CFAS Communication on COVID-19 

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CFAS COVID-19 Update #11: September 30th, 2020

Dear Members:
 
The Canadian Fertility and Andrology Society continues to monitor the regional and national COVID-19 outbreak information. In our last COVID-19 update, we reminded everyone to please stay diligent and follow all protocols established by the public health authorities.
 
We recommend fertility care to remain accessible throughout the resurgence phase of the pandemic. Fertility clinics should recognize the ongoing obligation to perform regular, required quality control; maintenance of laboratory equipment and cryopreserved material; develop and/or maintaining a PPE plan; develop a human resource plan; and continue to exercise extreme caution through the implementation of all protocols and guidance.
 
Please find document Fertility care during the COVID-19 pandemic: Guiding Principles to assist Canadian ART clinics by clicking here.
 
We also suggested the utilization of the 'COVID Alert' App, which helps break the cycle of infection. The App can let people know of possible exposures before any symptoms appear. The App does not track the user's location, name, address, phone number, health information, or any other sensitive information. You may report a COVID-19 diagnosis via the App if you are a resident of New Brunswick, Newfoundland and Labrador, Ontario or Saskatchewan. For more detailed information, please click here.
 
As the flu season approaches, it is crucial that our healthcare facilities do not become overwhelmed. We recommend getting the flu shot; as stated by the World Health Organization (WHO), this will make it easier to distinguish between COVID-19 and flu cases.
 
Thank you to the IVF Medical Directors group for providing further guidance. Thank you to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.
 
Sincerely,
 
Jason Hitkari, President (2020-2021)
Goldi Gill, Executive Director
CFAS Board of Directors 

CFAS COVID-19 Update #10: September 24th, 2020

Dear Members:

Due to the quick rise in COVID-19 cases in various regions across Canada, we would like to remind you to please remain diligent and follow all protocols established by the public health authorities.

Additionally, you may want to utilize the 'COVID Alert' App which helps break the cycle of infection. The App can let people know of possible exposures before any symptoms appear. The App does not track the user's location, name, address, phone number, health information, and any other sensitive information. You may report a COVID-19 diagnosis via the App if you are a resident of New Brunswick, Newfoundland and Labrador, Ontario and Saskatchewan. For more detailed information, please click here.

As the flu season approaches, it is crucial that our healthcare facilities not become overwhelmed. We recommend getting the flu shot. As stated by the World Health Organization (WHO), this will make it easier to distinguish between COVID-19 and flu cases.
 
Should you wish to consult further information and CFAS' resources related to COVID-19, please click here.
 
Sincerely,
 
Jason Hitkari, CFAS President (2020-2021)
Goldi Gill, Executive Director
CFAS Board of Directors

CFAS COVID-19 Update #9: August 10th, 2020

Dear Members:

We would like to inform you that our advice surrounding COVID-19 and ART remains unchanged from our COVID-19 Update released on June 25th and revisited August 7th. To review the statement from June 25th, see below. We would also like you to know that the Guiding Principles to assist Canadian ART clinics to resume services and care ​document was sent out to the IVF Medical Directors for review and no changes were made. 

Sincerely,

Eileen McMahon, CFAS President (2019-2020)

Goldi Gill, CFAS Executive Director

CFAS Board of Directors


CFAS COVID-19 Update #8: June 25th, 2020

Dear Members:
 
The Canadian Fertility and Andrology Society continues to monitor the regional and national COVID-19 outbreak information. We maintain support for safe resumption of fertility services ensuring that considerations for governmental advisories, stability of personal protective equipment (PPE) supply, and safety for staff and patients are made. Many provinces have continued to open for business and as fertility clinics resume services, we reaffirm that reproduction is an essential human right[i] and the development and delivery of reproductive technologies to help Canadians build their families are essential health services[ii].
 
Choosing Wisely Canada asked all of us to consider initiatives to reduce unnecessary testing during this time and to support the sustained reduction of unnecessary care beyond COVID-19. The major focus of CWC relevant to us is on sustaining the reduction in unnecessary testing such as blood tests and ultrasounds during fertility treatment and supporting virtual visits with doctors and nurses during the pandemic. We also recommend you review the CFAS Choosing Wisely list[iii].
 
