Shielding the Fetus From the Coronavirus

New studies suggest the Coronavirus can cross the placenta to the fetus, but newborns have been mildly affected if at all.

Newborns and babies have so far seemed to be largely unaffected by the coronavirus, but three new studies suggest that the virus may reach the fetus in utero.coronavirus fetus

Even in these studies, the newborns seemed only mildly affected, if at all — which is reassuring, experts said. And the studies are small and inconclusive on whether the virus does truly breach the placenta.

“I don’t look at this and think coronaviruses must cross across the placenta,” said Dr. Carolyn Coyne of the University of Pittsburgh, who studies the placenta as a barrier to viruses. She was not involved in the new work.

Still, the studies merit concern, she said, because if the virus does get through the placental barrier, it may pose a risk to the fetus earlier in gestation, when the fetal brain is most vulnerable.

Pregnant women are often more susceptible to respiratory infections such as influenza and to having more complications for themselves and their babies as a result. It’s still unclear whether pregnant women are more likely to contract the new coronavirus, said Dr. Christina Chambers, a perinatal epidemiologist at the University of California in San Diego.

“We don’t have any knowledge of that at all — that is a complete open question at this point,” she said. It’s also unclear what effect the virus has on the fetus, she added.

The placenta usually blocks harmful viruses and bacteria from reaching the fetus. And it allows in helpful antibodies from the mother that can keep the fetus safe from any germs, before and after birth.

Still, a few viruses do get through to the fetus and can wreak havoc. The most recent example is Zika, which can cause microcephaly and profound neurological damage, especially if contracted in the first and second trimesters.

Neither the new coronavirus, nor its more familiar cousins, has seemed to belong to this more dangerous category. If so, “we would be seeing higher levels of miscarriage and preterm delivery,” Dr. Coyne said.

NYTimes.com by Apoorva MAndavilli, March 27, 2020
 
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Effect of COVID-19 on LGBTQ Family Planning

The Effect of COVID-19 on LGBTQ Family Planning is evolving and far reaching.  It is also temporary.

The Effect of COVID-19 on LGBTQ Family Planning – The COVID-19 pandemic has affected us all in ways more numerous to describe.  Those of us with families have had to learn about home schooling, some the hard way (me).  Everyone has had to adjust to what essentially has become a home quarantine situation and the emotional effects of social isolation.  And we are all witness to the world going through a major change which will create a new reality for everyone when we emerge on the other side.  But we will emerge on the other side. effect of COVID-19 0n LGBTQ family planning

While I myself have experienced the loss of a friend due to the virus, as well as the infection of a family member, I know that we all are doing our best to maintain a sense of normalcy and peace within.  Practicing this type of self-care will help mitigate the effects of COVID-19 on LGBTQ family planning.

The effects of COVID-19 on LGBTQ family planning are very real.  I have said in the past that there are no accidental pregnancies in the LGBTQ community.  Everything is carefully thought out and planned in advance.  However, the COVID-19 virus has created specific and real-world disruptions to our ability to create families.

For example, those were using, or planning to use, an IVF clinic for either surrogacy, artificial insemination (AI), intrauterine insemination (IUI) or in vitro fertilization (IVF) procedures have experienced an actual shut down of normal operations.  The clinic administrators that I have spoken with are optimistic that once the virus is contained, or at least the infection curve has flattened, that they will resume normal operations.  For the time being, they are following ASRM guidelines.  But they will also be dealing with backlogs of patients and procedures that may cause further delay in your family building timeline. 

effect of COVID-19 0n LGBTQ family planningFor lesbian couples who have thoughtfully chosen to use a clinic to assist in insemination, this delay is not only frustrating, it can also change the projected timeline of their families.  Even those couples who choose anonymous sperm donors will most likely have to wait an indefinite period of time to undergo AI or IUI procedures.  For those who choose known sperm donors, the essential DNA testing that is a prerequisite for clinic inseminations will also be on a delayed time schedule.

