Reproductive Health Center, Tucson, Arizona

Hutchison’s Huddle: Fertility Treatment After COVID-19

With COVID-19 spreading quickly across the United States and hospitals everywhere being inundated with patients, the American Society of Reproductive Medicine recommended that fertility treatments pause for the time being. Pausing treatment for our patients was heartbreaking and we know that waiting even longer to start your journey is hard. Thankfully, there are lots of things you can do to get yourself in an even better position to start treatment. To help, Dr. Hutchison took to Facebook to share a few things you can do while waiting for the ASRM recommended restrictions to be lifted.

Find our current policies surrounding COVID-19 here. 

Watch the entire Hutchison’s Huddle on Facebook.

To everyone waiting to start or continue your fertility treatment: we see you. We know that it is hard to wait even longer than you have to see your dreams come to fruition. In these challenging times, we are here for you. Send us your questions via email, Facebook, or give our office a call. We are happy to help.

Hello! Hi, this is Dr. Scot Hutchison here in Tucson, Arizona for another Hutchison’s Huddle. Today’s topic is Life after COVID or, more accurately, Fertility Treatment after COVID. So a lot of you are aware of the American Society of Reproductive Medicine’s recommendations, so transfers and other forms of fertility treatment are on hold right now. To explain why that is, is I think there’s a few things going through people’s minds–one is that even if you have a relatively uncomplicated pregnancy that you might siphon some resources away from people who are sick with COVID down the road. Another is that if we get to nine months from now, and there really is very little anesthesiology around, that potentially you could not have an epidural or C-Section in a prompt fashion. So anyway, that’s, I think, why they’re kind of thinking that’s the way it is. 

Anyway, what we are doing here though, in the meantime is teeing everybody up as best we can to get them ready for treatment. I think we talked about it last week or the week before we’re trying to make people as healthy as they possibly can be. So I would definitely take your opportunity to make yourself as healthy as you can [before treatment begins]. Get your exercise, sorry, that’s why I’m a little out of breath. But you know, eat really healthy food, take the Coenzyme Q10, vitamin D, your prenatals. Guys and gals avoid alcohol, tobacco, CBD, that kind of thing. 

Also, we’re seeing lots of new patients with telemedicine and that can be done with or without a camera. I think it’s really been a boon so far. I mean, most of the patients, I think, really feel like we cover a lot of good ground. And the time that we would normally spend doing the exam is now devoted to trying to optimize everything and getting a more clear history picture. On average, those visits are running about an hour, typically, but I’ve had them go as short as 35 minutes or so. But if you can get us some of your old records ahead of time, and what I do is I look through all those. And the need for an exam is really minimized. So we will do those down the road, look it over. Boy, there’s a whole lot we can learn from laboratories and previous studies and just your history, too, t try to put you on the right path. So,  we schedule those and we’ll do several of those a day typically and we’ll spread them out so that everybody has enough time for their questions and things like that. So anyway, that’s been very gratifying. 

The other parts of this whole illness thing, we don’t really know–it looks like the attack rate’s about half which means an awful lot of people are gonna get sick. I think that like, you know, a lot of these health department people have been warning us that things are going to get worse before they get better. Eventually though, I think this will all settle down. Hopefully there will be a good vaccine and we can then not have to worry about this bubbling up year after year after year. Definitely stay inside, work from home if you can, and minimize your contact with other people. It really looks like droplet transmission is the way most people get the disease, so please stay away from others and keep your distance. 

Anyway, if people have questions, please let me know and we can answer those right now. Oh, and there we go! Here we have some. 

Somebody said as a new patient, can I have my first consult via telemed? Yes, absolutely! 

Can I get my initial testing done before my telemed consult? Yes. So we are still doing those laboratory tests. I tell people to go into the lab early in the morning before there’s a crowd there. If you do have a surgical mask, I would wear it or even a cloth mask and try to minimize your waiting in line or around other people. 

Another person asked, is it a good idea to track my cycles before an initial consultation? Yeah, I think that’s a great, great thing to do. Fortunately, I think most people are doing that when I talk to them.