The CFAS documents Guiding Principles to assist Canadian ART clinics to resume services and care and Recommendations related to IVF Laboratory shutdowns and start-up during a Pandemic will continue to be revised on an as-needed basis and again we encourage all feedback to help develop and improve these guidance documents[iv][v].
 
For your reference, there is a government supply hub resource[vi] that provides information to help organizations sell and buy personal protective equipment (PPE) during the pandemic.
 
We will continue to revise our guidance every three weeks or as more information becomes available.
 
Thank you again to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.
 
Sincerely, 
 
Eileen McMahon, President (2019-2020)
Goldi Gill, Executive Director 
CFAS Board of Directors 
 
References:
[i] COVID-19 and Human Reproduction Joint Statement: ASRM/ESHRE/IFFS: https://cfas.ca/Endorsements.html 
 
[ii] CFAS Right to Family Position Statement: https://cfas.ca/position-statements.html#rtf2 
 
 
[iv] CFAS Fertility Care during the COVID-19 Pandemic document: https://cfas.ca/Fertility_Care_during_COVID-19.html 
 
[v] CFAS ART Labs and the COVID-19 Pandemic document: https://cfas.ca/ART_Labs_and_COVID-19_II.html 
 
 

CFAS Endorsement of the COVID-19 and Human Reproduction Joint Statement: ASRM/ESHRE/IFFS: June 5th, 2020

The Canadian Fertility and Andrology Society (CFAS) is pleased to endorse the Joint Statement on Assisted Reproduction and COVID-19 issued by the American Society for Reproductive Medicine (ASRM), the European Society of Human Reproduction and Embryology (ESHRE) and the International Federation of Fertility Societies (IFFS).

The Joint Statement raises several important points. Specifically, that reproduction is an essential human right that exists regardless of race, gender, sexual orientation or country of origin, that the initial postponement of all but most urgent fertility care in the early days of the pandemic was necessary, and that the selective resumption of this important healthcare is now warranted.

View the Statement


CFAS COVID-19 Update #7: June 3rd, 2020

Dear Members:
 
The Canadian Fertility and Andrology Society continues to monitor the regional and national COVID-19 outbreak information. In our last guidance, we maintained support for a gradual and safe resumption of services ensuring that considerations for governmental advisories, stability of personal protective equipment (PPE) supply, and safety for staff and patients are made. As clinics resume services, we recommend they implement an integrated clinical and ethical framework that is transparent for patients.
 
The CFAS documents Guiding Principles to assist Canadian ART clinics to resume services and care and Recommendations related to IVF Laboratory shutdowns and start-up during a Pandemic will be revised on an as-needed basis and we encourage all feedback to help develop and improve these guidance documents. 
 
To view the revised version of our Guiding Principles document online or download it as a PDF, click here.
 
We continue to recognize that there is an ongoing obligation to perform regular, required quality control and maintenance especially of laboratory equipment and cryopreserved material irrespective of whether fertility services have resumed.
 
We are now moving to revise our guidance every three weeks or as more information becomes available.
 
Thank you again to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.
 
Sincerely,
Eileen McMahon, President (2019-2020)
Goldi Gill, Executive Director
CFAS Board of Directors 

CFAS COVID-19 Update #6: May 13th, 2020

Dear Members:

The Canadian Fertility and Andrology Society continues to monitor the regional and national COVID-19 outbreak information. In our last guidance, we provided information for fertility clinics planning for restart including guidance on what to consider in order to establish the date to reopen:

  • Provincial and municipal advisories 

  • Resource availability and limitations, including health care resources and Personal Protective Equipment (PPE) for patients and staff

  • Assessment of COVID-19 transmission risk to staff and patients​

In addition, to facilitate decision-making, and to ensure decisions would be made in an equitable and transparent way, we proposed that clinics implement an integrated clinical and ethical framework to encourage all clinics to use the same transparent guiding principle of safety to patient and staff. 

We also provided CFAS documents Guiding Principles to assist Canadian ART clinics to resume services and care and Recommendations related to IVF Laboratory shutdowns and start-up during a Pandemic to assist clinics in their preparations for resumption of care.

We continue to support a gradual resumption of care and recognize that the urgency to resume essential fertility care is growing. This urgency stems not only from the risk that for many patients, delays in treatment will affect their chance of success but also an increasing concern about the mental health of fertility patients left to wait indeterminately.

