Fertility preservation services and COVID-19: the urgent need for phase two

Abstract

By the time of writing, epidemic in Italy, one of the countries at the epicentre of the European COVID-19 outbreak, has entered phase 2 with high levels of caution. The overall system has been burdened with the paralysis of standard practices dedicated to the delivery of health services. This interruption has included the provision of assisted reproductive treatments to infertile couples, apart from fertility preservation services to oncologic patients. On behalf of a tissue establishment inside a public hospital, we experienced a reduction of 65% of demands for fertility preservation. The unexpected and unavoidable shifts of health networks required to overcome the COVID-19 pandemic have indirectly created a new barrier obstructing the access to fertility preservation services. It is known that gaps in the organization of oncofertility cares and the lack of patients' awareness regarding fertility preservation strategies are the most common barriers to services. The delicate working conditions due to COVID-19 have amplified those barriers, complicating the chance of counselling cancer patients of fertile age about fertility preservation options. The restart should include strategies to reduce the risk of a missed reproductive counselling, limiting the chance for the virus to become a further barrier.

Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields

“…Moreover, to diminish the exposure to the virus, treatment initiation was postponed for newly diagnosed patients, or a follow-up appointment was replaced with a telemedicine consultation. In Italy, a reduction of up to 65% in cancer patient addressability to FP procedures was mentioned, with a delay in new cancer diagnosis and reduced FP procedures [ 57 ]. Gupta et al demonstrated the effectiveness of fertility counseling for newly diagnosed cancer patients of reproductive age from 36.7% (June 2019–January 2020) to 70% (February 2021) [ 102 ].…”

“…The experience on FP procedures of an Italian hospital-based tissue establishment during lockdown showed a reduction of 65% in cancer patient addressability, predominantly to the sperm bank. The authors speculate that COVID-19 induced general paralysis of the healthcare system and was associated with a delay in new cancer diagnosis, subsequently diminishing FP demand [ 57 ].…”

“…Women followed the protocol at home to reduce access and hospitalizations. Additionally, in the case of males after a telephone triage, they were first approached before the cryopreservation process at the sperm bank [ 57 , 58 ].…”