1The fertility clinic cancelled my cycle what can I do now to improve my chances to get pregnant later?
A: There is a lot you can do to take care of yourself during this time. Remember, the healthier you are when you start your cycle the better
- Overall, you do want to ensure you are maintaining a healthy weight
- Eat a well-balanced diet; find time for regular daily physical activity. The silver lining is that you have more time now to do both
- Take prenatal vitamins (Vitamin D, CoQ10 and Folic Acid), and remember that a different mix of prenatal vitamins for men might be improve sperm quality as well
- As always, quit smoking and avoid alcohol
- An important one right now is your mental health as well; do try to manage your anxiety and stress levels during this challenging time. The Anova Wellness team is doing virtual consultations
- Get all the routine testing up to date so that it is ready when we reopen
- Ensure the paperwork is complete (mainly consent forms)
- Get in contact to learn about the different financial options that exist, such as payment plans and financing options.
2My funded cycle was postponed. Does this mean that the funding will be cancelled?
A: Unfortunately, it is too early to tell what government officials will do after the crisis is over. It would make sense that if you weren’t able to access your funded cycle, you could use it later.
However, this pandemic will have substantial financial implications on the Ministry of Health, and we don’t know at this point what will be done to minimize the health, economic, and social impacts of this rapidly evolving public health issue.
It is important to note that the waitlist for funded cycles maybe even longer post-COVID-19. Waiting longer for some women means that they will have to rethink their fertility treatment route and consider switching to paid cycles to increase their chances of getting pregnant. Time matters, and the best care plan for you may mean paying privately sooner rather than waiting for a funded cycle
3Are you planning to give priority to your “older” patients when you resume?
At Anova, we take pride in our personalized approach. Once resumed, our doctors will review the list of our patients and see what order will give you the best chances, age will be a factor – but we will also try and respect the order that was established before COVID-19 interrupted the plans. We are currently evaluating how we can increase the number of IVF treatments we can offer per month to help couples get back on track.
We are currently trying to get in contact with women who had been notified of a funded cycle, as well as any patient who was prepared to pay privately for their IVF treatment. If you haven’t heard from us yet, please email us.
We are currently trying to get in contact with women who had been notified of a funded cycle, as well as any patient who was prepared to pay privately for their IVF treatment. If you haven’t heard from us yet, please email us.
4My fertility clinic has cancelled my cycle, can I still take Clomid or Letrozole and try to conceive naturally?
First, we need to turn to international recommendations from the governing medical bodies when facing times of uncertainty – it’s why they exist. According to CFAS and ASRM guidelines, until more is known about the virus, and while we remain in this public health emergency, it is best to avoid the initiation or creation of a pregnancy. COVID-19 is a new virus, and there is still not enough research to understand its impacts on embryogenesis, fetal development, and pregnancy complications, so we need to be cautious.
In addition, prescribing ovulation induction drugs to a patient without the appropriate monitoring is NOT safe. Patients can hyper-stimulate on ovary stimulation drugs. They can get ten follicles on each one of these drugs, and without proper monitoring, there is no way to know how many follicles were created. Conceiving naturally, with this many follicles, significantly increases the risk for multiple pregnancies, which is considered to be higher risk pregnancy and can be dangerous for both mom and babies.
Even if we can’t see you at the clinic right now (though we are still seeing patients virtually!), we are still responsible for your health, and responsible for every prescription we prescribe. Therefore, Anova fertility will NOT prescribe these medications or refills during this time.
In addition, prescribing ovulation induction drugs to a patient without the appropriate monitoring is NOT safe. Patients can hyper-stimulate on ovary stimulation drugs. They can get ten follicles on each one of these drugs, and without proper monitoring, there is no way to know how many follicles were created. Conceiving naturally, with this many follicles, significantly increases the risk for multiple pregnancies, which is considered to be higher risk pregnancy and can be dangerous for both mom and babies.