We continue to recognize that there is an ongoing obligation to perform regular, required quality control and maintenance especially of laboratory equipment and cryopreserved material irrespective of whether fertility services have resumed.

We have provided further clarification in the Guiding Principles to assist Canadian ART clinics to resume services and care document. Please find the link to the updated document here.

This guidance document will be revisited at least every two weeks, or as more information becomes available, given that the situation is evolving and changing.

Thank you again to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.

Sincerely,

Eileen McMahon, President (2019-2020)

Goldi Gill, Executive Director 

CFAS Board of Directors 


CFAS COVID-19 Update #5: April 29th, 2020

Dear Members:

As you know, the Canadian Fertility and Andrology Society has been closely monitoring the regional and national COVID-19 outbreak information. It is our understanding that most fertility clinics in Canada, alongside other specialties, have severely curtailed services in order to preserve healthcare resources including personal protective equipment (PPE), and to limit staff and patient exposures to coronavirus. However, as provinces across the country begin to see more recovered than active cases and a prolonged flattening of the curve, clinics need to prepare for gradual and safe resumption of services so that fertility care, an essential service, is not unnecessarily delayed.

The CFAS documents Guiding Principles to assist Canadian ART clinics to resume services and care and Recommendations related to IVF Laboratory shutdowns and start-up during a Pandemic will be instrumental in assisting clinics in their preparations for resumption of care. Please see links to documents below.

PLANNING FOR RESUMPTION OF SERVICES:

The knowledge about COVID-19, the testing methodologies for its detection and acquired immunity, as well as its treatment options are rapidly evolving(i). Therefore, in the setting of the COVID-19 pandemic, the decision for when healthcare in general, and fertility clinics in particular, ought to proceed with medically necessary, time-sensitive procedures requires careful proactive consideration of several factors including:

  • Provincial and municipal advisories 
  • Resource availability and limitations, including health care resources and Personal Protective Equipment (PPE) for patients and staff
  • Assessment of COVID-19 transmission risk to staff and patients

To facilitate decision-making, and to ensure decisions are being made in an equitable and transparent way, we propose that clinics implement an integrated clinical and ethical framework to incorporate the above factors systematically. A principles-based, care-oriented approach should include an assessment of patient medical need and guiding ethical principles whereby the risk of worse patient outcomes should be weighed against the risk of patient and staff exposure to the virus.  

TIMING OF RESUMPTION OF SERVICES:

Given the current pandemic, the following criteria should be met before resuming fertility services: 

  1. The prevailing regulatory environment does not prohibit service resumption in your jurisdiction

  2. A plan for a methodical, phased approach to slowly reopen services has been implemented

  3. All recommended safety measures have been implemented including:

  • Minimizing face to face interactions to support physical distancing (i.e. remote consults unless in person absolutely necessary)  

  • Pre-screening of patients prior to clinic visits

  • In-person screening of staff and patients upon arrival to clinic

  • Additional infection prevention and control measures within the clinic (ie. physical distancing between and among staff and patients, PPE, enhanced cleaning and disinfection protocols) 

Of note, we recognize that there is an ongoing obligation to perform regular, required quality control and maintenance especially of laboratory equipment and cryopreserved material irrespective of whether fertility services have resumed.

FRAMEWORK FOR SERVICE PRIORITIZATION:

The Canadian Emergency Department Triage & Acuity Scale (CTAS)(ii) provides clinical guidance while the Crisis Standards of Care from the Institute of Medicine (IOM)(iii) lay out the ethical framework for prioritization: 

Fairness

  • Does not require all persons be treated in identical manner

  • Does require that differences in treatment access be based on appropriate differences among individuals

  • Consider categories to determine priority such as care urgency (iv) :

  • Priority A patients – emergent – conditions or situations that are a potential threat to function, requiring immediate intervention (ie. oncology patients)

  • Priority B patients – urgent – serious conditions or situations that require prompt intervention  

  • Priority C patients – less urgent – conditions and situations that relate to patient distress or potential complications that would benefit from intervention 

The duty to care

  • Health professionals have an obligation to provide care for patients 

  • Health care institutions/facilities have a reciprocal duty to support health care workers

The duty to steward resources

  • Health care institutions/facilities, public health officials, physicians, and other health care professionals have a duty to steward scarce resources

