Elise Adams, hoping that her dreams of having a family are not being shattered while the entire country is shut down, focuses instead on deepening her relationship with her husband and finding joy in life’s simple pleasures.
For several years, Elise, 29, and her husband Michael, 28, have been undergoing infertility treatments, and she recently suffered a heartbreaking miscarriage.
But before she could move forward with her next infertility procedure, the suburban Atlanta couple received a crushing blow: they are among an estimated 7 million infertility patients around the nation impatiently waiting to get the green light for their parenting plans.
Despite the roller-coaster of emotions Elise and Michael are feeling during the coronavirus pandemic, they are doing their best to stay strong.
Her husband has been extremely supportive every step of the way. Since her recent miscarriage, Michael, the assistant VP of a financial services company, has been working at home. They enjoy their home-based lunch dates, taking their adorable dog for long walks while social distancing with others, and are mastering a favorite pastime thanks to the purchase of a ping pong table.
But most of all, they have a message of hope for others going through difficult personal problems during the coronavirus pandemic.
“Try to stay hopeful, as much as you can. When I first started the treatments, I was reading self-help books about fertility issues and that only made it worse,” advises Elise, a marketing director for a now-closed private school.
“I would say to read funny, light-hearted books, and don’t keep your frustrations in, because that can be isolating,” she told Medium.
“I would advise anyone going through something like this to talk to your trusted friends about it, so it doesn’t feel as lonely,” Elise said. “What has helped me most was hearing other people’s stories and not feeling so alone.”
The couple is using their stay-at-home togetherness during the coronavirus to further cement their already close bond that started when they began dating in 2012 while attending college in Athens, Georgia. They fell in love and were married in 2016. A year later, Elise tried to get pregnant, and when she was unsuccessful, the couple turned to fertility specialists.
Several years, and numerous emotionally wrought and expensive medical treatments later, including a recent miscarriage during her third round of in vitro fertilization, (IVF), the couple was ready for the next step…until COVID-19 suspended elective medical procedures — including those for infertility — until further notice.
“We had told our families that I was pregnant and it would have been the first grandkid,” Elise said. “My mother sent me a hat that said “mom” on it. The last thing we wanted to do was to take a break from this.”
When the COVID-19 restrictions were put in place in early March, Elise and Michael initially expected a three-month postponement of their infertility treatments, but they did not imagine a complete shutdown would leave them in limbo during such a major undertaking in their lives.
Among the issues for Elise and Michael is the lack of control over everything in their lives, including their dreams of parenthood. “This is our last embryo, so we were ready to get pregnant, or move on. Now, we are in limbo.”
When they recently spoke to their doctor, he said they could potentially start her fourth and final round of IVF — transferring their final embryo in June — “as long as his office is able to re-open,” Elise explained. “We would be doing it now if it wasn’t for COVID-19.”
“Now everything is closed, and I am worried about what these next few months are going to hold for us,” Elise said. “All of our feelings and emotions are valid, and sometimes I feel really sad. But at the same time, we know we have been so blessed in our lives and can’t harp on the bad.”
She knows that her physician, Dr. Andrew Toledo, the CEO of Reproductive Biology Associates in Sandy Springs, Georgia, is doing everything he can. A few weeks ago, he told them to call his office in May to begin to move forward, if possible. Her medicine, which costs thousands of dollars, is expiring at the beginning of 2021, so this adds to the urgency.
Despite everything, Elise and Michael know they are in this together, and that they will come out on the other side. “There are good days and bad days,” she explained, while being grateful for their own love story. “We are worried about what these next few months are going to hold for us, and we also know that we have each other to lean on through thick and thin.”
In March, the American Society of Reproductive Medicine (ASRM) released a set of national guidelines recommending that fertility providers suspend all “non-urgent and elective” surgeries.
Determining which procedures are urgent for the medical practices that represent a substantial group of patients each year was left to the doctors in consultation with their patients, all with everyone’s safety being foremost.
The Fertility Providers Alliance (FPA) a newly formed industry group that represents more than 400 fertility specialists who provide care to tens of thousands of patients each year throughout the nation, agreed with these recommendations.
