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COVID-19 UPDATES FOR THE ACS

Please visit NHS Inform for the most recent advice on the coronavirus (COVID-19) vaccine and pregnancy. Here you will find information specific to those in the process of having fertility treatment.

Update Friday 11th March 2022

On the 7th January 2022 it was nationally agreed that fertility treatment for unvaccinated women would be deferred with immediate effect. This recommendation was reviewed, as planned, alongside emerging evidence of risk and the prevailing levels of COVID-19, during January and February 2022.

Data from PHS demonstrates that both COVID-19 cases and hospitalisations are stabilising, and a reduced proportion of cases are resulting in hospitalisations, following the emergence of Omicron as the dominant variant. While data specifically on pregnant women is very limited, the available data on unvaccinated individuals suggests that the risk of severe disease requiring hospital or critical care admission has reduced over the last four to six weeks. Therefore, it has been determined that fertility treatment for unvaccinated patients will no longer be deferred.

The JCVI (Joint Committee on Vaccination and Immunisation) advice on vaccinating pregnant women, namely that pregnant women should now be considered as a clinical risk group and part of priority group 6 within the vaccination programme remains the same. Therefore, we will continue to fully inform patients, prior to their treatment, of the evidence concerning the safety of vaccines in those planning pregnancy, undergoing fertility treatment and the pregnant population in respect of maternal and perinatal outcomes, including evidence for continued vaccine effectiveness against symptomatic COVID-19 disease. Furthermore, we will continue to advise patients at the start of the fertility pathway, and at every opportunity thereafter (making every contact count) about the risks of non-vaccination.

In line with the reviews recommendations, we will also ask patients to sign an informed consent form acknowledging that they are aware of the risks prior to treatment, similar to other aspects of the fertility pathway.

The COVID-19 vaccines are safe and effective and there is no evidence to suggest that the COVID-19 vaccines will affect fertility in women or men.

More information is available on this at https://www.nhsinform.scot/covid-19-vaccine/the-vaccines/pregnancy-breastfeeding-and-the-coronavirus-vaccine

Update Thursday 23rd December 2021

The Scottish Intensive Care Society Report, published on 13 October, highlighted that of the 89 COVID-19 positive pregnant women who were admitted to critical care between December 2020 and end September 2021, 88 were unvaccinated, 1 was partially vaccinated, and none were fully vaccinated. Wave 3 has seen increased numbers of pregnant women being admitted to hospital with moderate to severe COVID-19 symptoms requiring critical care, with clinicians reporting a particular peak in September.

On 16 December, the Scottish Government, Chief Medical Officer, Dr Gregor Smith wrote to NHS Chief Executives highlighting recent updates to the Joint Committee on Vaccination and Immunisation advice on vaccinating pregnant women, namely that pregnant women should now be considered as a clinical risk group and part of priority group 6 within the vaccination programme.

In addition to this, the latest evidence from the UK Obstetric Surveillance System (UKOSS) and the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) shows that unvaccinated pregnant women and their babies have died after admission to hospital with Covid-19 and 98 % of pregnant women in ICU with Covid-19 are unvaccinated. We also know that of all the women who have died during pregnancy or up to 6 weeks after birth, 88% of them were unvaccinated. 

In light of the above evidence, the speed at which the Omicron variant is spreading through communities and the safety of pregnant women and their babies, it has been nationally agreed that fertility treatment for unvaccinated women will be deferred with immediate effect. We will review this decision during February 2022 or earlier if appropriate. Older women who have their treatment deferred, will have the deferral time added back on to their fertility journey to ensure that they do not lose out on eligibility for treatment due to their age.

Women who are within 12 weeks of having their second Covid vaccine dose or who have had their booster will continue their treatment as normal. For those who have recently had or are about to receive their booster vaccination, treatment can begin 10 days after the booster vaccination has been received. Positions on waiting lists will not be penalised if extra time is needed for vaccination.

Further information regarding the Omicron variant will continue to become available and any changes to current guidance will be communicated as soon as it becomes available.

For further information regarding covid vaccination in pregnancy and breastfeeding, please see the following link:

Pregnancy, breastfeeding and the coronavirus vaccine | The coronavirus (COVID-19) vaccine (nhsinform.scot)

FAQ following update on 23rd December 2021
1. How long the treatment will be deferred / postponed?

Treatment will be deferred until February 2022 at which point the advice will be reviewed to determine if treatment can recommence of whether further deferral will be required.

2. If the risks are in pregnancy, why does my partner status matter?

If your partner gets infected you will be exposed to risk of infection. If you are a confirmed contact you will then need to isolate and will be unable to attend for monitoring/ treatment.

3. It is our personal choice to get vaccinate. Why are you forcing us to get vaccinated?

· It is still your personal choice as to whether to have the vaccine, all we are saying is that we cannot proceed with treatment without evidence of vaccination due to the risks involved.

· JCVI (Joint Committee on Vaccination and Immunisation) has put pregnant women in high risk category.

· RCOG (Royal College of Obstetricians and Gynaecologists), RCM (Royal College of Midwives), Scottish Government all are advising vaccination, including boosters for pregnant women.

4. Is it for all fertility treatment or only IVF?

The guidance relates to all fertility treatment and not IVF alone.

5. I am self-funding, why does policy apply to me?

As this is based on clear clinical advice around the risks for this group of women and the decision is based on protecting this group, this policy applies to all patients having treatment in Centres, not just NHS patients.

6. Will I have to provide evidence?

Yes. Please download the app. This will be checked when you come in to the centre.

7. If I wait, I will be more than 40. This will compromise my funding status

No this will not compromise your funding status. All patients having treatment deferred will have the deferral time added back on to their treatment journey to ensure that no patient loses out on treatment due to their age.

8. Can I go through stimulation and freeze embryos?

The same concerns around infection during treatment and subsequent cancellation of the cycle prior to egg collection apply.

9. Will there be further deferral?

We don’t know at this stage. The available data will be reviewed in February.