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

Andrew D A C Smith, Piotr Gromski, Karema Al Rashid, Kate M Tilling, Debbie A Lawlor, Scott M Nelson*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Research Question
Discontinuation of in vitro fertilisation (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. We sought to estimate the impact of cessation of treatment on individual prognosis and United States 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. We recalibrated this model to cumulative live-birth rates reported for the 135,6733 stimulation cycles undertaken in the USA in 2016, with live-birth follow-up to October 2018. We calculated the effect of a one-month, three-month and six-month shutdown in IVF treatment 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% CI: 0.3, 0.3], 0.8% [0.8, 0.8] and 1.6% [1.6, 1.6] for a one-month, three-month and six-month shutdown, respectively. This corresponds to a reduction of 369 [95% CI; 360, 378), 1,098 [1071, 1123] and 2,166 [2,116, 2,216] live-births in the cohort, respectively. The greatest contribution to this reduction was from older mothers.

Conclusions
We demonstrate 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 an individual and population level.
Original languageEnglish
Number of pages3
JournalReproductive BioMedicine Online
Early online date6 Jul 2020
DOIs
Publication statusE-pub ahead of print - 6 Jul 2020

Structured keywords

  • Covid19

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