Even if we can’t see you at the clinic right now (though we are still seeing patients virtually!), we are still responsible for your health, and responsible for every prescription we prescribe. Therefore, Anova fertility will NOT prescribe these medications or refills during this time.
5Can I still try to conceive naturally?
In addition to the details given to the above question, it is not recommended to start a pregnancy during this time, for the following reasons:
- In the early weeks of pregnancy and throughout the first trimester is when a patient will have their most interactions with the healthcare system. Right now, our healthcare system is trying to adjust, to be able to handle the COVID-19 pandemic. By not creating new pregnancies we are helping to decrease the overall burden on the system and support our healthcare workers.
- As mentioned, the scientific community has not had time to do extensive, robust studies on the impacts of the COVID-19 virus on moms, dads, eggs, sperms, embryos, and babies.
- All pregnant women are, to some extent, considered immunocompromised. Since we know that COVID-19 is more dangerous to certain people, including those that are immunocompromised – we want to avoid getting anyone pregnant and having them be more at risk of severe complications if they develop COVID-19.
6I am currently pregnant, what are the risks I am facing?
COVID-19 is a new virus, and the data is very limited. Globally, there are not many pregnant women infected with COVID-19.
Currently, the data is reassuring and suggests that pregnant women are not at a higher risk of infection, nor at a greater risk of infection, nor a higher risk of severe morbidity (other health concerns) compared to non-pregnant women of the same age.
Moreover, the vast majority of infants born to pregnant women infected with COVID-19 have been healthy at birth, with near-term prematurity (preterm birth) being the most commonly reported adverse pregnancy outcome. However, adverse pregnancy outcomes are thought to be proportional to the degree of maternal respiratory illness.
You might also want to read this resource from the Centre for Disease Control.
Currently, the data is reassuring and suggests that pregnant women are not at a higher risk of infection, nor at a greater risk of infection, nor a higher risk of severe morbidity (other health concerns) compared to non-pregnant women of the same age.
Moreover, the vast majority of infants born to pregnant women infected with COVID-19 have been healthy at birth, with near-term prematurity (preterm birth) being the most commonly reported adverse pregnancy outcome. However, adverse pregnancy outcomes are thought to be proportional to the degree of maternal respiratory illness.
You might also want to read this resource from the Centre for Disease Control.
7I was recently given a referral to see a fertility specialist; can I still come for my first visit?
Yes, we are still accepting new referrals, and our physicians are seeing them through virtual consultations. To book your first appointment, reach out to us, and we will get you booked.
Now is a good time to learn more about the potential reasons you are facing fertility challenges, and to come up with a care plan moving forwards.
Now is a good time to learn more about the potential reasons you are facing fertility challenges, and to come up with a care plan moving forwards.
8I was told that I need to start taking birth control while I wait for IVF post-COVID19, why? I am concerned about having those drugs in my body.
We are getting this one a lot from women who need to postpone their IVF cycle. We have asked all of our patients who are in this situation to call and speak to one of Anova’s nurses. If you haven’t yet, please contact us.
Birth control medication (OCPs) allows us to essentially take control of your menstrual cycle. While this may seem counterintuitive, it means that we will be better able to time the start of the IVF treatment once we are allowed to do so.
If you are not comfortable taking birth control, that is a personal decision. If you choose to go this route, we are asking for you to call in on the first day of your period to have an update conversation with the nursing team.
Birth control medication (OCPs) allows us to essentially take control of your menstrual cycle. While this may seem counterintuitive, it means that we will be better able to time the start of the IVF treatment once we are allowed to do so.
If you are not comfortable taking birth control, that is a personal decision. If you choose to go this route, we are asking for you to call in on the first day of your period to have an update conversation with the nursing team.
9Can a pregnant woman with COVID-19 pass the virus during pregnancy to their baby?
The COVID-19 is a new virus, and it is too early to tell as there is not enough data to conclude about vertical transmission, which refers to the transmission of the infection from mother to fetus). According to one study conducted on nine pregnant women in China, there was no evidence of vertical transmission. However, recent study suggests that vertical transmission is possible.
