Lockdown measures have abruptly halted active treatment of infertility, that they will prioritise cases with advanced maternal age, whose gametes are frozen for long
Specialists from all over India at the IHW Council’s web summit said that the lockdown should be used as an opportunity by women with the polycystic ovary to lower their stress levels and modify diet and exercise to facilitate the treatment as they can spare more time for them.
“Polycystic ovary syndrome (PCOS) is one of the most common conditions in Indian women and one out of 10 suffer from it. The treatment is 70 per cent diet modification and 30 per cent exercise. Ensure your diet is low in trans fat – so say no to junk food and sugar – and increase the share of protein,” said Dr Shivani Sachdev Gour, Founder & Director, SCI Healthcare, New Delhi.
“The general conception is women who have PCOS are stressed due to the lack or absence of periods. However, it is the other way round – these women are generally more stressed than others because they are constantly reminded by people around them of their difference, either due to the physical features such as unwanted hair growth or irregular periods. The stress level in these women vary, so some take more time to respond to treatment than others. Now with the lockdown, they are at home and this is an opportunity to talk to the family about the condition – family should be helpful to these women. These women also need constant counselling. It is advisable they do everything possible to keep their stress level down – be that reading or meditation,” Dr S Krishnakumar, Chief Consultant, JK Women Hospital, Vice President, IAGE & Secretary-General, Indian Society for Assisted Reproduction (ISAR), Mumbai.
“Safety is very important for the patients during this time. So, we avoid going ahead for any treatment for infertility or IVF and advice for oral treatment. We advise our patients to utilise this time of lockdown and bring some lifestyle changes, an exercise which will help in improving their PCOD or infertility,” said Dr Sujoy Dasgupta, Consultant, Reproductive Medicine, Genome Fertility Centre, Kolkata.
The virtual summit on PCOS and infertility treatment during the ongoing lockdown, organised by the Integrated Health and Wellbeing (IHW) Council, was attended by Dr KU Kunjimoideen, Founder and Managing Director, ARMC IVF, President Perinthalmanna O&G Society & Joint Secretary – Indian Fertility Society, Kerala, Dr Milind Patil, Director, Shobha Nursing Home & Shobha Test Tube Baby Centre, Solapur, Maharashtra, Dr Sujoy Dasgupta, Consultant, Reproductive Medicine, Genome Fertility Centre, Kolkata, and Dr Geetha Haripriya, Chairperson, Prashanth Multispeciality Hospital & Medical Director, Prashanth Fertility Research Centre, Chennai.
Acknowledging that the lockdown measures have abruptly halted active treatment of infertility, that they will prioritise cases with advanced maternal age and whose gametes are frozen for long, and an extensive change in protocols will be required once the lockdown is lifted.
“We do not have enough data to say whether the virus COVID-19 can transmit from mother or father to the child, or whether the child can become a carrier if a woman conceives during the pandemic. The only infertility treatment allowed now is for cancer patients who want to freeze their sperms or eggs. Once the lockdown is lifted, we will prioritise the cases with advanced maternal age or where the gamete has been frozen for a long time,” said Dr Gour.
Discussing access to the right kind of healthcare during lockdown as a challenge, Dr Durga Rao, Co-Founder & Medical Director, Oasis Fertility, Hyderabad said, “A woman’s location has become a crucial factor in providing the treatment as those who are living in an area identified as a hotspot or containment zone not only need to take extra care to prevent infection but also need to ensure they can access antenatal care in a hospital set up. It is difficult for her to get the right kind of healthcare as it calls for a rigorous set of measures. Women in these areas should try to conceive naturally while high-risk pregnancies need access to good healthcare.”
Kamal Narayan, CEO, IHW Council, who also moderated the session, said, “Just like maternal care cannot wait due to lockdown, couples who are undergoing treatment for infertility also need to continue their regime and decide on the next step based on the specialist’s intervention, which is the same for those undergoing treatment for polycystic ovary. However, the lockdown has restricted their visits to the doctor’s chambers and can disrupt the entire treatment. The panellists at the summit shared their views on how people can maintain the rhythm of the treatment and the future they see post the lockdown.”
The doctors said that the pandemic may alter the way infertility treatment is provided and new guidelines are needed keeping in mind the scientific facts. “Once the lockdown is lifted, we will need strict guidelines in place as social distancing is likely to become the norm. The process of framing the guidelines should start now so that it can be transmitted to the audience and they can get used to it. We will also need protocols in place to enhance the telemedicine capability,” said Dr Kaberi Banerjee, Medical Director, Advance Fertility & Gynecological Center, President, ISAR- Delhi Chapter.
“We will need extensive guidelines for the staff as well as for the process to disinfect labs as the fumes of the sanitisers with 70 per cent of alcohol can cause damage to the gamete,” said Dr Gour.