If I’m unable to start treatment, what things can I do to improve my fertility in the meantime? Well, we touched on that. That’s Mediterranean type diet, so lots of fatty fish, nuts, eggs, poultry, leafy greens, vegetables, olive oil, and really light on the sugars and the refined carbohydrates. Portion sizes for starches–I always tell people I think that pretty much what you could hold in your hand like if you reached into the rice cooker and you pulled out a you know a ball of rice that’s, I think, a reasonable starch portion for you. Same with potatoes, bread, pasta, and the like. The other nutrition tips–avoiding those sugars is really the critical thing I think. And other things like red meat which can increase inflammation in the body. (Read more about holistic fertility care here)

Someone writes, certain supplements or vitamins [to take while preparing for treatment]? Again the Coenzyme Q10, 100 to 125 milligrams twice a day. Coenzyme Q10 should be in a medium chain triglyceride vehicle. And the brands that have that are the–you can find it at Costco and which I think you can get online from Costco now to call Qunol or from a reputable online merchant, like and their version of COq10 is called NeoQ10. 

How much caffeine should I be drinking when preparing for fertility treatment? We’d like you to be down to around 60 milligrams a day for women. Men can drink more, but I tell people to wrap it up by noon, and I’m really not a fan of energy drinks or soda, because those really appear to pull sperm production down. 

And then what exercise is appropriate for preparing for fertility treatment? So, I like people to do–so women who are ovulating should do what’s considered moderate activity. So, you know, and that can be running a few miles or doing some other kinds of exercise, but not to ultimate exhaustion is the thought. Of course, you know, with trained athletes they can–they’re never going to get exhausted. So, I’m not a big fan of people training for marathons, for example, who are already ovulating for women. Who are not ovulating who have polycystic ovary syndrome, that recommendation is the opposite. So we do want those women exercising vigorously to where they’re breathing hard for several minutes per exercise session, because it does seem to really improve their ability to ovulate. Women who have some degree of hypothalamic dysfunction, which is where there’s potentially–you’re not cueing ovulation, and it’s not from insulin resistance just from polycystic ovary syndrome, those women appear to have worsened ovulation with much more vigorous exercise. So for a lot of those folks, and a lot of them are distance athletes, and the stress, even though they enjoy it, the stress of that severe exercise maybe part of what’s keeping them from ovulating and doing very well. And we see that play a factor, not just with ovulation, but also with uterine lining development as well. So I think that if you’re a more extreme athlete, if you’re running, say 40-50 miles a week, I would really tell you to back that off quite a bit. And, and then, we just have to do whatever is gonna work best for making you ovulate appropriately. 

Anyway, if anyone else has any questions, Oh, here we go. Here’s one. What kind of things do you need to see to be comfortable with going forward with a frozen embryo transfer both with a virus [COVID-19] and in the couple? Like if I can work home indefinitely? Obviously, if you can work from home and definitely I mean, that’s awesome. I think that we’re going to have to see is how full the hospitals are over the next month or so. And if the number of cases starts to fall, and the hospitals are and are not so busy, then I think it’s very reasonable to proceed with transfer, providing that everything else is looking okay, too. Again, remember, even if you’re working from home, if you have some problem with the pregnancy, if you have a miscarriage or tubal pregnancy, or even just going into labor, you’re going to be going to the hospital unless you’re going to be doing a home delivery, which I would strongly recommend against, just because they can be pretty lethal, as well as the virus. I would just kind of keep your ear to the ground. Check in with this every month or so and we’ll try to keep you apprised of what we are thinking as well. But yeah, we don’t want to make things harder for the healthcare system than it already is right now.

So, anyway, if that’s all, if anyone else has any questions, I would be happy to answer them. But otherwise, stay healthy, stay safe, and take really good care of yourself so that we can all look forward to having a bunch of babies later, in the early part of this next year probably, that’s what we’ll hope for! 

So have a great night. Feel free to look back on other Hutchison’s Huddles and a lot of my coworkers and co-conspirators are on there with reviewing a bunch of different topics in OB/GYN and fertility stuff, so feel free to look at those. Call us if you have any questions!

And oh, and then a patient says, Have you seen any information if the virus affects fertility? No, it doesn’t. I don’t think it will be and it doesn’t appear to affect babies right now, as far as we know. And the CDC, last I looked, was having women breastfeed even if they had active COVID-19, they were having them breastfeed the baby, as long as they were doing really good hand washing. But no. I mean, obviously, there’s droplets spread of it, so I mean, I can’t believe those kids won’t be exposed. But yeah, it doesn’t look like it has anything. I think that the main thing affecting fertility will be just, if you’ve got lung damage from the disease, are you going to have to hold off on pregnancy for longer just so that you can heal up in order to compensate for the increased metabolic demand of the pregnancy. 

But anyway, have a great night and we will see you down the road! And my thanks to Karina Bacame for making these happen and the rest of our team who are working mostly from home, and we will see you on down the road and have a great night.

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