Resumption of medically assisted procreation: new recommendations on how to care for couples in the context of SARS-COV-2 circulation

The cessation of medically assisted procreation (MAP) activities, recommended by the Agence de la biomédecine last March, has raised many questions among couples whose journey has been interrupted and who have seen their chances of procreation temporarily reduced by this new waiting period. Keen to accompany and support couples affected by this measure, the Agence de la biomédecine has set up a working group to prepare for the resumption of MPA activities from May 11, 2020, despite the uncertainties linked to the evolution of the pandemic. New recommendations have been issued, in close consultation with learned societies, experts, a patient association, and representatives of the French Ministry of Solidarity and Health and regional health agencies, to provide a framework for this resumption by adapting patient care and follow-up procedures during the period of Covid-19 circulation.taking medical activities in healthcare establishments, according to local and regional conditions of virus circulation.

Please note While the recommendations drawn up by the Agence de la biomédecine are a prerequisite for the resumption of activities in MPA centers, regional health agencies (ARS) will be responsible for authorizing or not the resumption of medical activities in healthcare establishments, depending on local and regional conditions of virus circulation.

In order to ensure that patient care is consistent with respect for barrier gestures and social distances, the Agence de la biomédecine recommends a gradual, progressive resumption of MPA activities, in line with strict health safety criteria, in order to limit the risks of contamination for both patients and healthcare staff. As the loss of chance of procreation is not the same for all couples, it will be necessary to prioritize certain types of treatment. The working group, in conjunction with learned societies and patient associations, has drawn up a list of priorities to help AMP centers in this delicate process.

The need to prioritize care when centers reopen

After assessing each situation, the medical teams at the AMP centers will decide whether or not to resume treatment of couples, always with the aim of reducing the risk of exposure of patients and caregivers to Covid-19. The priority situations established by the working group concern :

• An indication for urgent fertility preservation - for people with cancer whose treatment is toxic to fertility
• Reduced or cancelled chances of procreation due to a longer delay in treatment, such as advanced age or reduced ovarian reserve.
• Cancellation of a current stimulation attempt in March 2020, when MPA activities cease due to the epidemic.

For patients with a medical history that could lead to severe complications in the event of Covid-19 contamination - chronic respiratory pathology, stroke, diabetes, overweight, etc. - the Agence de la biomédecine recommends that AMP centers postpone their treatment until further notice, except in special cases.

The Agence de la biomédecine recommends that couples remain in contact with the medical team of the AMP center that has taken charge of them. The medical teams will keep patients informed of any measures and developments that may be implemented concerning their MPA program.

In its recommendations, the Agence de la biomédecine does everything in its power to help centers limit the risks that could lead to the discontinuation of a course or the center's activity during this period of Covid-19 circulation.

Nevertheless, certain situations are likely to interrupt the activities of an AMP center, whether they are linked to the couple themselves, to the center and its medical team, or to developments in scientific knowledge:

• The couple's personal situation: a change in the state of health of one of the couple's members or a close relative that could suggest a Covid-19 infection during treatment.
• Situation at the MPA center: arrival of a new wave of the pandemic; too many MPA center staff assigned to care for Covid-19 patients in other units, or too many MPA center staff affected by Covid-19.
• Evolution of scientific knowledge: if a risk to the health of women, men or the foetus is identified in connection with Covid-19, the care of all patients may be reconsidered.

For treatment considered urgent, if the nearest center or the one that treated patients before the epidemic is not or is no longer able to welcome couples, they may be referred to another center, if possible within the framework of a cooperation agreement.

These initial measures will be adjusted as the Covid-19 health situation and scientific knowledge evolve.

Composition of the working group

• French Urology Association (AFU)
• Fédération nationale des biologistes des laboratoires d'étude de la fécondation et de la conservation de l'œuf (BLEFCO - national federation of fertilization and egg preservation laboratory biologists)
• Fédération nationale des centers d'étude et de conservation des œufs et du sperme humains (CECOS Federation) (National Federation of Human Egg and Sperm Study and Conservation Centers)
• French National College of Gynecologists and Obstetricians (CNGOF)
• French Federation for Reproductive Studies (FFER)
• National Federation of Medical Gynecology Colleges (FNCGM)
• Study group for oocyte donation (GEDO)
• Study group on in vitro fertilization in France (GEFF)
• Research and study group on ovarian and testicular cryopreservation (GRECOT)
• French-language andrology society (SALF)
• French Society for Preimplantation Diagnosis (SFDPI)
• Society for Reproductive Medicine (SMR)
• French Society of Hospital Hygiene (SF2H)
• French National Cancer Institute (INCa)
• Regional Health Agency (ARS) Grand-Est
• Regional Health Agency (ARS) Ile de France
• Collective of French private AMP centers
• Collectif BAMP !
• Direction générale de l'offre de soins (DGOS)
• Dr Jade Ghosn, Infectious Diseases Department, Bichat Hospital
• Dr Florence Damond, Virology, Hôpital Bichat
• Dr Nadhira Fidouh, Virology, Hôpital Bichat

About Agence de la biomédecine

The Agence de la biomédecine is a public body under the aegis of the French Ministry of Health, created by the French Bioethics Act of 2004. Its missions cover four major areas of human biology and medicine: assisted reproduction, prenatal and genetic diagnosis, embryo and embryonic stem cell research, and organ, tissue and cell procurement and transplantation. www.agence-biomedecine.fr Twitter : @ag_biomedecine

Press contacts:

bcw | burson cohn & wolfe - Juliette Billaroch, juliette.billaroch@bcw-global.com - 06 26 28 40 11 bcw | burson cohn & wolfe - Dominique Kerforn, dominique.kerforn@bcw-global.com - 06 26 39 83 73 Agence de la biomédecine - presse@biomedecine.fr

Downloads Resumption of medically assisted procreation : new recommendations on how to manage couples in the context of SARS-CoV-2 circulation - May 15, 2020 Information letter for patients on the national kidney transplant waiting list, with a view to a gradual resumption of renal transplantation activity from May 11, 2020 - May 15, 2020 Recommendations on the modalities for resuming MPA activities in the context of SARS-CoV-2 virus circulation - May 15, 2020 Download the press kit Other subjects that may interest you Gamete donation and MPA Tour de France "#FaitesDesParents" : Agence de la biomédecine reaches out to the French to raise awareness of gamete donation Publié le 05/09/24 Gamete donation and MPA Agence de la biomédecine needs to double the number of donors to meet unabated demand Publié le 02/07/24 Gamete donation and MPA Opinion barometer on gamete donation: French better informed, young people less willing to donate Published 05/06/24