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Population implications of cessation of IVF during the COVID-19 pandemic

Smith, Andrew D.A.C.; Gromski, Piotr S.; Al Rashid, Karema; Tilling, Kate; Lawlor, Deborah A.; Nelson, Scott M.

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Authors

Piotr S. Gromski

Karema Al Rashid

Kate Tilling

Deborah A. Lawlor

Scott M. Nelson



Abstract

Research question: Discontinuation of IVF cycles has been part of the radical transformation of healthcare provision to enable reallocation of staff and resources to deal with the COVID-19 pandemic. This study sought to estimate the impact of cessation of treatment on individual prognosis and US population live birth rates. Design: Data from 271,438 ovarian stimulation UK IVF cycles was used to model the effect of age as a continuous, yet non-linear, function on cumulative live birth rate. This model was recalibrated to cumulative live birth rates reported for the 135,673 stimulation cycles undertaken in the USA in 2016, with live birth follow-up to October 2018. The effect of a 1-month, 3-month and 6-month shutdown in IVF treatment was calculated as the effect of the equivalent increase in a woman's age, stratified by age group. Results: The average reduction in cumulative live birth rate would be 0.3% (95% confidence interval [CI] 0.3–0.3), 0.8% (95% CI 0.8–0.8) and 1.6% (95% CI 1.6–1.6) for 1-month, 3-month and 6-month shutdowns. This corresponds to a reduction of 369 (95% CI 360–378), 1098 (95% CI 1071–1123) and 2166 (95% CI 2116–2216) live births in the cohort, respectively. Th e greatest contribution to this reduction was from older mothers. Conclusions: The study demonstrated that the discontinuation of fertility treatment for even 1 month in the USA could result in 369 fewer women having a live birth, due to the increase in patients’ age during the shutdown. As a result of reductions in cumulative live birth rate, more cycles may be required to overcome infertility at individual and population levels.

Journal Article Type Article
Acceptance Date Jul 1, 2020
Online Publication Date Jul 6, 2020
Publication Date Sep 1, 2020
Deposit Date Jul 7, 2020
Publicly Available Date Jul 7, 2021
Journal Reproductive BioMedicine Online
Print ISSN 1472-6483
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 41
Issue 3
Pages 428-430
DOI https://doi.org/10.1016/j.rbmo.2020.07.002
Keywords ASRM; COVID-19; HFEA; IVF; live birth; SARS-CoV-2
Public URL https://uwe-repository.worktribe.com/output/6183549

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