Baby Was Infected With Covid-19 in Utero, Study Reports

Researchers said the case strongly suggests that Covid-19 can be transmitted in utero. Both the mother and baby have recovered.

Researchers on Tuesday reported strong evidence that the Covid-19 can be transmitted from a pregnant woman to a fetus in utero.Covid-19 in utero

A baby born in a Paris hospital in March to a mother with Covid-19 tested positive for the virus and developed symptoms of inflammation in his brain, said Dr. Daniele De Luca, who led the research team and is chief of the division of pediatrics and neonatal critical care at Paris-Saclay University Hospitals. The baby, now more than 3 months old, recovered without treatment and is “very much improved, almost clinically normal,” Dr. De Luca said, adding that the mother, who needed oxygen during the delivery, is healthy.

Dr. De Luca said the virus appeared to have been transmitted through the placenta of the 23-year-old mother.

Since the pandemic began, there have been isolated cases of newborns who have tested positive for the coronavirus, but there has not been enough evidence to rule out the possibility that the infants became infected by the mother after they were born, experts said. A recently published case in Texas, of a newborn who tested positive for Covid-19 and had mild respiratory symptoms, provided more convincing evidence that transmission of the virus during pregnancy can occur.

In the Paris case, Dr. De Luca said, the team was able to test the placenta, amniotic fluid, cord blood, and the mother’s and baby’s blood.

The testing indicated that “the virus reaches the placenta and replicates there,” Dr. De Luca said. It can then be transmitted to a fetus, which “can get infected and have symptoms similar to adult Covid-19 patients.”

A study of the case was published on Tuesday in the journal Nature Communications.

Dr. Yoel Sadovsky, executive director of Magee-Womens Research Institute at the University of Pittsburgh, who was not involved in the study, said he thought the claim of placental transmission was “fairly convincing.” He said the relatively high levels of the coronavirus found in the placenta and the rising levels of virus in the baby and the evidence of placental inflammation, along with the baby’s symptoms, “are all consistent with SARS-CoV-2 infection.”

Still, Dr. Sadovsky said, it is important to note that cases of possible coronavirus transmission in utero appear to be extremely rare. With other viruses, including Zika and rubella, placental infection and transmission is much more common, he said. With the coronavirus, he said, “we are trying to understand the opposite — what underlies the relative protection of the fetus and the placenta?”

NYTimes.com, July 16, 2020 by Pam Belluck

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The Challenges of the Pandemic for Queer Youth

The Challenges of the Pandemic for Queer Youth – Issues include limited access to community support and counseling and, in some cases, quarantining with unsupportive family members.

The pandemic has affected queer youth in many ways.  When Brittany Brockenbrough’s transgender son lost his in-school counseling and the ability to have meet-ups with other L.G.B.T.Q. youth during the pandemic, his mental health suffered.How Coronavirus Is Affecting Surrogacy

“He began to feel depressed and was withdrawn,” said Ms. Brockenbrough, a mother of two in Virginia. She was later able to get her son teletherapy and in-home support from a local mental health agency and to find ways for him to stay in touch with others in his community through such activities as weekly Zoom meetings and online game nights.

“He is doing much better now that he is back in treatment and staying connected to the community,” she said. “Social distancing and taking precautions is necessary, but for the L.G.B.T.Q.+ community, even those who have supportive parents, losing the ability to have that in-person social support with other L.G.B.T.Q.+ youth can have a significant impact.”

As young people continue to adjust to the pandemic, some are dealing with increased anxiety and stress. For those who are lesbian, gay, bisexual, transgender, queer or questioning, there may be additional challenges and risks resulting from limited access to community support, lack of in-school counseling and, in some cases, the difficult circumstances of quarantining with unsupportive family members.

“My parents do not accept that I am gay,” an 18-year-old from Yonkers, N.Y. who did not want his name published, said. “My support system was mostly at school, and now I am quarantining with family members who don’t accept who I really am.”

 

The young man, whose virtual high school graduation was last week, said his parents reacted with “anger” and “disgust” when they found out he was gay, and that being home with them during the Covid-19 shutdown has been very uncomfortable. “It is humiliating to have to rely on people who do not respect you,” he said.

L.G.B.T.Q. youth are already a vulnerable population and at higher risk for anxiety, depression, homelessness and self harm than their non-L.G.B.T.Q. peers. A 2018 study in JAMA Pediatrics by researchers at Harvard University and the Fenway Institute found that transgender youth were at a greater risk for attempted suicide, depression and anxiety, and that gender-affirming mental health services are greatly needed to address these concerns.

