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Patient Management and Clinical Recommendations During The Coronavirus (COVID-19) Pandemic

Update #6:The present update by the ASRM Coronavirus/COVID-19 Task Force (the “Task Force”) affirms the recommendations presented initially in Update No. 3 (American Society for Reproductive Medicine Patient Management and Clinical Recommendations during the Coronavirus (COVID-19) Pandemic - Update No. 3, April 24, 2020), when the Task Force issued recommendations for gradually and judiciously resuming the delivery of reproductive care, and which were elaborated upon further in Updates No. 4 and No. 5. Read the full document here

The COVID-19 pandemic continues to impact the vast majority of the world. The experience of the past few weeks has highlighted a few features of the pandemic, including: a) increasing regional, socioeconomic, and ethnic variability in SARS-Cov-2 transmission and COVID-19 incidence; b) a resurgence in cases and deaths in the United States as efforts to reopen local economies and resuming work have been undertaken; c) the extended presence of the threat; d) the continued absence of an effective and safe vaccine and/or targeted therapies; e) the expanding availability and use of testing; and f) the need to ensure that essential medical care, including reproductive care, is provided in this environment, while maximizing the safety of patients, their families, and healthcare personnel.

Considering these observations, the present update by the ASRM Coronavirus/COVID-19 Task Force (the “Task Force”) affirms the recommendations presented initially in Update No. 3 (American Society for Reproductive Medicine Patient Management and Clinical Recommendations during the Coronavirus (COVID-19) Pandemic - Update No. 3, April 24, 2020), when the Task Force issued recommendations for gradually and judiciously resuming the delivery of reproductive care, and which were elaborated upon further in Updates No. 4 and No. 5.

Since the last update, the Task Force has observed the following: 
  • As of July 8, 2020, COVID-19 cases have exceeded 3 million in the US with over 133,000 deaths.
  • In the past four weeks viral spread across much of the U.S. has increased 90% from the levels of disease present in late May, and rates of infection in the U.S. have risen to 60,000 new cases per day, the highest rates of infection to date.
  • In 32 U.S. states infections increased sharply after reopening measures were instituted.
  • As much of the U.S. is experiencing a rapid increase in cases, hospital resources have again become strained, as was observed in the North Eastern states earlier in the epidemic.
  • The prevalence of disease continues to disproportionately affect Latino and African American individuals, infections are increasing in younger people overall, and availability of an effective vaccine still appears to be a long way off.
  • Currently, many states and locales are re-instituting or instituting measures to reduce spread of disease.
  • There is mounting concern that more restrictive recommendations similar to those presented initially by the Task Force on March 17, 2020 may need to be enacted in specific regions because of significant flares in the incidence of COVID-19, which are now affecting increasing numbers of individuals of reproductive age.
  • The recent resurgence of viral transmission reaffirms that we will need to continue to practice in a COVID-19 environment for the foreseeable future.
As stated in Update No. 4 (American Society for Reproductive Medicine (ASRM) Patient Management and Clinical Recommendations During the Coronavirus [COVID-19] Pandemic – Update No. 4, May 11, 2020), and reiterated in Update No. 5 (published June 8, 2020), the Task Force continues to support the measured resumption of care with appropriate and prudent measures for disease prevention and implementation of travel restrictions and quarantines when appropriate.

In the current update, further information is provided regarding travel for third-party reproduction, COVID-19 and pregnancy, the importance of mitigation strategies, and concerns regarding COVID-19 and psychosocial dynamics. The next update from the Task Force will be in four weeks (on or about August 10, 2020), unless conditions warrant greater frequency.

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