Fear and uncertainty: How the pandemic impacted fertility treatment

The start of the pandemic was a trying time, characterised by uncertainty and anxiety.

For people in the midst of fertility treatment, whose uncertainty and anxiety levels were already high, it was even harder.

The Future of Fertility special report looks at how the pandemic affected IVF services, and the people availing of those services.

[ The Irish Times ePaper ]

Although there is no published research available on the impact of the pandemic on fertility treatments in Ireland, Rachel Sherlock of NISIG, the National Infertility Support and Information Group, saw it first-hand.

“Both anecdotally and from the calls and messages we received we could see lots of fear, especially at the beginning,” she says. “In March 2020, appointments were pushed back and kept getting rescheduled. And time is critical for IVF. Many couples felt they just didn’t have a year. For some it might have been their third or fourth try.”

The biggest challenge facing most people who embark on IVF in this country is the cost. It currently costs from €4,500, and many couples will try three or more times.

Because there is no financial assistance from the State for IVF, for many people it takes time to save, at a point when time may be working against them. The prospect of further delay was therefore devastating.

The pandemic forced NISIG to amend its practices too; taking face-to-face consultations and support group meetings online. That proved so successful it plans to continue offering both online and in person meetings.

Some patients like being able to access the support they needed, without having to get up, get dressed, or travel to attend, often when at a low ebb.

While the country’s fertility clinics were typically back up and running immediately after the first lockdown, backlogs took time to work through, so delays were inevitable.

For those travelling to countries such as Spain, the Czech Republic, or Ukraine, popular destinations for donor conception, embryo adoption or surrogacy services, challenges remained long after lockdowns were lifted.

As well as flight restrictions such people were faced with ever-changing rules about which countries were open for travel and which weren’t, and what quarantines were required when they landed, or returned home. Trying to negotiate that, and manage workplace absences, made an already difficult time even worse.

“The uncertainty that was the hardest,” says Sherlock.

While the country’s IVF clinics had to close, behind the scenes they were working hard to take as many of their services online as possible, ready to restart once the first lockdown was lifted.

Such was the success of online consultations that SIMS IVF will continue providing them as an option in future too, in addition to face to face meetings with staff. It has clinics in Clonskeagh and Swords in Dublin, and Mahon in Cork, as well as a satellite office in Carlow, and plans to launch two additional clinics in the coming weeks. The idea is to reduce the amount of time those seeking its services have to spend on the road.

“It means less time off work, less travel and more time to spend with loved ones and family. Young people in particular are very comfortable online. They feel they are doing this in the comfort and privacy of their own home and can ask relevant questions without having to get in the car and explain where they are going or why they need a day off work,” says Damien O’Dowd, group clinic director at SIMS IVF.

Changes introduced on foot of the pandemic extend to staff too, with the provision of not just new satellite offices but early morning and later evening consultations giving them more opportunities for flexible working.

The longer opening hours also help the clinic cope with the increased demand for services that have been a side-effect of the pandemic. With travel off the table for much of the past 18 months, people who might previously have sought out treatment abroad chose local clinics instead.

Greater workplace flexibility prompted some to take action who might otherwise have waited, says O’Dowd. SIMS IVF has seen a 20 per cent increase in enquiries.

Demand has increased at Beacon CARE Fertility in Dublin too. It closed briefly in March 2020 but by autumn of last year it had worked through its backlog of appointments. “We are back on track at a higher level than we were prior to the pandemic,” says Dr Bart Kuczera, a consultant at the clinic.

“We’ve been busier than ever during the pandemic. Some people put things on hold but more were rethinking their values in life and speeding things up. They had enough time to think and [are] putting family higher in their priorities,” he adds.

“People were also saving more by working from home, not going out and not going on holidays, so more people had the money too.”

Treatment trends

Finances

Perhaps the biggest trend is the growing need for financial support for IVF. In the UK and Northern Ireland, depending on where you live, anything from one to five rounds of IVF are available free of charge through the National Health Service. Here it’s not unusual for people to remortgage their home, says Rachel Sherlock of NISIG, the National Infertility Support and Information Group.

Even worse, they could be trying to save for a house, says Damien O’Dowd, group clinic director at SIMS IVF. “Or they may have one child already and be paying childcare. It’s an age group at which people have a lot of financial outgoings already.”

Finding out more, sooner

People are getting proactive about fertility. “We are seeing people coming to us that little bit earlier. We offer fertility testing packages where a person can have testing done and decide whether to proceed to a consultation, to break the ice, whether it’s a single person or a same-sex or heterosexual couple. People will do it a couple of years before they want to start a family, particularly if they are in their 30s,” says Damien O’Dowd, group clinic director at SIMS IVF.

Frozen eggs

Egg freezing is becoming a routine practice, and among younger women. “The most common age we see women freezing their eggs now is in the early to mid-30s, down from 35-39 year-olds, which we used to see more of,” says Dr Bart Kuczera of Beacon CARE Fertility. It is, he says, viewed as an insurance policy.

Upping your game

There’s a growing realisation that while women can’t improve the quality of their eggs – they are born with all the eggs they’ll ever have – men can improve the quality of their sperm. “Lifestyle has more impact on male fertility. Avoid alcohol, don’t smoke and take vitamins, there are loads of special compounds now available in chemists which help motility and DNA integrity,” says Dr Kuczera.