Gay male couples who are considering surrogacy are facing an even more complicated challenge.  First, there will inevitably be a delay in the embryo creation aspect of the beginning of their journey due to IVF clinic shutdowns.  If an intended parent already has embryos created, perhaps from a previous surrogacy journey, they may be in a better position.  However, they will also experience a delay in embryo transfer until restrictions on IVF clinic activities are lifted.  A silver lining is that they will be able to match with surrogates sooner, thereby shortening the time to pregnancy once those IVF restrictions are lifted.

Lesbian couples who choose a known sperm donor and home insemination may be the only group in our community who might not experience the delays discussed above.  However, these types of inseminations will not have the benefit of genetic testing.  Nor are they technically “legal” in some states (Missouri, Georgia, Oklahoma and Colorado) because they are not performed by a licensed professional.  It is key that if you are considering home insemination that you consult with an Assisted Reproductive Technology (ART) attorney in your area and, for the safety and security of all parties, must have carefully prepared legal agreements in place and a second or stepparent adoption plan incorporated into that agreement.

For those in the midst of a surrogacy journey, perhaps awaiting their carrier to give birth, the effects of COVID-19 on LGBT family planning can be particularly frustrating due to travel and hospital restrictions.  Many hospitals are restricting the number of people who can be in a delivery room, particularly if they have traveled from an area that has been severely affected by COVID-19, like New York, Washington or California.  Be prepared for snags in the road and lots of patience.  You will go home with your child!  You may have to be flexible in your travel plans, i.e. be prepared for long drives instead of air travel.

For lesbian couples and gay men with surrogates who are pregnant, there is a limited study from Wuhan China showing that babies of mothers with the virus were not effected, meaning that there was no vertical transmission.

Couples considering adoptions are also at a bit of a standstill depending on where they live in the US.  Most state court systems have closed to all but “essential” proceedings.  While I would argue that adoptions are essential, the courts have determined that they are not.  I have several cases now awaiting the scheduling of finalization hearings that are simply on hold until the pandemic subsides.  This includes private placement adoptions and step or second parent adoptions.  This does not mean that making connections with birth parents must be put on hold, but the legal work that is required to effectuate the adoption may be delayed, causing additional anxiety.Effect of COIVD-19 on LGBTQ family planning

You may be asking what you can do to mitigate the effects of COVID-19 on LGBTQ family planning.  I know that I am.  Here are a few options that you can consider now.

  1. Make sure that your Estate Plan is in place and up to date. Ask yourself, “Do I need a Will?”  If you have named guardians for children in your Wills, please review to make sure that they are current and correct.  If you have not created an Estate Plan, now is a good time to do the work to ensure that you have prepared for the unexpected.  Here is a list of the documents you should be considering for your estate plan.  We have also seen a relaxation of Notary laws allowing for online notarizations.  This can make the execution of documents much easier in certain states.
  2. If you have been thinking about creating your family, now is a great time to do more research. Men Having Babies is a great resource for surrogacy.  “If These Ovaries Could Talk” is a wonderful podcast for all LGBTQ family planning.  This should include speaking with your friends who have had children to get their perspectives on the process.  It is also a really good time also to start thinking about the financial implications of having a family.  Many of us will be irreparably financially harmed by the COVID-19 pandemic.  Many of us will have to rethink the timelines we had anticipated would apply to our family planning journeys.  You may want to meet with a financial professional to discuss the best way to get your family plan back on track.
  3. Practice self-care! Whether you have children or not, staying calm and finding peace in your heart will help you get through this.  While you might feel alone, you are not alone.  Reach out and find solace in your friends and family if you can.  Take walks if you can and get outside.  Remind yourself of what will be on the other side of this experience.

If you have specific questions about how to address the effects of COVID-19 on LGBTQ family planning and estate planning, and you think I can be of help, please do not hesitate to reach out to me.  Thank you for taking the time to read this and remember to breathe.

ASRM Guidelines on Fertility Care During COVID-19 Pandemic

ASRM Guidelines on Fertility Care During COVID-19 Pandemic: Calls for Suspension of Most Treatments

ASRM Guidelines on COVID-19: The American Society for Reproductive Medicine (ASRM), the global leader in reproductive medicine, today issues new guidance for its members as they manage patients in the midst of the COVID-19 pandemic.  Developed by an expert Task Force, of physicians, embryologists, and mental health professionals, the new document recommends suspension of new, non-urgent treatments.ASRM guidelines COVID -19

Specifically, the recommendations include:

  1. Suspension of initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
  2. Strongly consider cancellation of all embryo transfers, whether fresh or frozen. 
  3. Continue to care for patients who are currently ‘in-cycle’ or who require urgent stimulation and cryopreservation.
  4. Suspend elective surgeries and non-urgent diagnostic procedures.
  5. Minimize in-person interactions and increase utilization of telehealth.