  • Professionals must accept the responsibility to plan and use resources, such as PPE, prudently so to balance the obligation to honor the duties of care and stewardship   

Transparency

  • The prioritization plan should be communicated clearly 

Consistency

  • Consistency in treating like groups alike promotes fairness

  • Patients at different centres in the same affected area should not receive vastly different levels of care 

Proportionality 

  • Safety measures for staff and patients will include burdensome recommendations (including screening, physical distancing, PPE)

  • These burdens should be commensurate with the scale of the virus and offer clear benefits in proportion to the burden

Accountability

  • Effective crisis standards require that individuals at all levels accept and act upon appropriate responsibilities

  • Accountability during and after the pandemic is key  

This guidance document will be revisited at least every two weeks, or as more information becomes available, given that the situation is evolving and changing.

Thank you again to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.

Sincerely,

Eileen McMahon, President (2019-2020) 

Goldi Gill, Executive Director 

CFAS Board of Directors 

Click the links below to view updated/new guidelines:

ART Labs and the COVID-19 Pandemic (Updated)

Fertility Care during the COVID-19 Pandemic (New)

References:

[i] Prachand VN, Milner R, Angelos P, Posner MC, Fung JJ, Agrawal N, Jeevanandam V, Matthews JB. Medically-Necessary, Time-Sensitive Procedures: A Scoring System to Ethically and Efficiently Manage Resource Scarcity and Provider Risk During the COVID-19 Pandemic, Journal of the American College of Surgeons (2020), doi: https://doi.org/10.1016/ j.jamcollsurg.2020.04.011.

[ii] Beveridge R, Clarke B, Janes L, Savage N, Thompson J, Dodd G: Canadian emergency department triage and acuity scale: implementation guidelines. Canadian Journal of Emergency Medicine. 1999, 1 (suppl 3): S1-24.

[iii] Committee on Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations; Institute of Medicine. Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington (DC): National Academies Press (US); 2012 Mar 21. 4, Cross-Cutting Themes. Available from: https://www.ncbi.nlm.nih.gov/books/NBK201082/.

[iv] Dietz JR, Moran MS, Isakoff SJ, Kurtzman SH, Willey SC, Burstein HJ, Bleicher RJ, Lyons JA, Sarantou T, Baron PL, Stevens RE, Boolbol SK, Anderson BO, Shulman LN, Gradishar WJ, Monticciolo DL, Plecha DM, Nelson H, Yao KA. Recommendations for Prioritization, Treatment and Triage of Breast Cancer Patients During the COVID-19 Pandemic. The COVID-19 Pandemic Breast Cancer Consortium. Retrieved from https://www.facs.org/-/media/files/quality-programs/napbc/asbrs_napbc_coc_nccn_acr_bc_covid_consortium_recommendations.ashx


CFAS COVID-19 Update #4: April 15th, 2020

Dear Members:

The Canadian Fertility and Andrology Society continues to closely monitor the regional and national COVID-19 outbreak information. We recommend that all members honour the rules and regulations of their provincial bodies. At this time, most guidelines are unchanged.

Given that the number of total cases of COVID-19 (confirmed and probable) continues to rise in Canada, our recommendations remain to:

• Conduct consultations by telemedicine or phone
• Complete current IVF cycles utilizing freeze-all only
• Suspend all diagnostic and elective procedures and surgeries
• Postpone any new cycle starts (IUI, IVF, FET), aside from urgent cryopreservation for oncology, until further notice

However, as provinces across the country start to see the other side of their peaks of infection and prepare to plan for potential relaxation of some of the measures in place, we recommend that clinic management start to plan for how they will be able to restart clinical activities. Important measures will include how to limit the number of staff-patient interactions and to maintain strict controls on individuals who are seen in the clinic. Measures may be considered to prioritize certain patients for whom time to treatment is an important factor. Effective planning at this point will allow for the efficient and safe return to treating patients when the current conditions permit it.

We recognize that clinics have an ongoing obligation to perform regular required quality control and maintenance especially of laboratory equipment and cryopreserved material.

This guidance document will be revisited at least every two weeks, or as more information becomes available, given that the situation is evolving and changing.

Thank you again to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.

