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.
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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