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Coronavirus Updates: March 27, 2020

Coronavirus Updates: March 27, 2020

Dear Spring Family,

As we continue to learn more about the coronavirus, we are committed to sharing this knowledge with our patients. We recognize that this pandemic is ever evolving and please know that our Medical Directors are closely monitoring ongoing developments and changing our protocols and recommendations accordingly. At this time, our latest treatment policy remains: we are not starting any new IVF or egg freezing cycles as long as shelter in place is in effect, nor are we performing any embryo transfers or IUIs. We are however continuing to safely and thoughtfully monitor patients who are currently in cycle with us through their egg retrievals, and as always, are available to any patients with questions or concerns. Our clinic in San Francisco will remain open with limited hours. 

As you may have read, on March 26th, physicians in China reported the first potential case of vertical transmission (from mother to fetus) of SARS-Cov-2.[i]  While this is only one case (of 38 previously reported successful deliveries with no data to suggest transmission) the evidence provided is compelling:

  • A 29-year-old woman was diagnosed with coronavirus in her 34th week of pregnancy, successfully continued her pregnancy to term and delivered a healthy baby girl 3 weeks later, by cesarean section
  • Two hours after birth, the infant was noted to have two types of antibodies that were positive for SARS-Cov-2 antibodies, IgG and IgM. 
    • Antibodies are produced from specialized immune cells in the body and fight infections and can be used to detect evidence of a prior infection
    • IgG antibodies can cross the placenta, so an infected mom can pass these on to her baby
    • IgM antibodies do not cross the placenta and take 3-7 days to develop after an infection, so these findings indicate that the fetus was infected while in utero
  • The infant tested negative for the coronavirus on four separate tests taken from nasopharyngeal swabs.
  • The mother’s breast milk was also tested, but no viral DNA was detected.
  • The mother’s vaginal secretions were tested and also showed no evidence of infection
  • Both mother and infant recovered and were discharged from the hospital in good condition.

Why is this important?  

This is the first report of possible transmission of virus from mother to baby, and although it is only a single case, it could suggest that pregnant women can transmit the virus to their fetus. It is important to recognize that no illness or virus was detected in the newborn.  The infant had no evidence of respiratory symptoms. The infant was born vigorous and healthy with Apgar scores of 9 and 10 at one and five minutes.  Fortunately, both mother and newborn made a full recovery and were discharged home.  While this may be scary to expecting mothers, it is important to recognize that the baby showed no evidence of respiratory distress. Children infected with this coronavirus also seem to have a milder range of illness than adults at this time.

Is this definitive?

No. More investigations are needed before a definitive conclusion is reached. Another possible explanation for transmission of the virus is that inadvertent maternal blood was exchanged during the cesarean section (from mom to baby), giving the impression that the baby was previously infected in utero. Future reports and testing are needed to confirm or refute this finding.

Please also know, that at this time there is currently no recommendation to avoid, postpone or terminate a pregnancy due to SARS-CoV-2/COVID-19, nor is there any recommendation to avoid a vaginal delivery.

We recognize that this is a stressful and trying time for all, especially for our patients who may be actively trying to conceive or who have recently become pregnant – we are here for you. If you have any questions, please reach out to your care team. 

Warmly,
Your Team at Spring

 

March 19th, 2020: 

Dear Spring Family,

Firstly, thank you for the overwhelming outpouring of support that you’ve shared during this unprecedented time. We recognize the tremendous trust you have placed in our entire team as your partners in your fertility journeys, and we take this responsibility very seriously.

As we have continued to closely monitor the evolving Coronavirus developments and evaluate our responsibility to our patients, staff, and global community, at this time, we have made the difficult decision to temporarily cease all new cycle starts. We will continue to care for patients who are currently in cycle with us, as well as be available for any patients who have questions or complications. Additionally, we will continue to conduct new patient consults and will complete those via video conference.

We know that for many of our patients, treatment is time sensitive, and we are actively working with other leading fertility centers and community groups to develop new guidelines and recommendations that best serve the interests of our patients and our larger health system. We remain dedicated to our staff – your care teams will continue to be available to you via phone, email, and video, so that when we resume initiation of treatments, we can move as quickly and expeditiously as you choose, and the level of support from your team at Spring will remain the same.

Please know that the decision to cease cycle starts is based solely on what we feel is our social responsibility to limit the transmission of Coronavirus and protect our patients, staff, and community.

We firmly standby our mission: to partner with our patients to achieve their goals. In today’s climate, our collective goals are to keep each other safe, protect our vulnerable populations, show compassion to and support those who are struggling, and remember that we will get through this together.

We’re with you,
Your Family at Spring

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