Coronavirus (COVID-19) and Fertility
When you are trying to conceive, everything feels uncertain, unpredictable and frustrating. Whether you are trying naturally or going through the process of fertility treatments, life feels very much out of your control. Add to this a global pandemic (which is making everyone feel as though life is out of control) and you will likely be feeling filled with anxiety.
You are probably doing and have already done a lot of research as to ways to increase your fertility and chance of conception, and trying to avoid any unnecessary risks to your chance of conceiving. If you are now facing the uncertainty of COVID-19, you have another complete unknown to contend with. This is a new disease with so little research or evidence available, it is possible you've even started wondering whether now is even the right time to conceive. But then the thought of not trying feels like wasting time as you just never know which month might be your month!
As we are currently in a phase of lock-down, you may also be struggling with your mental health. Without daily routine to take your mind off things, you may be obsessing about all of the uncertainties around trying to conceive that you're facing and this may send you into a further negative spiral. You may also be missing out on your usual exercise, your eating patterns may change and you may have lost your methods of managing your stress (cancelled yoga classes, no chance of complementary therapy and only one trip out of the house each day). All of these things could have an impact on mental health, your hormone balance and your fertility. But being told to relax and not think about it, is now more then ever a useless piece of advice! Everyone is stressed and worried, so of course you will be too.
If you are trying to conceive naturally....
....what can you do? This is a time where we must focus on what we can control and not what we cannot control. It's a real test of mental resilience, something that you need a bucket load of on any fertility journey.
Try to keep your daily routine as much as possible and focus on what positives this could bring.
Sleep is a key factor in optimising fertility. Good sleep helps to promote a good hormone balance and reduces stress levels. If your life is usually very busy, maybe you will even have time to improve your sleep, allowing yourself a regular routine, more hours in bed and a chance to get the illusive 7-8 hours.
Stay hydrated. Being well hydrated is key for overall health and aiding good digestion as well as optimising cervical mucus quality. If you're at home you may have more time to focus on getting your recommended 8 glasses a day.
Exercise: It is important to keep at least the same level of exercise that you were getting before. You can't go to the gym or classes, but maybe you could replace this with a long run or walk in the middle of the day. If you are usually at work all day, you may not get the chance to exercise outdoors in the daylight, and exercise in nature has added benefits for your mental health.
Food: try to stick to your regular mealtimes and focus on getting good healthy nutritious meals. You will have to be more organised with your food shopping and meal planning, and much more time to cook from scratch. The more nutrients you're getting from your meals, the more you can justify a few treats now and again. Its about maximising the good stuff, not depriving yourself.
Make your online world a positive one. People are really creating a sense of community online and many people are offering services for free on Zoom or Facebook. There's plenty of resources for learning, classes for exercise and relaxation, guided meditations and support for staying calm. Find what works for you and most importantly, try to ignore what doesn't! If you follow people filling your timeline with fear or you'e reading the news 25 times a day, then try to reduce these negative inputs.
Do what you love. You may still have to work but hopefully with social plans cancelled you will have more time to yourself, to remember what you loved doing. Read, paint, draw, write, play music, dance, learn something new or even catch up on some indulgent TV.
Nurture the right relationships. When you're trying to conceive it can put pressure on a lot of relationships. You and your partner might be struggling when the sole focus of your relationship is trying to conceive. Being stuck in the house together could feel like the exact opposite of what you need, but try and turn it in to a positive, it gives you more time together to do and discuss things other than optimising conception. You may even have time to have sex that is just for fun, imagine that!
You may have been struggling recently with social interactions, social situations with pregnant friends or friends with new babies. You may have been keeping things to yourself and felt withdrawn from you normal social groups. With everyone in isolation, this pressure has now been removed. You have the perfect reason not to see people and you can make an effort to call those that you feel benefit you.
Stay safe and follow government guidelines. Keep yourself physically well, follow advice to stay in your house with only people that live with you. Limit your trips out to essential food shopping and one form of exercise a day, observing the social distancing rules. And of course, wash your hands well regularly and certainly after any potential exposure.
If either you or your partner are NHS workers or keyworkers, then you are doing an amazing job and I understand that you will struggle with any of the above advice, your life must feel upside down and you probably have less time not more. And if you are also trying to conceive the stress must be un-imaginable. Please know that everyone is thinking of you and appreciating you, even if they don't know everything that you are going through personally.
If you are undergoing fertility treatment...
..... there has been further anxiety in recent weeks over whether or not you will be able to continue with your treatment cycle. Messages have been mixed and have differed between clinics. On 24 March 2020, the HFEA (Human Fertilisation and Embryology Authority) issued guidance which must be adhered to by all clinics, at least giving everyone certainty as to whether their treatments will go ahead. In line with guidance from the the British Fertility Society (BFS) and Association of Reproductive and Clinical Scientists (ARCS), they have issued General Directions which now require all clinics to have a COVID-19 strategy in place and to wind down their treatment services by 14 April 2020.
The strategy requires patients to follow strict guidelines when attending appointments, often being advised to wait out in cars rather than in a waiting room, and if anyone is in a high risk group or is experiencing any symptoms (high temperature or continuous cough) then they must self isolate for 14 days. For specific procedure guidelines you will need to contact your clinic.
This news may come as a relief to some people who are able to complete their cycle within this period. Although clinics are recommending that people delay fresh embryo transfers and to freeze and store the embryo, it is still up to the couple and many people are choosing to go ahead despite the unknown regarding follow up appointments after clinics cease services.
However, for others this will be devastating. Some people may have been preparing for months or even years for their cycle, after various tests and procedures to ensure the optimum chance of success before they proceed with treatment cycle. This whole process will have been emotionally and physically draining and expensive for those funding themselves. Many people will have already started hormone treatment and will have to deal with the physical and emotional roller-coaster of that without the attached hope that should accompany it.
Clinics are offering free freezing and storage where a live cycle has been postponed, abandoned cycles are not being charged and where a multi package treatment has been purchased the are offering extensions.
There is also some further complications for patients or donors that have travelled to a high risk country. It has been confirmed that you must not donate if you have been in or travelled through a high risk country in the previous 28 days. For those that have had some treatment abroad you must contact your individual clinic to find out how this will affect you in the coming weeks.
If you are affected by this change of policy, you will be grieving for your lost cycle and angry about all the unknowns in this rapidly changing situation. Of course you can also focus on things that you can control, but the reality is, you have just been hit by something entirely unexpected in an already stressful situation. Allow yourself to be angry and to grieve and don't be afraid to ask for professional support.
Support is available
At Muma Nurture we are offering services online throughout the current crisis, which means that our counselling services are still available. Please get in touch if you are struggling with any of these issues.