Guidance on Fertility Care during COVID-19 | 10 April 2020

The President of the Republic of South Africa Mr Cyril Ramaphosa has announced on the 9th of April to extend the nationwide lockdown for an additional two weeks after the 16th of April. SASREG has made two statements on Fertility care and surgery during the COVID-19 pandemic on the 19th of March 2020 and 24th of March 2020. This is an update on the SASREG guidelines and replaces and clarifies the guideline from the 24th of March 2020. All recommendations that are made in our document “Guidance on Fertility care and surgery during COVID-19 from 19 March 2020 are still valid.

SASREG has requested a senior legal opinion if fertility clinics are entitled to continue with their services during the lockdown period and to what extent and to what conditions fertility service can be provided and ART cycles can be initiated. Infertility is a disease as defined by the WHO that can lead to disability (loss of function). Section 27 of the constitution entrenches the fundamental right to access health care services and specifically includes reproductive health. The Disasters Management Act Regulations provides that during the lockdown every person is confined to his or her place of residence, unless strictly for the purpose of performing an essential service. In order to decide whether practitioners operating at a fertility clinic may continue to provide services to members of the public, it must be determined whether the services being provided are essential services.

Based on the legal opinion SASREG feels that in certain circumstances fertility clinics could consider initiating fertility treatments. These categories could be considered as essential services:

  1. Patients of advanced age.
  2. Patients with a diminished ovarian reserve.
  3. Patients with poor prognosis for whom time is essential.
  4. Oncofertility patients.

The fertility treatments must be done in a responsible way as stipulated in the previous guidelines of SASREG.

Fertility clinics should:

  1. Stagger arrival times for appointments to avoid contact between patients.
  2. Maximise social distancing during all consultations and procedures.
  3. Perform telephonic or online consultations if appropriate.
  4. Create rotating teams to limit exposure between staff members.

It is the responsibility of every clinic to decide if these recommendations are applicable to them. Every fertility clinic can decide on the above recommendations what are essential services and what are their specific practice recommendations. The head of practice must determine which staff are required in order to render these essential services. No staff can be forced to work during the lockdown period. The necessary permits must be provided by the head of the clinic to all essential staff. All patients must be provided with a letter on the letterhead that patients can provide when stopped by enforcement officers.

If you would like to obtain a copy of the legal opinion you can contact the SASREG president on sheylen@capefertility.co.za