Publication - Advice and guidance

Coronavirus (COVID-19): fertility treatment - plans for restarting treatment - framework

In response to the direct threat of COVID-19 to patients, the wider Scottish population and NHS Scotland services, all NHS funded Scottish centres took the decision to pause services from 17 March 2020. This document sets out the plans for restarting fertility services from 18 May 2020.

Coronavirus (COVID-19): fertility treatment - plans for restarting treatment - framework
14 Appendix 4 – Road map

14 Appendix 4 – Road map

Phase 1

Phase 2

Phase 3

Phase 4

Phase 5

Treatments that can be done

Only if patients wish to proceed

Urgent Fertility preservation

Frozen embryo transfer

Donor insemination (DI)

(natural cycle only)

Diagnostics where feasible

Treatment for only those without comorbidities

In addition to phase 1

Start of stimulation in older women (≥ 40 years)

Ovulation Induction (oral)

Treatment for only those without comorbidities

In addition to phase 2

Ovulation Induction

(injectables)

DI with stimulation

Start of stimulation in younger women

Treatment for only those without comorbidities

In addition to phase 3

Non urgent Fertility preservation

Treatment in those with co morbidities

In addition to phase 4

Donor recruitment

Conditions to be satisfied to move to next phase

Easing of lockdown restrictions progressing as planned

No further suspension of activity by HFEA

No evidence of detrimental effect of Pregnancy on Covid and vice versa

In addition to requirements in phase 1

Low incidence of OHSS

Staff returning from deployed areas as planned

In addition to requirement in phase 2

Low incidence of OHSS

In addition to requirement in phase 3

Full staff complement

Social distancing rules relaxed

Full resumption of all services back to pre -Covid state

Conditions to step to previous phase

Government Ease down restriction tightening

Complications during treatment

Not adequate staff (either deployed/ self- isolation)

Government Ease down restriction tightening

Complications during treatment

Not adequate staff

(either deployed/ self- isolation)

Government Ease down restriction tightening

Complications during treatment

Not adequate staff

(either deployed/ self- isolation)

Government Ease down restriction tightening

Complications during treatment

Not adequate staff

(either deployed/ self- isolation)

Assumptions for Road map

  • Emergency fertility preservation will continue throughout, this include sperm cryo preservation when immediate IVF/ICSI not possible, and sperm count declining
  • Moving in phases is not dependent on testing strategies as that will be covered in Government policies
  • Diagnostic means semen analysis (which all centres may not wish to proceed) and HyCoSy and USG as that will be required prior to DI and other treatments
  • Those waiting for surgery (due to any reason) will need to wait for NHS theatre lists

Pre- implantation Genetic testing – depends on NSD s decision as to which phase they can be done.


Contact

Email: anthea.taylor@gov.scot