-19 pandemic.
Padma Rekha Jirge, Sadhana Patwardhan, Shishir Narendra Jirge, Deepali A Bhomkar, Shruti M Chougule, Anita Salpekar, Deepak Modi