The above recommendations will be revisited periodically as the pandemic evolves, but no later than March 30, 2020, with the aim of resuming usual patient care as soon and as safely as possible.  ASRM has been closely monitoring developments around COVID-19 since its emergence. Data on its impact on pregnancy and reproduction remains limited. However, the task force used best available data, and the expertise and experience of the members to develop the recommendations. Until more is known about the virus, and while we remain in the midst of a public health emergency, it is best to avoid initiation of new treatment cycles for infertility patients. Similarly, non-medically urgent gamete preservation treatments, such as egg freezing, should be suspended for the time being as well. Clinics who have patients under treatment mid-cycle should ensure they have adequate staff to complete the patient’s treatment and should strongly encourage postponing, the embryo transfer.

Ricardo Azziz, CEO of the ASRM stated, “This is not going to be easy for infertility patients and reproductive care practices. We know the sacrifices patients have to make under the best of circumstances, and we are loath to in add, in any way. to that burden. And it will not be easy for our members. The disruption to routines, the stress on staff members and the very real prospect of economic hardship loom large for ASRM members all over the world.  But the fact is that given what we know, as well as what we don’t, suspending non-urgent fertility care is really the most prudent course of action at this time.”

Dr. Racowsky added, “We should recognize that the situation on the ground is fluid, and as such we will continue to revisit and review our recommendations at least every two weeks, to provide providers and their patients with the best information and support we possibly can.”

ASRM Press Release – May 17, 2020

Click here to read the entire release

Richard E. Weber, Beloved Lawyer Dies From Coronavirus Complications

Richard E. Weber will be remembered as having brought ‘joy and exuberance’ to everything he did.

We have some unfortunate news today from New York, where an esteemed member of the legal profession passed away due to complications of coronavirus.Richard E. Weber

Richard E. Weber, 57, was a partner at Gallo Vitucci Klar as well as a board member of the LGBT Bar Association of New York. Big Law Business has some additional details on his death:

“Everyone at Gallo Vitucci Klar LLP is heartbroken and devastated by the loss of Richard,” senior partner Howard P. Klar said in an emailed statement. “He was a wonderful attorney and shining light at our firm. Our thoughts right now are with his family.”

Klar said the firm’s Manhattan office has been closed since Weber disclosed his symptoms on March 10. Attorneys and staff have been working remotely and the office was deep cleaned and disinfected. No one else at that office or the firm has had any Covid-19 symptoms or a positive diagnosis, he said.

According to Eric Lesh, executive director of LeGaL, Weber had been hospitalized and tested positive for COVID-19. Three days before Weber died, he have a conversation with Lesh where he “convey[ed] … that this was the sickest he’d ever been and that he was recovering and on the mend.” From the LGBT Bar’s Facebook 

“It is with heavy hearts that we reach out to LeGaL’s members and friends with news of devastating loss of our longtime board member, Richard Weber, to Coronavirus complications.

We cherish Richard’s memory and hold his partner, Antonio, and family in our hearts. Richard gave generously of his time and talents to improve the lives of LGBTQ New Yorkers.”

AboveTheLaw.com, March 20, 2020 by Staci Zaretsky

Click here to read the entire article.

COVID-19 and CoronaVirus Effects on Pregnancy, What the Few Studies Have Shown Us

COVID-19 and CoronaVirus Effects on Pregnancy, What the Few Studies Have Shown Us

COVID-19 and CoronaVirus Effects on Pregnancy, What the Few Studies Have Shown Us.

Dr. Said Daneshmand MD, FACOG discusses COVID-19 and Pregnancy and the few studies that exist.  While this is ever changing, this is the first discussion of the effects of CoronaVirus, COVID 19 on pregnancy.

 

 

Click here to view the Video on YouTube.