Resuming assisted reproduction services during COVID-19 Pandemic: An Indian experience

Purpose The pandemic of COVID-19 has affected many countries; and medical services including assisted reproductive treatment (ART) have been hampered. The purpose of the study was to assess the preparedness of ART clinics and staff to resume services; patients’ reasons to initiate treatment and key performance indicators (KPIs) of ART labs during pandemic. Methods Semi-descriptive report of two private in-vitro fertilization (IVF) clinics in Maharashtra, India, when COVID-19 testing for asymptomatic people was unavailable. Time required for replenishing laboratory supplies, and staff preparedness to function under ‘new norms’ of pandemic was documented. Infection mitigation measures at workplace and triaging strategy were evaluated. KPIs of the clinics were evaluated. Results 30% of the patients consulted through telemedicine accepted or were eligible to initiate treatment upon clinic resumption. Lack of safe transport and financial constraints prevented majority from undergoing IVF, and only 9% delayed treatment due to fear of pandemic. With adequate training, staff compliance to meet new demands could be achieved within a week, but supply of consumables was a major constraint. 52 cycles of IVF were performed including fresh cycles and frozen embryo transfers with satisfactory KPIs even during pandemic. Conscious sedation and analgesia during oocyte retrieval was associated with reduced procedure time and no intervention for airway maintenance, compared to general anaesthesia. Self reported pain scores by patients ranged from nil to mild on a graphic rating scale. Conclusion This study provides a practical insight and will aid in forming guidelines for resumption of IVF services during pandemic.