Covid Update (June 3, 2021)

Updated June 3, 2021

Practice Operations

On behalf of The Center for Advanced Reproductive Services [CARS], we hope during these challenging times this letter finds you and your family safe and healthy.  As Connecticut has remained stable with COVID-19 cases and hospitalizations, we are writing to tell you about fertility treatments at CARS at this time.

At each CARS office, policies & procedures have been implemented to optimize physical distancing and other mitigation strategies to minimize risk of exposure for patients and staff. As of June 3, 2021:

  • We are currently at 100% of normal volumes for IUI & IVF and continue to carefully track CT COVID -19 data, internal mitigation systems and our inventory of PPE.
  • Maintain social distancing standards for patients and staff.
  • Maintain personal protective equipment [PPE] and mitigation strategies to limit risk of exposure for patients & staff.
  • 97% of our staff have received their first and second COVID 19 vaccinations. Those who are not vaccinated are on a weekly COVID 19 testing schedules.

Next Steps [effective Monday, June 7, 2021]

Continued restrictions:

  • All CARS facilities will continue to require ALL patients and partners, children, guests, etc to always wear masks.
  • All patient consults will continue to be remote via TEAMS.
  • All live appointments will continue to be scheduled only. No walk ins. This includes Quest blood draws.
  • PACU [retrieval & transfer areas] continues to be closed to partners and family members.
  • Anesthesia guidelines for IVF retrieval remain unchanged.
  • Men will continue to produce sperm specimen at home unless living > 1 hour away.

Discontinued restrictions:

  • Virtual waiting room, texting to enter. Patients can come right in. Please arrive as close to your scheduled time as possible to control patient traffic thru the offices.
  • Patient screening tables
    • A modified screening will occur at each clinical entrance:
      • Do you have any cold or flu symptoms?
      • Have you traveled internationally?
      • Temperature.

To achieve this a thermometer will be relocated at each clinical entry way. Whoever brings patient into clinical area will screen patient according to aforementioned.

  • Partners and other family members are welcomed for all visits so long as masked at all time.
  • Children are allowed in building so long as masked.

Travel

The only travel we are concerned with at this time for patients is international travel. If a patient travels internationally we will require negative COVID test 72 hours before or after arriving back to CT.

Practicing medicine, especially fertility treatments, in a COVID – 19 world is very different than a year ago. There are several interventions we are continuing as part of our efforts to keep everyone safe.

Patient Visits

  • All patients visiting CARS must be scheduled at a specific time. This includes morning ultrasound and blood monitoring, and Quest blood draws throughout the day. No more walk ins of any kind.
  • If you need to change the time you are scheduled for your monitoring blood work or ultrasound, please contact the front desk.
  • All new patient visits, IVF consultations [1B] and established subsequent office visits continue to be telehealth via Microsoft TEAMS.
  • MD clinic visits on site will be limited to ultrasounds, procedures, emergencies and clinical follow up appointments for telehealth patients.
  • Every attempt will be made for onsite visits to be as efficient as possible. There will be limited on-site counseling and instructions. Discussions can occur immediately following your visit with a call from your car or we can call you later when you’ve arrived home. Our doctors and nurses will have access to Microsoft TEAMS for video conferencing.
  • Semen analysis appointments will be scheduled and patients asked to produce at home. Specimen collection kits will be provided to patients in advance via a repository by front doors at each office. Male partners must personally deliver semen specimens to practice.
  • Please stay in contact with us and call your nurse or financial services representative [FSR] when you intend to start a cycle.  Your physician team will review your personal case and follow up with next steps.
  • All patients undergoing care are required to provide an active credit card on file so we can run co-pays, deductibles, etc so front desk and financial staff are protected from handling credit cards, money, checks, etc.

Health Screening

Patients are asked about symptoms and travel history upon entry into clinical areas and temperatures are being assessed. All patients must wear a mask at all time when in our offices. If you have a mask at home [homemade cloth masks are fine] we ask that you use it or one will be provided.

Satellite Patients

CARS will begin to see all satellite patients for basic monitoring [bloodwork and monitoring ultrasounds]. As always CARS will not perform pregnancy testing or ultrasounds on satellite patients.

COVID 19 Testing for IVF patients

We are requiring IVF patients have at least one COVID 19 negative test between Baseline and day of Retrieval [preferably stim day 4/5]. Our staff will provide you with testing site options and instructions on the day of Baseline. Any patients testing COVID 19 positive during an IVF cycle will be managed on a case per case basis.

Fertility Treatments and COVID 19 Vaccine

We are all excited about the recent developments and promise regarding Covid 19 vaccines. These vaccines have not been extensively studied in pregnant women. As vaccines become more widely available, a practical question has arisen regarding the timing of vaccine administration with respect to certain invasive reproductive care treatments. In general, it is recommended that: Patients scheduled for elective surgery or outpatient procedures, including oocyte retrieval, embryo transfer, and intrauterine insemination, avoid COVID-19 vaccination at least three days prior and three days after their procedure. This recommendation is not because being vaccinated is unsafe, but rather because known side effects of the vaccine may impact intra-operative and post-surgical monitoring. Common side effects after COVID-19 vaccination, especially after the second dose, include fever, chills, fatigue, myalgia, and headaches, which typically occur and resolve within three days. Anesthesia impairs normal thermoregulatory control and may be impacted by pre-existing fever. Additionally, these side effects would make it difficult to determine if a post-procedure fever is related to the vaccine or to a developing infection related to the procedure. Finally, many medical facilities may not allow patients into their facility or proceed with any elective procedure if a patient has COVID-like symptoms, including those that are possible side-effects of the vaccine, even if their COVID-19 test is negative. Practices should notify and encourage their patients to communicate with their surgeons and fertility programs when they become eligible for COVID vaccination. This will help coordinate planned surgical procedures, fertility testing and treatment, and will decrease the chance of inadvertent procedure cancellation.

We will get thru this together.

Thank you for your continued patience and understanding during this time of uncertainty. The COVID-19 pandemic has changed many things including the way we practice fertility medicine, but one thing that has not changed is our commitment to helping our patients build families. We have been thinking about you during this difficult time and eagerly look forward to safely making your family building dreams come true. If you have any questions or concerns please contact Paul Verrastro, CARS CEO at 860.321.7082, EXT 8005.

Have a great summer and thank you for your continued support.

Paul Verrastro, CEO

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