An unprecedented situation has been created due to the COVID-19 pandemic. The worldwide healthcare system is facing major challenges. The whole social and economic framework of our societies is tremendously impacted. In India, National Lockdown was started on 23rd March to restrict the spreading of infection. This year, different states have declared complete or partial lockdown because of the arrival of the second phase and worsening the condition. In this situation, many ART clinics are shutting down their services, and many patients who are undergoing fertility treatment facing mental and economic setbacks. In the initial phase of the COVID 19 pandemic the different healthcare organizations had encouraged not opting for elective medical procedures including different ARTs to limit the spreading of the infection. But gradually the situation is changing. People are coping with the condition and vaccination is in continuation. In such conditions, egg donation and further steps are gradually started in a different fertility clinic. However, these organizations are followed national health policies and safety measures.
In egg donation, intended parents have the personal unique choice to choose an egg donor. A matching egg donor is a tough job regardless of the current Covid-19 pandemic. Therefore, fertility clinics or egg donation facilities are facing additional challenges in the egg donor matching process. In some cases, intended parents have already selected an egg donor but are unable to continue because of the COVID-19 pandemic or the donor is affected with Coronavirus infection. In such a situation, intended parents need to hold their patience and cooperate with fertility clinics to start the new course of action.
Many egg donation centers start to proceed new egg donation cycle. However, most of them are determining how much important to start the cycle on an immediate basis. After all, egg donation centers have to manage the crowd. Many patients are already in the waiting period because delaying to start the procedure in COVID -19 pandemic.
In the current scenario, the egg donation process restarts in many egg donation centers. But medical staffs have an additional workload because of maintaining all the safety measures due to the COVID-19 pandemic. In egg donation, screening egg donor is already a tedious medical job. Addition screening tests for COVID-19 infection make it more complicated, and increases cost also.
In the COVId-19, both intended parents and egg donors need to maintain extra precautionary measures for their health to avoid infection during the egg donation phase. In this aspect, both intended parents and egg donors must be aware of what additional requirements they need to navigate for the successful completion of egg donation services. Fertility clinics need to share all the necessary information to help bridge the gap between what intended parents and egg donors already know and what they need to know to make an informed decision about donating and receiving eggs during the COVID situation.
Some egg donors may previously apply to become egg donors but were unable to do because of coronavirus infection. After recovery, they will connect to the egg donation center to determine how to proceed going forward. In such a situation, egg donation centers also reconnect egg donors who have already applied but missed the process because of COVID -19.
Currently, many egg donation centers start accepting egg donation applications. These centers do a critical analysis of all the applications for the approval process. Once the application is approved, then staff from the egg donation center will connect to the egg donor for fixing video consultations and then proceed for medical testing. After completion of these initial steps, an egg donor profile is created. In a COVID situation, this procedure may take a little more time than usual.
Some essential recommendations for egg donation rather all ART services are as follows:
- Routine sanitization must be followed in all the areas in the egg bank as well as egg donation processed room and other parts of the ART clinic according to the local protocols
- In case of a finding of any COVID-19 positive patient or staff, then specific sanitization procedures against COVID-19 should be done
- All staff must be given COVID-19-specific training
- ART clinic and egg donation service centers must prepare COVID-19-specific standard operating procedures
- Shifting duty hours adjustment according to the need
- A limited number of visitors allowed in the center
- Wearing of protective screens for staff must be an essential requirement
- All clinic staff and patients must have the provision of personal protective equipment and sanitation devices
- Restricted entry of visitors including partners
- Redesign of waiting rooms and working spaces to ensure social distancing
- Maintain specific timetable for management of appointments and screening tests
- Staff members need to divide into small teams to reduce unnecessary exposure.
- During oocyte retrieval or implantation need to properly screen for COVID-19. Finding positive needs necessary measures like contact tracing and sanitization.
- Tele-medicine, video consultation options must be open for egg donors and receivers.
A plan for collaboration with other clinics is needed in case of the emergency closure of the ART clinic. The closure can be due to a sudden outbreak of the infection in a mass number of working staff. The primary objective of collaborating with other clinics is to safeguard the patients who are already undergoing treatment and cannot be interrupted.