Covid-19 and Fertility

June 26, 2020 Patient Letter

The recent Executive Order GA-27, issued yesterday by Governor Abbott, which goes into effect today at noon, mandates that elective procedures at hospitals are prohibited. This is due to the fact that hospital beds need to be reserved for COVID patients.

This order only applies to elective procedures done in hospitals and will not affect procedures done in an ambulatory surgery center that conducts fertility services outside a hospital.

Furthermore, after consultation with hospital administration and legal, any procedures conducted at the Women’s Specialty Surgery Center in professional building three at THR Presbyterian Hospital Dallas are allowed at this time.

This of course is a dynamic situation and could change in the future.

Dallas-Fort Worth Fertility Associates

Dallas Fertility Center

May 4, 2020 Patient Letter

As most Texans are aware, Governor Abbott issued another Executive Order allowing certain businesses to open starting May 1, 2020, with certain restrictions and continue social distancing rules and recommendations. As a medical practice, we are slowing initiating some treatment cycles, but are recommending ongoing vigilance with respect to the Covid-19 pandemic.

At the time of this letter, Dallas County appears to be “surging” or at least plateauing with respect to the number of new cases reported daily. Although our local hospitals have high census for Covid-19 patients, they have additional capacity to treat these patients. Regardless, continued vigilance is needed to combat the spread of this disease.

The Texas Medical Board requires all physicians providing patient care or engaging in an in-person patient encounter, to implement the following minimum COVID-19 standards of safe practice. Dallas-Fort Worth Fertility Associates had already implemented these and other changes.

A mask must be worn by both the patient and physician or the physician’s delegate when in the proximity of the patient (meaning less than a 6-foot distance between the patient and the physician or the physician’s delegate); Follow policies the physician, medical and health care practice, or facility has in place regarding COVID-19 screening and testing and/or screening patients; Before any encounter, patients must be screened for potential symptoms of COVID-19 or verified previously screened within the last 20 days; and Prior to care involving a medical procedure or surgery on the mucous membranes, including the respiratory tract, with a high risk of aerosol transmission, the minimum safety equipment used by a physician or physician’s delegate should include N95 masks, or equivalent protection from aerosolized particles, and face shields.

As noted in our prior communications, all patients presenting to our clinic must wear a mask, and must come alone without a visitor – including your partner who must wait in the car.

All patients will continue to be screened by undergoing a temperature scan and answering screening questions. In the event you are ill, or fail to pass the screening temperature (T<99.5) or questions, you must reschedule your appointment.

Dallas-Fort Worth Fertility Associates
Dallas Fertility Center

April 21, 2020 Patient Letter

As you are probably aware, Governor Abbott signed another Executive Order on April 17, 2020. We have been discussing the intent of the Order, and how best to implement the Order as it applies to a reproductive practice. The Order, GA-15, extends the original Order until May 8, 2020.

We will continue to consult with patients by teleconference, or videoconference for all patients for both physician and nurse visits, when appropriate.

We will continue to minimize in-person interactions:

We will continue to practice social distancing, and therefore have limited seating in our waiting room, so if the room if full, we ask that you call to check in and wait in your car.

We will continue to take your temperature before being allowed into our offices. If your temperature if >99.5 you will be asked to reschedule your appointment.

If you have been ill, generally not feeling well, have any symptoms of fever/cough/shortness of breath, or have been exposed to someone diagnosed with or presumably diagnosed with Covid-19, or traveled to a Covid-19 hot spot in the past 2 weeks, PLEASE DO NOT COME TO THE OFFICE.

All patients in Dallas County must wear a facial mask or covering (a scarf, or handkerchief will suffice) while at our office per Dallas County Orders. Your appointment will be rescheduled if you arrive without a mask.

No visitors are allowed, including your spouse and especially no children.

We will continue to conduct essential monitoring for patients that are pregnant, and necessary diagnostic office testing.

Regarding IVF stimulations, we are hoping the current Order expires on May 8, 2020, and we can begin conducting oocyte retrievals during the week of May 11, 2020, but are fully aware that the order may be extended.

deally, we will have Covid-19 testing capability, so that patients undergoing treatment can be tested before initiating treatment. We continue to research testing capability that is cost effective, and will adopt a Covid-19 testing policy soon.

Again, this is a fluid situation, and we anticipate modifications in the future.

Dallas–Fort Worth Fertility Associates
Dallas Fertility Center

DCHHS: https://www.dallascounty.org/departments/dchhs/2019-novel-coronavirus.php

Interesting Pandemic Article: https://www.visualcapitalist.com/history-of-pandemics-deadliest/

March 29, 2020 patient letter

Governor Abbott has ordered non-essential business to close, and the Texas Medical Board have ordered a restriction of elective procedures through April 21, 2020.

First, Dallas-Fort Worth Fertility Associates is an essential business as a healthcare clinic, and will continue to care for patients that need ongoing monitoring or other testing. Our phones will continue to be answered, and our physicians will be available should an urgent issue arise. At this time, most (almost all) of our patient consultations are being conducted by telemedicine – phone calls or video conferencing, until that time when restrictions are lifted.