Sincerely,
Eileen McMahon, President (2019-2020)
Goldi Gill, Executive Director
CFAS Board of Directors


Updated April 9th, 2020

The CFAS would like to thank its ART Lab SIG for preparing a guidance document pertaining to IVF labs and the COVID-19 pandemic. To view the document, click here. In addition, 3 CFAS COVID-19 webinars are now available online in the members' only section of our portal, here.


CFAS COVID-19 Update #3: March 31st, 2020

Dear CFAS Members:
 
The Canadian Fertility and Andrology Society has been closely monitoring the regional and national COVID-19 outbreak information. We recommend that all members honour the rules and regulations of their provincial bodies. At this time, most guidelines are unchanged and some are in fact stronger than two weeks ago.
 
Given that the number of total cases of COVID-19 (confirmed and probable) continues to rise in Canada, our directives remain to:
 
  • Conduct consultations by telemedicine or phone
  • Complete current IVF cycles utilizing freeze-all only
  • Suspend all diagnostic and elective procedures and surgeries
  • Postpone any new cycle starts (IUI, IVF, FET), aside from urgent cryopreservation for oncology, until further notice
 
We recognize that clinics have an obligation to perform regular required quality control and maintenance especially of laboratory equipment and cryopreserved material.
 
This guidance document will be revisited at least every two weeks, or as more information becomes available, given that the situation is evolving and changing.
 
Thank you again to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all.
 
 
Sincerely,
Eileen McMahon, President (2019-2020)
Goldi Gill, Executive Director
CFAS Board of Directors

CFAS COVID-19 Update #2: March 18th, 2020

Dear CFAS Members:

The Canadian Fertility and Andrology Society takes the health and safety of our members, staff, and broader communities seriously. We support national public health measures to flatten the transmission curve of COVID-19. Specifically, measures to drastically reduce face-to-face interaction. If we do not apply measures, the number of cases is expected to grow exponentially. The time to act is now. 

What we know:

The Chief Public Health Officer of Canada, Dr. Theresa Tam, is recommending that we need to act quickly to help flatten the curve to reduce the impact of COVID-19, by practicing social distancing. 

Prime Minister Justin Trudeau is advising we take steps to limit the spread of COVID-19 by limiting the number of people we come in close contact with, maintaining a distance of 2 m (6’) from others, and avoiding non-essential trips outside the home.  

Travel is no longer the only mode of transmission for the novel coronavirus; community transmission is occurring in a number of provinces.

On March 15, 2020, the Ontario Medical Association strongly recommended social distancing. They also recommended physicians identify and reduce non-essential visits and temporarily put on hold non-essential care and elective surgery to protect all health-care providers, patients and the public, and most importantly, to manage what is expected to be tremendous demand on the system from spread of the virus.

On March 16, 2020, Newfoundland Health Authority directed that all non-emergency appointments at outpatient clinics be rescheduled and has indicated that elective surgeries have been rebooked.

On March 17, 2020:

  • Alberta declared a public health emergency under the Public Health Act.

  • Manitoba’s Chief Public Health Officer, Dr. Brent Roussin, stressed the importance of social distancing.

  • The Nova Scotia Health Authority and IWK Health Centre suspended non-urgent and elective services, limited public gatherings and ordered all bars to close.

  • Ontario declared a state of emergency in order to protect the public.

On March 18, 2020:

  • The Government of British Columbia declared a provincial state of emergency.

  • The Government of New Brunswick has advised all residents to self-isolate.

  • The Government of Saskatchewan declared a provincial state of emergency.

  • Quebec Premier François Legault stressed the need to "respect the rules" and recommendations set forth by health officials to slow the spread of the virus.

What we are doing:

We are actively monitoring the evolving COVID-19 situation to provide updates to our membership, while being cognizant of the fact that public health interventions have the potential to significantly impact fertility care, civil liberties and economic status.

What this means for our members:

It is our hope that specific measures to minimize non-essential contacts with the health care system will reduce transmission to our members, families, and patients, thereby slowing the increase in the number of cases and protecting our medical systems from being overwhelmed. As such, our advice to patients would be that they stay at home if they can and that would include not attending fertility consultations or procedures.