For this reason, it is important that pregnant women will practice vigilance and self-isolate as much as possible.
For this reason, it is important that pregnant women will practice vigilance and self-isolate as much as possible.
10What can I do to protect myself from COVID-19
According to public health recommendations by Public Health Ontario, here are some reminders for what you can do to protect yourself and those around you:
- Practise physical distancing. Keep a safe distance of 2 meters away from other people.
- Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose, and mouth
- Avoid contact with others. No visitors unless essential (such as care providers), stay away from elderly persons, and people with chronic medical conditions.
- Stay home, and avoid all non-essential trips. Do not go to work, the corner store, or other public places.
- Practice good cough and sneeze etiquette. Cover your mouth and nose every time you cough or sneeze. If you don’t have a tissue, sneeze or cough into your sleeve or arm.
- Clean and disinfect frequently touched objects and surfaces. Think doorknobs, railings, sinks, etc.
11When we return to the clinic to complete our cycle, will we have to have special measures taken?
The well-being and safety of our patients and staff is our priority. Anova is always on top of all recommendations from Public Health, WHO, ASRM, and CFAS and will follow all the protocols and requirements for returning patients. As the COVID-19 outbreak is evolving, we cannot foresee the future recommendations. Rest assured, we will continue to provide updates as we receive them.
12Are new patients able to come in for blood work, or do we need to wait?
As of April 3rd, Anova will complete the diagnostic cycles for patients already in the process. You will be asked to call on day one of their period and book day three bloods, and day three ultrasound. However, we continue to monitor Public Health regulation closely; this might be updated later on. It is recommended to contact us (416) 225-4440 before you come in.
13Can a pregnant woman with COVID-19 pass the virus during pregnancy to their baby?
The COVID-19 is a new virus, and it is too early to tell as there is not enough data to conclude about vertical transmission, which refers to the transmission of the infection from mother to fetus). According to one study conducted on nine pregnant women in China, there was no evidence of vertical transmission. However, recent study suggests that vertical transmission is possible.
For this reason, it is important that pregnant women will practice vigilance and self-isolate as much as possible.
14What can I do to protect myself from COVID-19
According to public health recommendations by Public Health Ontario, here are some reminders for what you can do to protect yourself and those around you:
- Practise physical distancing. Keep a safe distance of 2 meters away from other people.
- Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose, and mouth
- Avoid contact with others. No visitors unless essential (such as care providers), stay away from elderly persons, and people with chronic medical conditions.
- Stay home, and avoid all non-essential trips. Do not go to work, the corner store, or other public places.
- Practice good cough and sneeze etiquette. Cover your mouth and nose every time you cough or sneeze. If you don’t have a tissue, sneeze or cough into your sleeve or arm.
- Clean and disinfect frequently touched objects and surfaces. Think doorknobs, railings, sinks, etc.
15When we return to the clinic to complete our cycle, will we have to have special measures taken?
The well-being and safety of our patients and staff is our priority. Anova is always on top of all recommendations from Public Health, WHO, ASRM, and CFAS and will follow all the protocols and requirements for returning patients. As the COVID-19 outbreak is evolving, we cannot foresee the future recommendations. Rest assured, we will continue to provide updates as we receive them.
16Are new patients able to come in for blood work, or do we need to wait?
As of April 3rd, Anova will complete the diagnostic cycles for patients already in the process. You will be asked to call on day one of their period and book day three bloods, and day three ultrasound. However, we continue to monitor Public Health regulation closely; this might be updated later on. It is recommended to contact us (416) 225-4440 before you come in.
1Will Anova need to close again, and will my fertility care be interrupted?
Anova does not foresee a closure like we experienced from March-May, as we are now included as a Phase 1 essential healthcare service able to operate under our Independent Healthcare Facility license. We have a stable stock of PPE, and continue to work with protocols and processes that minimize the risk of exposure for our patients and team members.
