We are happy to report that that we have started our first group of IVF patients and expect to gradually increase treatment volumes over the summer.  Through our virtual support groups and feedback, we know that many of you have been waiting for direction.  In this update, we try to provide some answers to your questions and offer greater clarity about what to expect in the coming months.  We hope that this information is useful and we welcome your feedback.  For those who are interested, we will host webinar sessions in the coming weeks where you can connect with and ask questions of the clinical and management team.   Much has changed in the last few months for all of us.

What is your plan for resuming all services?

We have established three Phases as outlined below. Through each Phase we will increase the volume of activity and closely monitor our ability to ‘ramp up’ safely.  In each Phase, we will first call patients whose cycles were cancelled or deferred due to COVID-19.  Once this group has been set-up to start, we will announce a date in which remaining patients in that Phase may call with a Day 1.

 

When will Frozen Embryo Transfer (FET) and Donor Egg Bank Cycles start?

It is our intent to start Phase 2 by the end of June or beginning of July.  This means that patients whose fresh embryo transfer or FET was cancelled due to COVID-19 will be contacted by our team starting in a few weeks to begin setting up cycles.  Our decision to commence Phase 2 will depend on multiple internal and external factors as outlined in question 4 (below).  We will evaluate the progress during the week of June 22nd and plan to make a final decision during that week. 

 

When will IUI and Intercourse Cycles Start?

We know that patients will have been waiting a long time to start a funded IUI cycle, especially as funding for IUI was exhausted in October 2019. We will evaluate readiness to start Phase 3 by the end of July.   Please note:  Our decision to commence Phase 3 will depend on multiple internal and external factors as outlined in the response to the question below.

 

What criteria is Mount Sinai Fertility using to determine when to begin the next Phase of treatments?

We have specific criteria for evaluating the transition into each Phase. When we introduce fresh and frozen embryo transfers, our volumes will increase significantly and we must ensure we are able to safely handle this increase in volume.  The following criteria will be used to evaluate our readiness to transition from one Phase to the next:

  • Availability of Personal Protective Equipment (PPE):  As more healthcare services open in the community, the demand for PPE will increase substantially.  The Ontario Medical Association recognizes that there is a limited supply of PPE in Ontario and access to products that meet Canadian guidelines has become a critical issue for healthcare providers.
  • Prevalence of COVID-19 transmission in the community:  Like all healthcare providers, we follow guidance from the Ministry of Health and other provincial authorities.  A spike in the occurrence of COVID-19 cases in Toronto can impact our decision to increase activity.  We are watching these trends closely.
  • Ability to safely accommodate additional volume:  Like all businesses that serve the public, we have had to redesign how we deliver care so that we can maintain appropriate distancing for patients and staff.   As we increase the number of patients, processes and schedules need to be adapted to accommodate everyone safely.
  • Ability of staff to adapt safely to process changes:  Many patients will not be aware of how much has changed internally at Mount Sinai Fertility.  However, we have adjusted almost every process. We hope many of these changes will result in a better experience and enable us to manage a higher volume of activity.  We appreciate your understanding as we adapt to changes. Our goal is to continuously improve so that we have an optimal patient experience with high quality and safe care.

 

I’m expecting to do a funded IVF cycle. When can I expect to go through?

Our team has already started the first group of funded IVF patients who were cancelled due to COVID-19. We are now starting to contact patients who were scheduled to start a funded cycle in April. If you were scheduled for a funded IVF cycle in April, you will receive a call within the next couple of weeks. If you believe that you were cancelled in March and did not receive a call, please contact MSF.Feedback.MSH@sinaihealth.ca.

The team will continue to move through the funded IVF waitlist to set up patients for the coming months. Patients will retain their position on the list. COVID-19 has pushed back the schedule by approximately three months. We will do our best to catch up.

 

Will private pay patients be starting at the same time as funded patients?

Yes.  Each month, we plan to perform a set number of IVF cycles.  We manage our volumes to maintain quality and safety.  Within each month, cycles are split between funded and unfunded IVF cycles.

 

Some clinics are starting all treatment types (IVF, FET, IUI) at the same time. Why is this not Mount Sinai Fertility’s approach?

Most clinics have adopted a Phased approach and are starting with reduced volumes, whether they choose to stagger the start of treatment types or start all treatment types simultaneously.  We developed our approach with input from experts at Sinai Health along with an ethicist to guide our decision-making.  While we aim to transition to each Phase as quickly as possible, we also want to make sure we do not compromise your safety and are pursuing the best outcome possible for you.

 

How will I be notified when the next Phase is starting?

The best way to remain up to date on our plans is to keep an eye on our web site where we will be posting updates on a regular basis.

 

When can I ship my donor gametes to the clinic?

We started accepting shipments from recognized donor gamete banks on June 8th.  Banks and labs wanting to ship specimens to Mount Sinai Fertility can contact the lab directly to make plans.  Banks must supply the relevant paperwork to comply with Health Canada Regulations.

 

Many are very worried about a second wave and the potential for clinics to close in the fall.  Are there plans to have the clinic open for longer hours to provide physical distancing while increasing the volumes and moving into the Phases in a timely manner?

At this time, our main objective is to gradually increase volumes while ensuring safe and quality care.  While it is our plan to reach full capacity by fall, we need to do so without compromising care and safety of staff and patients.  By starting slowly, we minimize risks including potential for outbreaks in the clinic.  At this time we do not anticipate needing extended clinic hours.

 

Who can I contact if I want more information?

Please e-mail any questions to MSF.Feedback.MSH@sinaihealth.ca. We will respond to your questions within 2 business days. When e-mailing a question, please provide your full name and date of birth so that we may be as specific as possible in our response. If you prefer to remain anonymous, that is also fine.