Sarah Gundle, a clinical psychologist in New York City, said that while online supports are available during this crisis and can provide help, for many they cannot replace in-person treatment and interaction with a community that accepts and validates your identity.

“L.G.B.T.Q.+ youth who have to be at home for extended periods of time and live with unsupportive family members — or their family environment makes it unsafe for them to be out at home — can experience a profound sense of isolation,” Dr. Gundle said. “A pandemic brings significant uncertainty — there is no definitive end — and it can feel as if there is no escape. Many L.G.B.T.Q.+ youth also have to worry about their safety and the repercussions if their family members find out.”

When college campuses closed in March because of the pandemic, having to return home to an unsupportive space was not a safe option for some students.

Danushi Fernando, the director of L.G.B.T.Q. and Gender Resources at Vassar College in Poughkeepsie, N.Y., said that approximately 225 students — following state guidelines — remained on campus through the spring semester for various reasons, some because they did not feel safe sheltering with their families. Vassar also provided support for students through virtual gatherings, support groups and counseling.

NYTimes.com, June 29, 2020 – by Misha Valencia

To read the entire article, click here.

Estate Planning and COVID-19 – Protecting What’s Most Important in a Time of Crisis    

Estate Planning and COVID-19 – Protecting What’s Most Important in a Time of Crisis

Estate Planning and COVID-19 – Like so many of us during this pandemic, our anxieties have been at an all-time high.  The sense of helplessness and the lack of a clear light at the end of the tunnel have many asking what they can do to better protect themselves and their families.  The good news is that we are not completely helpless.  Technology has made communicating easier and many states have adapted their current laws to make it easier to have a sense of control when it feels so distant.estate planning and COVID 19

First, with video conferencing technology, you can speak face to face with an attorney in your area.  Many attorneys are offering complimentary video consultations and you don’t even have to leave your couch.  This type of meeting is likely to become the new normal for attorney consultations and I for one couldn’t be happier.

Many of you may already have some valuable estate planning tools in place.  Understanding the difference between probate assets v. non-probates assets is the best place to start.  If you have a 401(k), an IRA, a life insurance policy or own property as joint tenants with right of survivorship, you have already created an estate plan without knowing it.  Any assets that has a designated beneficiary or that you own “jointly” with someone else, passes directly to that beneficiary or joint owner upon your death.  That is good news when you consider that this aspect of your estate planning may be immune to COVID-19.

Other important benefits that had been instituted in New York State, for instance, stem from Executive Orders signed by the Governor allowing for the remote notarization of documents (NY Executive Order 202.7) and also the remote witnessing of Will signings (NY Executive Order 202.14).  Almost every state has instituted either a remote notary order, a remote witnessing order, or both.  Here is a good place to look to see if your state has such orders.  While each state is different, the goal is to make it easier (easier that even before the pandemic) for people to secure their families and assets.

foster parentsHow do these remote sessions allow for estate planning and COVID-19?  Each state will have a different set of requirements,  but In NY, all parties must be on a Zoom or Skype call simultaneously and in the State of New York, the signers must show their IDs to the notary or witnesses, the signatures must take place in sight of the notary or witnesses.  The signers must fax or scan the documents to the attorney supervising the Will signing, or the notary public, who will then have the witnesses sign, or the notary will notarize the documents.  IMPORTANT: this must happen on the same day as the signing.

It is a good idea to conform the notarization by adding language stating that the signing or notarization are occurring in accordance with the specified executive order.  Also, you may want to consider signing the documents again in the direct presence of a notary after the pandemic has abated as a measure of caution.  This is a suggestion and no mention of multiple signing is present in the current NY Executive Order.

It is important to remember that if you have children and you have not named a guardian for them in your Will ( in most states it is the only document that a court looks to in determining your choice for a guardian should something happen to you and your child’s other parent), now is the time to act.   And if you have been thinking about reviewing your complete Estate Plan, or just your Last Will and Testament, now is the perfect time.

So if you are asking what you can do about your estate planning and COVID-19, there are options.  Consult your local attorney to find out the specifics of your state.  Ask for a video conference so you can speak face to face.  Be proactive and make the most of this quarantine time.  We are doing so much to protect our communities, let’s protect our families at the same time.

Timeforfamilies.com, May 7, 2020 by Anthony M. Brown, Esq. 

UPDATE: The New York Executive Order allowing for remote notarization and document witnessing has been extended until October 4, 2020.

Contact Anthony at anthony@timeforfamilies.com.

