Five questions COVID raised around fertility

We are all eager to see the back of 2020. But for all its pain, the coronavirus did raise interesting questions.

Read time: 1 minute, 30 seconds

It's impossible to look back on the year, and not think about the coronavirus. It touched everything — including assisted reproduction and fertility. 

Below I list five questions raised by the pandemic for this field. As you will see by the string of thought fragments that follow the questions, they are, in my view, not yet settled. May we continue to reflect.

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Is assisted reproduction an essential service?

IVF

Heart surgery

Chemotherapy

Egg donation

Full rehab after cancer surgery

Family support in hospitals

Treatment of ovarian hyperstimulation syndrome

In-person visits to elders in long term care

In-person worship

In-person primary education

In-person funerals

Emergency dental care

Casinos

IUI

Abortion

Home birth

Support person during labour and delivery

Dialysis

In-person weddings

Childcare

Public transport

In-person visits to minor children in group homes

Should pregnancy be discouraged during the pandemic?

Worse COVID-19 outcomes during pregnancy

Unclear if coronavirus can be transmitted via sperm

Unclear if coronavirus can be transmitted via oocytes

Unclear if coronavirus can be transmitted via unprotected sex

Unclear if coronavirus will have an effect on a developing fetus

Unclear if vaccine is safe during pregnancy

Mothers separated from newborns

Assisted reproduction uses scarce health resources

Pregnancy uses scarce health resources 

Childbirth uses scarce health resources

Time runs out

Despair uses scarce health resources

Despair

Is international surrogacy ethical during a pandemic?

Crossing closed borders

Not being able to cross closed borders

Quarantining

Missing the birth while quarantining

Missing the first days while quarantining

Missing the first few weeks while arranging difficult travel across closed borders

Missing the first few months while pleading to cross closed borders

Newborns separated from parents

Newborns with temporary caregivers

Pressure on surrogates to be temporary caregivers

Surrogates as temporary caregivers

Newborns in orphanages

Delays with official documents

Extra burden on officials providing documents

Transporting newborns through airports during a pandemic

Transporting newborns in airplanes during a pandemic

Pregnancy risk (see 'Should pregnancy be discouraged during the pandemic?' above)

How do we support families with young children? 

Single parents

Single parents without childcare

Single parents without adequate pay

Isolated non-custodial parents

Families who rely on elderly grandparents for childcare

Families who can't see elderly grandparents in person

Female parents whose careers take second place to male parents' careers

Two-mom families

Two-dad families

Four-parent families

Families who live in separate households

Families with numerous family bubbles

Families with ample backyards

Families in small apartments

Families without internet

Closed schools

Online schools

Fewer daycare spots

Increased daycare fees

Domestic violence

Has reproductive health care changed forever?

Fewer office visits

More virtual consultations

Curbside drop-off of specimens

Less frequent monitoring

At-home self-monitoring

Concierge care

At-home medical abortion

Restricted access to abortion

Fewer patients per professional

PPE

Deep cleaning

No partners allowed

Freeze-all 

Anxiety

Relief

Clearer consent

More burdensome consent

Mutual risk

Code of conduct

Mutual trust

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