A picture of medically assisted reproduction activities during the COVID-19 pandemic in Europe
The ESHRE COVID-19 Working Group, Nathalie Vermeulen, Eduard Hambartsoumian, Kazem Nouri, Thomas Ebner, Christine Wyns, Greta Verheyen, Elena Petrovskaya, Sasha Vujnic, Sanja Sibincic, Gueorgui Nikolov, P Andreeva, Dinka Pavičić Baldani, Patrik Stanić, Sozos J. Fasouliotis, Christiana Antoniadou, Anna M. Agathangelou, Alice Malenovská, Karel Rezabek, Ursula Bentin-Ley, Marie Louise Grøndahl, Anja Pinborg, Laure Morin‐Papunen, Sirpa Mäkinen, Pierre Boyer, C Rongières, J. de Mouzon, Daniela Nogueira, Tamar Barbakadze, Lika Chkonia, M. Kupka, Verena Nordhoff, T. Strowitzki, Basil C. Tarlatzis, Péter Kovács, Mátyás Szabolcs, Hilmar Björgvinsson, Mary Wingfield, Joyce Leyden, Gianluca Gennarelli, Lucia De Santis, Vyacheslav Lokshin, Valerija Magomedova, Raminta Baušytė, Ieva Masliukaitė, Caroline Schilling, Thierry Forges, Zorancho Petanovski, Valentina Sotirovska, Jean Calleja‐Agius, Tatjana Motrenko Simic, J Smeenk, Susana M. Chuva de Sousa Lopes, Annemiek Nap, Liv Bente Romundstad, Anna Janicka, Robert Spaczyński, Ana Luisa Sousa Ramos, Isabel Doria Reis, Corina Manolea, Monica Dascalescu, Ioana Rugescu, Tatyana Kodyleva, Sergei Nikitin, Elena Zakharova, Lela Šurlan, Martin Štimpfel, Milan Reljič, Ladislav Maršík, Joaquín Llácer, Francisco Domínguez Hernández, Carmina Vidal, Kjell Wånggren, Isabelle Streuli, Oliver Sterthaus, Hakan Yaralı́, L. Karakoç Sökmensüer, Mykola Gryshchenko, Julia Gontar, Virginia N. Bolton, Maya Chetty, Raj Mathur, Barış Ata, Luca Gianaroli, Kersti Lundin, Edgar Mocanu, Satu Rautakallio-Hokkanen, Juha S. Tapanainen, Anna Veiga
Abstract
STUDY QUESTION: How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)? SUMMARY ANSWER: MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks. WHAT IS KNOWN ALREADY: With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020. STUDY DESIGN SIZE DURATION: A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email. PARTICIPANTS/MATERIALS SETTING METHODS: The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country. MAIN RESULTS AND THE ROLE OF CHANCE: By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic. LARGE SCALE DATA: N/A. LIMITATIONS REASONS FOR CAUTION: Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country. WIDER IMPLICATIONS OF THE FINDINGS: The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations. STUDY FUNDING/COMPETING INTERESTS: There was no funding for the study, apart from technical support from ESHRE. The authors had no COI to disclose.