We will follow and adhere to the guidelines put out by governing bodies, including Public Health, CPSO and CFAS. Please follow us on social media for the most up to date clinic information
2What happens if some one I see daily tests positive for COVID-19?
Following the Public Health guidelines, you should isolate and get a COVID-19 test. If the results are negative, and you are symptom free for 48h since getting the test results back, contact the clinic for further instructions. If you do have or develop symptoms, the recommendation is to quarantine for 14 days and be re-tested.
3 Is there any thing I should be doing ‘extra’ to keep my care on track?
It is critical to be very diligent about behaviours and steps you can take to decrease your exposure risk. This includes of course frequent hand washing and wearing a mask, but also limiting the number of people you physically interact with. The smaller your ‘bubble’, and the fewer trips you make out in public, the less likely you are to come in contact with someone who later tests positive for COVID-19.
We are encouraging the entire community to get the flu shot this season.
4I have allergies, and often have a runny nose and sore throat. Can I still come into the clinic?
While many symptoms we are familiar with, they are still potential symptoms of COVID-19. Due to how readily this virus spreads, as a community we need to be cautious with any symptom and get tested.
Following the Public Health guidelines, you should isolate and get a COVID-19 test. If the results are negative, and you are symptom free for 48h since getting the test results back, contact the clinic for further instructions. If you do have or develop symptoms, the recommendation is to quarantine for 14 days and be re-tested.
5What happens if I test positive for COVID-19?
If this happens, please notify our team immediately, so that we are able to identify which staff you may have interacted with on your last visit.
As per Public Health guidelines, you need to self-isolate for 14 days regardless of whether you have symptoms, starting from the day you were tested
1What measures should I expect when coming to the clinic? How is Anova ensuring a safe environment?
To be able to ensure the safety of our patients and our team, there will be new processes and protocols in place, for an overview please click here.
At the time of booking your appointment, there will be a verbal COVID-19 pre-screen questionnaire & you will be sent a COVID consent form to complete and return.
On the day of your appointment, you will be asked to bring a face mask and to wait in your car until it is time for the appointment. In the lobby you will be greeted by a member of the Anova team. You will need to update your declaration of COVID-19 risk factors, sanitize your hands, wear a sticker, and will be brought to the elevator.
At the clinic, the door will be propped open and you will check in with reception before being brought to a clinic room. While we have adjusted the wait room to allow for social distancing, we will be treating it more as a ‘through room’ at this time.
After your appointment, you will need to check-out at reception, and leave the building promptly.
To decrease exposure risk, we are minimizing the amount of people in the clinic. This includes the restriction that at this time, family, visitors and support people will not be allowed inside the clinic. See more detailed response below.
On the day of your appointment, you will be asked to bring a face mask and to wait in your car until it is time for the appointment. In the lobby you will be greeted by a member of the Anova team. You will need to update your declaration of COVID-19 risk factors, sanitize your hands, wear a sticker, and will be brought to the elevator.
At the clinic, the door will be propped open and you will check in with reception before being brought to a clinic room. While we have adjusted the wait room to allow for social distancing, we will be treating it more as a ‘through room’ at this time.
After your appointment, you will need to check-out at reception, and leave the building promptly.
To decrease exposure risk, we are minimizing the amount of people in the clinic. This includes the restriction that at this time, family, visitors and support people will not be allowed inside the clinic. See more detailed response below.
2How do you pre-screen your staff?
The entire Anova team is also returning to the clinic under a new set of processes and protocols. All employees will be subject to COVID-19 risk screening before the start of their workday, and will use different PPE as appropriate to their role. They will also be wearing “Completed Screening” stickers, like our patients.
3Can my partner come in with me during my egg retrieval (OPU) or embryo transfer (FET)?
In accordance with the medical guidelines, and to limit the risk of exposure, no visitors or support people will be allowed in the clinic.
We will do our best to accommodate ‘virtual visitors’ for OPU and FET procedures.