While large government organizations cannot specifically address implementation of public health measures for fertility clinics, CFAS is providing interpretation as it applies to our members and professional behaviour mandates following the provincial government edict. We interpret this as requiring decisive actions by fertility clinics to drastically reduce in-person interactions by:

1. Conducting consultations by telemedicine or phone

2. Completing current IVF cycles but utilizing freeze-all only

3. Suspending all diagnostic and elective procedures and surgeries 

4. Postponing any new cycle starts (IUI, IVF, FET), aside from urgent cryopreservation for oncology, until further notice 

This guidance document will be revisited at least every two weeks, or as more information becomes available, given that the situation is evolving and changing. 

Thank you to each and every one of you for working hard under such challenging circumstances and for doing your part to play a meaningful role in protecting us all. 

Sincerely,

Eileen McMahon, President (2019-2020)

Goldi Gill, Executive Director

CFAS Board of Directors


Updated March 17th, 2020

Dear Members:

As per the Government of Canada website, COVID-19 (Corona Virus Disease 2019) is a disease that caused an outbreak of respiratory illness, including pneumonia, in Wuhan, China, in late 2019 and early 2020. Since that time, cases have been reported in a number of other areas, including Canada.

There is very little known about the impact of COVID-19 on reproduction and pregnancy. However, pregnancy increases susceptibility to respiratory infections and severe respiratory infections in pregnancy can lead to preterm labour and delivery. As such, we recommend that non-essential travel to areas where an increasing number of COVID-19 cases are being reported should be avoided by patients and their partners.

We recognize that this is a fluid situation and recommend all members monitor public health agencies for official directives and outbreak information.

All those in contact with patients have a critical role to play in helping to identify, report and manage potential cases of COVID-19.  We encourage everyone to follow good hygiene practices, including washing hands often, covering your coughs and sneezes, and avoiding contact with others when unwell.

As further developments in the COVID-19 outbreak and the mitigation strategies to limit its spread emerge, fertility clinics are having to make difficult decisions about what services they will or will not provide, and some are even contemplating closure.

CFAS recommends that each region follow their respective Public Health authority and Government of Canada directives. However, in addition to infection prevention and control strategies such as washing hands often, covering your coughs and sneezes, and avoiding contact with others when unwell, there are other potential strategies you can employ to minimize risk to staff and patients.

These include:

  • Telemedicine for any visits not requiring physical examination including for example consults, reviews, injection teaching appointments

  • Remote options for consent signing

  • Delaying FET cycle starts indefinitely

  • Delaying ETs (implementing freeze-all) indefinitely

  • Reduction of non-essential monitoring visits

  • Telephone screening of patients prior to presenting for appointments

  • In-person screening of patients and visitors upon presentation at clinic

  • Limiting accompanied visitors (partner only if applicable for example) 

  • Staggering arrival times for monitoring appointments

  • Decisions around missed monitoring appointments or cycle cancellation if patient becomes unwell

  • Review of PPE for droplet and contact precautions with all staff

  • Developing emergency preparedness strategies and protocols to account for      

  1. staffing shortages

  2. supply shortages

  3. adherence to directives for closure

  • Identification of COVID-19 Team Leads

  • Increased cleaning of clinic common and consult/exam/procedure spaces 

  • Clinic messaging to patients regarding COVID-19 and impact on care (for example via email or webpage)

Adapted from Bortoletto & Hariton (2020)

With respect to travel, Canada’s Chief Public Health Officer Dr. Theresa Tam has advised that Canadians “postpone or cancel all non-essential travel outside of Canada.” 

With respect to COVID and the risk to the fetus during pregnancy, there is very little data but we support the American Society for Reproductive Medicine’s (ASRM) Bulletin: COVID-19: SUGGESTIONS ON MANAGING PATIENTS WHO ARE UNDERGOING INFERTILITY THERAPY OR DESIRING PREGNANCY. Link here

You may find the following resources helpful:

Government of Canada:

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

The Society of Obstetricians and Gynaecologists of Canada (SOGC):

https://www.sogc.org/en/content/featured-news/sogc-statement-coronavirus.aspx


Updated March 17th, 2020

The CFAS would like to thank the Executive Committee of its Counselling Special Interest Group for providing the following information about coping during these uncertain times.
 
If you are feeling unsettled over recent events regarding COVID-19, you are not alone. Dealing with uncertainty is never easy. And change can be hard for many to deal with at the best of times. In the case of COVID-19, we are experiencing rapid changes and unknown territory. We would like to take this opportunity to share some strategies for managing uncertainty during this challenging time. (See the Coping with Uncertainty page in the menu on the right.)