Dr. James Grifo, MD., Ph.D., is a physician-scientist, who has treated patients for infertility issues since 1995. Dr. Grifo has been the Director of the Division of Reproductive Endocrinology at the NYU School of Medicine, where he also holds the faculty appointment of Professor of Obstetrics and Gynecology.
He says the professional guidelines became extremely complicated during these unprecedented times. (Infertility and IVF patients were still treated during SARS and the swine flu.)
“We were told to wind down the cycles that were ongoing and not to start new cycles,” explained Dr. Grifo, the program director of NYU Prelude Fertility Center and chief executive physician at Inception Fertility. “It became very complicated because we did not have the data to make proper decisions.”
Dr. Grifo is especially concerned about a 41-year-old female patient because of the urgency involved in trying to get pregnant sooner rather than later.
The national guidelines and local laws and regulations required that his lab shut down. Now that the lab has been thoroughly cleaned, he and his staff await word about when they can re-open.
“The state of New York, and many states, said that elective procedures [had to stop], but in our minds, infertility is not elective; it’s a disease,” Dr. Grifo explained. “We went from being an in-patient office to practicing telehealth. We were completely blindsided by this.”
The following is a deeper look from Dr. Grifo on just how infertility patients will fare in the coming months and his concern for the tens of thousands of couples like Elise and Michael Adams, who are yearning to make their family dreams come true.
You did not have much time
to react to these new guidelines regarding infertility treatment.
True. We were given a four-hour deadline.
What makes it so complicated? Where do you go from here?
It starts by defining the word urgent. And who gets to decide, and the fact that no one knows when we can start up again. We will do everything we can to safely treat and protect our staff. We know that our patients are “watching paint dry,” while hoping they can start up again.
What do you see as the possible long-term effects of this health pandemic?
Some clinics will simply be forced to go out of business.
Why do you feel that way?
Because IVF is an expensive practice. With no patients and no revenue coming in for several months, something has to give. One larger provider has furloughed 70 percent of its workforce. So, I predict that some really high-regarded clinics will probably not make it. These are challenging times. We endured SARS, Ebola and Hurricane Sandy, but the magnitude of this is completely unprecedented.
How are you continuing to help your patients?
I am following up with all of my patients, monitoring their blood work, and making sure they have all of their medications.
Can you give me an example of a patient that concerned you?
Yes, one of my patients had a positive pregnancy test, said she wasn’t feeling well, went to urgent care, and tested positive for COVID-19. She began feeling better and went to a private clinic for her 35-day blood test.
Do you have a second example?
Another patient tested positive for COVID-19 at 13 weeks and was concerned. She called in the middle of this and asked, “I have COVID-19, should I terminate the pregnancy?”
How did you respond?
Be careful and get better. Luckily, she had a mild case and didn’t miscarry. There are a lot of pregnant women out there from fertility treatments and they will mostly do fine. But we are not starting any new procedures. If a patient is 26, has cancer, and having a hysterectomy and needs a procedure to preserve her fertility, to me that is urgent.
How long have you been involved in helping patients with fertility treatments?
Thirty years. I did the first human embryo biopsy and tested the embryo, which is now a productive 27-year-old. We have been perfecting those techniques for decades to the point that we put back a single embryo.
What can you say about infertility procedures during these unprecedented times?
That even though we don’t agree on every element of this, all of us are focused on finding the best solution to protecting our patients and staff.
How do infertility doctors practice in the age of COVID-19?
Research, testing of antibodies, and social distancing, especially. We know that it is not going away next week. There is so much we need to learn about these situations. Do a rapid viral test of our patients and staff to see who has the antibodies to determine who could return. The regulators want it perfect. But there is no perfect when it comes to this. The major question is — when is the right time to go ahead?
I know New York is currently not the right place to do IVF, so we have to remain nimble and adapt. We are on pause. We hope to set up in early May, but we are assessing daily and everything is subject to change.
What words of wisdom can you share with your patients and millions of others around the nation who have put their infertility on hold?
It is so difficult to be a fertility patient. Years ago, my wife and I experienced fertility treatments and I can sympathize with the frustration and sleepless nights. No one wants to be on hold. So, my best advice is to try to stay hopeful.
This story was published on April 28, 2020, in Medium/Authority Magazine and is being reprinted with permission from the author, Debra Wallace, and the publisher.
View Debra’s profile on LinkedIn.