Second, Dallas-Fort Worth Fertility Associates is doing our part to do our civic duty, and has canceled and postponed IVF and FET treatment cycles. Per rules from the Texas Medical Board, a “procedure” does not include physical examinations, non-invasive diagnostic tests, the performing of lab tests, or obtaining specimens to perform laboratory tests. As such, we will continue to perform testing, including sonograms, as needed to care for our patients. Currently, Dallas-Fort Worth Fertility Associates have a “skeleton crew” policy in place whereby only the minimum number of employees required to care for our patients will be working in the clinics, and we have some employees working from home.

When will IVF and other treatments resume?

At this time, we are hoping that these restrictions will be lifted by April 21, 2020 but there is no guarantee of this, so we are all observing the situation and hoping to see improvements soon. Dallas County (and other counties) have a shelter-in-place order through April 3, 2020, but we anticipate that this will be extended. As of today, President Trump extended the Social Distancing Guideline through April 30. We currently have some patients who are taking birth control pills in anticipation of conducting IVF after April 21, 2020, but of course, the situation is dynamic and subject to change. Realistically, we are hoping to restart IVF treatment in May. Currently, IVF treatment for fertility preservation is being conducted as an urgent procedure for patients that have a diagnosis of cancer. Additionally, there is some consideration for initiating IVF treatment in patients that have a diagnosis of diminished ovarian reserve, or advanced maternal age, but no definitive decision has been made at this time.

When will our authorities remove these restrictions?

This question is the critical one, and at this time we are not aware of any published epidemiologic guidelines or criteria to determine when these restrictions will be removed. This of course is maddening, and worrisome for all of us. To speculate, we suspect that these restrictions won’t be removed until the number of reported cases is declining, but currently the number of new cases is accelerating. Alternately, perhaps this decision could be made based on hospital ICU and ventilator capacity, testing capacity, availability of personal protective equipment, or other parameters. Of note, the first reported case of COVID-19 in Dallas County was March 10, 2020, which was only 19 days ago.

We all look forward to when we can resume our normal, or perhaps new normal lives. Godspeed.

Dallas-Fort Worth Fertility Associates
Dallas Fertility Center

March 15, 2020 Covid-19 policy

Patient Letter:

In light of the COVID-19 virus, also known as the Corona virus, Dallas-Fort Worth Fertility Associates is taking precautions to keep our clinic safe so that our patients can continue to seek the care needed to create a family.

At this time, the CDC has not recommended closure of businesses, but has issued Interim Guidance for Businesses and Employers (https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html). Dallas-Fort Worth Fertility Associates is following all public guidance from the Centers for Disease Control (CDC) and our local State and Dallas County Health Department.

At this time, we are continuing to schedule office visits, and procedures, but have implemented some policies described below intended to mitigate exposure.

The safety of our patients and our staff remains our highest priority. We will continue to monitor the situation and take actions necessary to help keep our patients and staff safe while providing our patients with the highest quality of care.

Finally, let us all pray for the country, the world, and our local communities that we get through this safely.

Sincerely,

Dallas-Fort Worth Fertility Associates

DFW Fertility Associates COVID-19 Policies

Office Visits:

Illness Notification: If you are ill, have a cough, or fever, even if you think this is a simple common cold, please notify us to cancel an appointment. Please stay at home. In the event you are in the middle of a treatment cycle, you will receive a credit for treatment. This policy applies for patients and staff.
Check-in: If you come into the waiting room and find that there are no seats available, please check in, and please wait in your car. We will call you when you are ready to be seen. We have removed some of the chairs in the waiting room in an effort to enact social distancing.
Screening Protocol: All patients and visitors may be asked to have their temperature taken, and asked about recent travel. In the event that you have a fever (>100.4) you will be asked to leave.
Hand sanitizing: As supplies last, we will have hand sanitizer at the check-in window, and ask that you sanitize your hands. If you have your own pen, please use your own pen to check in.
COVID-19 Exposure: If you have been exposed to someone who has been diagnosed (or suspected) with Coronavirus, you should undergo voluntary self-quarantine for 14 days. Please do not come to our office if you have been exposed to someone diagnosed with Coronavirus, even if you are feeling well.
Visitors: If possible, please come alone to your office visit. Please do not bring children or family members, unless this is your spouse.
Post procedures: After visiting an exam room please wash your hands.

Treatment Cancellation:

In the event you have to cancel infertility care during the middle of a treatment cycle, the cancellation may have negative medical and financial consequences. We apologize in advance, but we must be safe and follow the regulations set up by state and national agencies. In the event your cycle is cancelled due to exposure or illness, we will credit your account so that you may proceed with your treatment in the future.

Telephone Consultation:

On March 14, 2020 the Texas Board of Medicine has temporarily allowed for Telephone Only consultation as a form of Telemedicine. This means that a new patient may visit with a physician by telephone, and this telephone only visit may establish a doctor-physician relationship, evaluation and management may be conducted, and physician offices may bill patients or insurance companies for theses visits. In the event you would prefer to visit with your physician by telephone instead of a face-to-face visit, please notify our office and this will be arranged for you.

Travel:

If you have traveled anywhere international in the past 2 weeks from the time of your scheduled visit, please notify our office. At this time, the CDC has not recommended cancellation of travel, but has encouraged a common sense approach. Please follow basic procedures to keep yourself safe:

https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

As you are aware, the Coronavirus pandemic is an evolving situation, and we will continue to monitor and uphold recommendations from our public health authorities. We apologize in advance, but we must be safe and follow the regulations set up by state and national agencies. And finally, this too shall pass.