Coronavirus: Urgent IVF cases allowed to proceed, says MOH

Treatment during circuit breaker permitted where delay may have negative impact on patient, it says

Madam Lee Yunting and her husband Edmund Ho have had to shelve their plans to undergo in-vitro fertilisation until after June 1, when the circuit breaker period is expected to end.
Madam Lee Yunting and her husband Edmund Ho have had to shelve their plans to undergo in-vitro fertilisation until after June 1, when the circuit breaker period is expected to end.PHOTO: COURTESY OF LEE YUNTING

The coronavirus pandemic has not only upended many lives but also aborted the plans of some couples to bring new life into the world via in-vitro fertilisation (IVF).

With the circuit breaker measures in effect, couples like Madam Lee Yunting and her husband have had to shelve their baby-making plans until after June 1, when the circuit breaker period is expected to end.

The 32-year-old art and design school instructor was turned away by three medical institutions - two public and one private - last month.

The reason: The hospitals have to focus on essential procedures.

But not all such couples have to wait. More than a few have been given the green light by the Ministry of Health (MOH) as they fulfil certain criteria.

The ministry, in response to queries, said IVF treatments are an essential healthcare service as they are time-sensitive. Treatments during the circuit breaker period are for situations where a significant delay, such as an extended period of four to six weeks, may have a negative impact on the patient.

This information has been given to public and private assisted reproductive centres, an MOH spokesman told The Straits Times.

In an April 24 internal circular to those centres, MOH said patients who have already started an IVF cycle, or those who require urgent IVF treatment before cancer treatment or have other urgent clinical conditions, can continue with IVF.

Couples aged 35 and older with poor ovarian reserve and with very poor sperm count can proceed too.

All other cases should be deferred, the spokesman said, adding that guidelines will be adjusted where necessary.

MOH also stressed that healthcare institutions offering IVF treatments must ensure that the tightened measures of the circuit breaker period are in place. These include safe distancing and, where appropriate, offering alternative means of consultation, such as teleconsultation.

 
 
 

Dr Jessie Phoon, director and senior consultant of KKIVF Centre at KK Women's and Children's Hospital, said that since Feb 7, it has recommended to patients to postpone non-urgent fertility treatments.

"We would like to assure couples that the slight deferment of one month will not affect their overall success rate," she said.

Professor P.C. Wong, senior consultant of the reproductive endocrinology and infertility division at National University Hospital Women’s Centre, said it will continue to provide IVF for patients who are unable to defer their treatment, adding that the centre will review the situation when the circuit breaker ends. "If the situation allows, we will restart IVF for the other groups of patients in phases."

Associate Professor Yong Tze Tein, head and senior consultant of Singapore General Hospital's department of obstetrics and gynaecology, said the hospital has reduced the number of IVF cycles since the Covid-19 outbreak started.

 
 

It gave priority to women aged 35 and older who have a low ovarian reserve. Men with a poor sperm count are another factor. "However, each couple has to be looked at as a whole to determine whether we can delay their cycle as we want to follow the principle of providing only essential services," Prof Yong said.

Dr Ann Tan, medical director of Virtus Fertility Centre, a private clinic, said those who have been affected, while disappointed, "understand the need for prudence at this time and accept the delay".

But a 37-year-old woman who will complete her three-month probation in a new job this month hopes to do a frozen embryo transfer (FET) at a private clinic without delay. "If the clinic lets me proceed, I will start, because you never know when Covid-19 will end," said the administrative assistant, who declined to be named.

"It also seems like patients will need to pay more for the storage of frozen embryos, given that (the storage period) will be extended."

 
 
 

Couples who were in the midst of IVF treatment at fertility clinics in Malaysia are another affected group. They were caught off guard by travel restrictions and now cannot visit the country.

Mrs Irene Moore, 40, who was planning for an FET in Johor Baru, said: "It's too risky to do an FET at this time in case I get Covid-19, so it's a waiting game until both the virus situation improves and borders are open again. We were lucky to have been blessed with a son from our second cycle and have been trying for years to give him a sibling."

Yoga teacher Sophie Sanders, 43, said: "We don't want to be quarantined for 14 days on either side.

"We don't have a choice about things being on hold. Meanwhile, I'm doing all I can to prepare my body for the next cycle, by exercising, taking supplements and trying not to be too stressed."

Correction note: The article has been edited to reflect Professor P.C. Wong's current job titles.

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A version of this article appeared in the print edition of The Straits Times on May 08, 2020, with the headline 'Urgent IVF cases allowed to proceed: MOH'. Subscribe