The CFAS cares about your physical health and safety, but also about your mental health and the well-being of your family as we adjust to this rapidly-evolving global pandemic. For this reason, we wanted to share the following important resources with you, which you can also share with patients expressing concern:

Government of Canada Resources for Canadian Businesses:
 
Canadian Federation of Independent Businesses: Information and Helpline (willing to help non-CFIB members) 
 
Managing Coronavirus Anxiety:
 
 
World Health Organization On Protecting Your Mental Health:
 
Free emergency childcare for healthcare workers in Quebec - Information on how to register:
 
Information regarding COVID-19 from the Canadian Psychology Association and resources for anxiety/stress:
 
Tips for those staying home with their children and practicing social distancing:
 
Links from the Canadian Cancer Society regarding cancer and COVID-19 as well as online peer support:
 
 
Mental Health Resources for Students:

We know a long road potentially lies ahead. We are here to support you and want to let you know we appreciate everything you do for your patients and society, not only in a public health crisis, but at all times.


CFAS COVID-19 Update #1: March 13th, 2020

Dear Members:
 
As further developments in the COVID outbreak and the mitigation strategies to limit its spread emerge, fertility clinics are having to make difficult decisions about what services they will or will not provide, and some are even contemplating closure.
 
CFAS recommends that each region follow their respective Public Health authority and Government of Canada directives. However, in addition to infection prevention and control strategies such as washing hands often, covering your coughs and sneezes, and avoiding contact with others when unwell, there are other potential strategies you can employ to minimize risk to staff and patients.
 
These include:
 
  • Telemedicine for any visits not requiring physical examination including for example consults, reviews, injection teaching appointments
  • Remote options for consent signing
  • Delaying FET cycle starts indefinitely
  • Delaying ETs (implementing freeze-all) indefinitely
  • Reduction of non-essential monitoring visits
  • Telephone screening of patients prior to presenting for appointments
  • In-person screening of patients and visitors upon presentation at clinic
  • Limiting accompanied visitors (partner only if applicable for example) 
  • Staggering arrival times for monitoring appointments
  • Decisions around missed monitoring appointments or cycle cancellation if patient becomes unwell
  • Review of PPE for droplet and contact precautions with all staff
  • Developing emergency preparedness strategies and protocols to account for      
  1. staffing shortages
  2. supply shortages
  3. adherence to directives for closure
  • Identification of COVID Team Leads
  • Increased cleaning of clinic common and consult/exam/procedure spaces 
 
Clinic messaging to patients regarding COVID and impact on care (for example via email or webpage)
 
Adapted from Bortoletto & Hariton (2020)
 
With respect to travel, Canada’s Chief Public Health Officer Dr. Theresa Tam has advised that Canadians “postpone or cancel all non-essential travel outside of Canada.” 
 
With respect to COVID and the risk to the fetus during pregnancy, there is very little data but we support the American Society for Reproductive Medicine’s (ASRM) Bulletin: COVID-19: SUGGESTIONS ON MANAGING PATIENTS WHO ARE UNDERGOING INFERTILITY THERAPY OR DESIRING PREGNANCY. Link here

Updated February 25th, 2020

Dear Members:

As per the Government of Canada website, COVID-19 (Corona Virus Disease 2019) is a disease that caused an outbreak of respiratory illness, including pneumonia, in Wuhan, China, in late 2019 and early 2020. Since that time, cases have been reported in a number of other areas, including Canada.

There is very little known about the impact of COVID-19 on reproduction and pregnancy. However, pregnancy increases susceptibility to respiratory infections and severe respiratory infections in pregnancy can lead to preterm labour and delivery. As such, we recommend that non-essential travel to areas where an increasing number of COVID-19 cases are being reported should be avoided by patients and their partners.

We recognize that this is a fluid situation and recommend all members monitor public health agencies for official directives and outbreak information.

All those in contact with patients have a critical role to play in helping to identify, report and manage potential cases of COVID-19.  We encourage everyone to follow good hygiene practices, including washing hands often, covering your coughs and sneezes, and avoiding contact with others when unwell.

You may find the following resources helpful:

Government of Canada:

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

The Society of Obstetricians and Gynaecologists of Canada (SOGC):

https://www.sogc.org/en/content/featured-news/sogc-statement-coronavirus.aspx