After the closure of all fertility clinics in March 2020 due to COVID-19, fertility services were given permission to resume in May 2020.
Fertility services restarted in phase 1 of the recovery plan as it was acknowledged that it is an extremely time sensitive treatment (https://www.gov.scot/publications/re-mobilise-recover-re-design-framework-nhs-scotland/pages/9/). In addition, the sudden halt to fertility treatments was noted to have added to the distress already faced by these patients (Boivin et al., 2020). The data on COVID-19 and pregnancy are still emerging and more details are set out by Royal College of Obstetricians and Gynaecologists (RCOG) within Coronavirus (COVID-19), pregnancy and women's health and United Kingdom Obstetrics surveillance system (UKOSS) COVID-19 in Pregnancy, with the former updated on a regular basis. Some risks have been identified in specific groups, but the data is largely reassuring.
All four NHS tertiary clinics in Aberdeen, Dundee, Edinburgh and Glasgow have worked together with Scottish Government and the patient stakeholder group- Fertility Network, with twice weekly meetings to create uniform documents and policies with a Once for Scotland approach https://www.gov.scot/publications/covid-19-fertility-treatment-scotland-plans-restarting-treatment-framework/.
Whilst the initial COVID-19 surge occurred rapidly, with little time for service preparation, there is now an opportunity to prepare for the forthcoming winter, when it is anticipated that Fertility services may be affected again.
NHS Fertility services were paused during the initial peak of the pandemic but have remained open during subsequent local lockdowns. This document sets out some of the issues that might occur in the event of a full lockdown again and how to ensure fertility centres provide services through any future local or full lockdowns, with appropriate measures being put in place in order support their patients in the most efficient and effective way and taking into account the COVID-19 Scotland's Strategic Framework https://www.gov.scot/publications/covid-19-scotlands-strategic-framework/. Table 1 document sets out an example of prioritisation and Appendix 2 includes activity in Tiers as per the Framework.
The intention and ambition of the Regulator, the Human Fertilisation and Embryology Authority (HFEA) is to avoid closure of licensed fertility services (letter from the HFEA Chief Executive, Appendix 1) and the Scottish Government is supportive of this in respect of NHS services as set out in this document.