台灣生殖醫學會

台灣生殖醫學會因應COVID-19的立場聲明

109-4-16

由於COVID-19的全球大流行，一些歐美各國生殖醫學界建議暫停對不孕症病人的治療。理由包括：孕婦可能是COVID-19的高風險群、不確定在懷孕時得到COVID-19會不會影響下一代、避免療程中群聚感染，以及保全醫護資源以供重症使用等等。

同時美國生殖醫學會(ASRM)及美國輔助生殖技術學會(SART)雖然也建議暫停不孕症治療，但也認同不孕症是一種疾病。不孕症的治療並不是選擇性的。治療不孕症在醫學上是必須的。

台灣防疫工作如履薄冰，因此目前能在這一波疫情中穩健守住。不論是人民生活或醫療工作，都不必像歐美各國採取較為嚴格的限制。但全球大流行的危機尚未解除，在接受不孕治療的同時也必須顧及防疫的要求。

台灣生殖醫學會尊重病人的自主權並支持我們的病人。同時我們也遵守中央疫情指揮中心的各項安排和指示。

我們建議病人在進入治療週期前應接受如下諮詢?：

1.應告知療程有可能因以下原因隨時終止，請病人評估是否要開始進入這個療程。

(1)病人出現COVID-19疑似症狀。

(2)同時期在生殖中心的其他病人確診。

(3)配合中央疫情指揮中心的各項指示。

2.療程中不可以出國。也不宜參加多人的聚會活動。

3.入境未滿14天不接受檢查及治療。

4.欲開始療程須先跟生殖中心確認可否。

5.接受療程的病人必須了解，目前沒有任何證據顯示在懷孕時感染COVID-19會不會影響到下一代。

TSRM position statement for COVID-19

Due to COVID-19 pandemic, European and American professional societies for reproductive medicine advise to suspend initiation of new treatment cycles for the following reasons, Pregnant women could be a vulveralbe group, the consequences of COVID-19 in pregnant women are not well known,avoid community spread during treatment , and ensure thenecessary reallocation ofhealthcare resources for critically ill.

In the same time, though ASRM and SART recommend suspending the infertility treatment, however they also advocate that infertility is a disease. Infertility care is not elective. Treatment of Infertility is medically necessary.

Taiwankeeps COVID-19 at bay at the present time due to we carefully enact prevention measures as if we’re treading on the thin ice. So Taiwanese still can live normal lives without lockdown.However, the pandemic crisis has not been lifted yet, we still need to cautiously follow the required epidemic prevention measures when receiving the infertility treatment.

TSRM respects patient autonomy and support our patients. In the meantime, we obey NHCC’s recommend mitigation and instructions.

We suggest giving patients the advisories as below before receiving assisted reproductiontreatment:

1. Patients should be informed that the treatment could be stopped at any time because of potential risks as below and ask patients to evaluate if it would be proper to receive the treatment.

   (1) Patients present suspected symptoms of COVID-19

   (2) There are confirmed COVID-19 cases in fertility center

   (3) Follow what NHCC instructs

2. During the treatment, patients cannot go abroad and attend gatherings.

3. Patients arriving in Taiwan within 14 days cannot take examinations and treatments.

4. Patients need to confirm the feasibility with IVF center before initiating ?the treatment.

5. Patients who are willing to initiate the treatment should be informed that currently there’s no evidence for the impacts on the baby delivered by COVID-19 infected pregnant women.

References：

1. IFFS

https://www.iffsreproduction.org/page/COVID-19

2. ICMART

https://www.icmartivf.org/news/

3. ESHRE:

https://www.eshre.eu/Press-Room/ESHRE-News

4. British Fertility Society

https://www.britishfertilitysociety.org.uk/2020/03/18/guidance-for-the-care-of-fertility-patients-during-the-coronavirus-covid-19-pandemic/

5. ASRM:https://www.asrm.org/news-and-publications/covid-19/statements/patient-management-and-clinical-recommendations-during-the-coronavirus-covid-19-pandemic/

6. SART

https://www.sart.org/professionals-and-providers/covid-19-resources/message-to-SART-members/