Post-procedure, patients who required sedation will be escorted by an Anova team member to the lobby, where they will be met by their support person
We will do our best to accommodate ‘virtual visitors’ for OPU and FET procedures.
Post-procedure, patients who required sedation will be escorted by an Anova team member to the lobby, where they will be met by their support person
4What will the business hours will look like during this time?
We will be adjusting the opening hours of the clinic as we work to limit the exposure risk through altered processes and procedures. To be able to ensure that the healthcare providers at Anova remain in full force, they will be working in non-overlapping teams.
5I heard I will need to wait in my car for my appointment, where should I park?
There is underground and street parking around 25 Sheppard Ave. West. Street parking with the city’s GreenP App would allow you to manage payment for parking most efficiently.
6Will I continue to meet my doctor virtually, or do I need to come in for my follow up appointment?
To limit the amount of people visiting the clinic, we will be continuing with OTN virtual appointments with the physicians whenever possible. Contact reception@anovafertilitiy.com for an appointment
The Anova Wellness providers are also seeing patients virtually, you can book with them here.
COVID19 Vaccine
*Disclaimer: This information was prepared based on information released by health officials: Health Canada, CDC, SOGC, CFAS, ACOG, and NACI as of Dec 22, 2020. As data continues to be collected, it may be subjected to change.
1What do we know about these vaccines?
Both the Pfizer and Moderna vaccines are based on a novel mRNA technology.
The COVID-19 mRNA vaccines provide our bodies with the template for our cells to make a harmless piece of a protein found on the coronavirus surface called the “spike protein.” When the mRNA template gets injected, cells in our body will generate the coronavirus spike protein, which will later be displayed on their cell surface. This will activate the immune system to create specialized antibodies that will identify and destroy the spike protein (and thus, any viruses that have these proteins on them).
The mRNA vaccines are considered safe because they do not contain any live, and they do not use any adjuvant, which may cause adverse reactions in people with a severe allergy. These vaccines do not enter the nucleus and do not alter human DNA in vaccine recipients.
2What are the side effects of these vaccines?
While mRNA vaccines are considered to be safe, most study participants for both the Pfizer-BioNtech and Moderna vaccines experienced mild side effects similar to influenza-like illness symptoms following vaccination (see table below, Source ACOG)
We have summarized the main features of each vaccine in the table below.
3Should I take the vaccine if I am currently pregnant or breastfeeding?
While mRNA vaccines are not considered live virus vaccines, they are not hypothesized to be a risk to pregnant or breastfeeding women. However, it is important to note both pregnant and breastfeeding women were excluded from the COVID-19 vaccine trials. Therefore, there is not enough data to suggest or deny efficacy or safety during pregnancy or breastfeeding.
According to an SOGC: “While there have been no red flags or hypothesized mechanisms for potential harm associated with administration of an mRNA vaccine during pregnancy until more data is available, the potential risks of vaccination to a pregnant individual and fetus remain unknown.”
While most pregnant women who become infected with SARS-CoV-2 will have mild-to-moderate symptoms, and many can be asymptomatic, some pregnant women are at high mobility risk. Risk factors for severe morbidity from COVID-19 include maternal age over 35 years old, asthma, obesity, pre-existing diabetes, pre-existing hypertension, and heart disease. For individuals at high risk of infection and/or morbidity from COVID-19, the SOGC states that the documented risk of not getting the COVID-19 vaccine outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding, and therefore, vaccination should be offered to them.
In any case, pregnant and breastfeeding people should consult their prenatal care provider, who could weigh in their individual risk factors versus benefits and help them make an informed decision that is right for unique circumstances.
4Should I take the vaccine if I contemplating pregnancy?
According to the SOGC recommendations, individuals planning a pregnancy, can complete the entire COVID-19 vaccination series (where possible) to achieve maximal vaccine efficacy ahead of pregnancy. However, it is not yet known whether an individual should delay pregnancy following receipt of the vaccine. If you are trying to conceive you should discuss your potential risks vs. benefits with your health care provider.