 

 

Fertility Clinics Stay Open Despite Unclear Guidelines

Fertility clinics stay open – Many providers have continued seeing patients through the pandemic, forcing them to choose between clients and staff safety.

Since March, fertility stay open clinics across the country have halted treatments for tens of thousands of people because of Covid-19, forcing patients to suspend their family planning. In recent days, some clinics have reopened, resuming services and procedures despite ongoing coronavirus concerns.

But shifting guidelines and minimal oversight have left clinics to decide for themselves when and how to resume in vitro fertilization, or I.V.F. At clinics where I.V.F. is ramping back up, or never slowed at all, some staff members are concerned about a lack of adequate protective equipment and safety policies.

On April 24, the American Society for Reproductive Medicine issued recommendations for restarting operations, leaving it up to individual clinics to determine how to proceed. The professional society had previously advised fertility clinics to avoid starting new treatments, postpone nonemergency surgeries and shift to telemedicine.

The shutdown generated a flurry of media attention and pushbackfrom fertility doctors and patients. Most clinics paused starting new I.V.F. cycles, which are highly time-sensitive. But a few remained open, even operating at full capacity, causing the industry to debate when to resume care and what counts as medically urgent.

“Fertility treatment is by no means elective,” said Leyla Bilali, a nurse at a fertility clinic in New York City, referring to the consensus that infertility is a disease. “It’s just, right now, it’s not a matter of life or death.”

Clinics that stayed open scrambled to implement protocols compliant with the Centers for Disease Control and Prevention, such as temperature checks, masks and physical distancing. Still, people have gotten sick. At Reproductive Medicine Associates of New York, seven staff members have tested positive for Covid-19. At Vios Fertility Institute in Chicago, clinicians have reported flulike symptoms but have not been tested because of limited test availability. And several employees at Extend Fertility, an egg-freezing clinic in Midtown Manhattan, fell ill with possible cases of Covid-19.

“We really didn’t feel it was appropriate to go out on a limb, outside major A.S.R.M. guidelines, and keep things open,” said Dr. Bat-Sheva Maslow, M.D., a reproductive endocrinologist at Extend Fertility who tested positive and recovered from the virus in March. “Covid-19 is almost impossible to control at this point. That weighed very heavily with us.” Extend Fertility has since closed its offices to virtually all patients.

Amid the pandemic, clinics face a dizzying array of vague and, at times, conflicting instructions from states, cities and health agencies like the C.D.C. Doctors must interpret guidelines as they see fit — often the case in fertility services, which are largely paid out-of-pocket and where patient care and profit can be at odds.

Because of unclear guidance, in most states it is difficult to tell whether remaining open during the pandemic is legal or if fertility procedures are considered an essential service. New York is an exception: On April 7, the state’s health department issued an advisory deeming infertility treatment an essential service, thus exempt from closure. New Jersey’s governor, in an executive order responding to the coronavirus crisis, made a similar but less specific exemption, referring to general family planning services but not directly to infertility.

NYTimes.com, by Natalie Lambert, May 1, 2020

Click here to read the entire article.

How Co-parenting Has Equipped Queer Families To Handle The Coronavirus Pandemic

Co-parenting families are drawing on the resiliency that comes from living on the margins in the Coronavirus pandemic.

Co-parenting families are drawing on the resiliency that comes from living on the margins in the Coronavirus pandemic. Four months ago, Lisa Lo, from Calgary, separated from the father of her two young children, ages two and five, in part because she wanted to open her marriage to relationships with both men and women.Co-parenting Coronavirus

Lo, whose name has been changed to protect her family’s privacy, is polyamorous, and she’s had three relationships since her separation, one of which has ended, and two of which have been complicated by pandemic living arrangements.

Some of these relationships have brought big feelings, but through it all, Lo is mindful of keeping an emotional balance for her kids, who spend most of their time with her. “They pick up on my emotions,” she said. “If I’m happy, they’re happy. If I’m stressed and upset, then they’re stressed and upset.”

But that was all pre-pandemic: “Now, dating has been put on hold,” she told HuffPost Canada. Lo’s priorities are different these days. She is very much focused on the challenges COVID-19 poses to all multi-household families: creating consistent self-isolation protocols, navigating the handing-off of children, communicating in a time of stress, finding legal counsel.

To create a situation that worked for everyone, Lo had to have hard conversations with her ex-husband about whether to integrate any of her existing polyamorous relationships into their isolation cohort.

They settled on Lo living with one somewhat-ex-partner (it’s complicated). They are also still employing a nanny in both households, in part, because this is supportive of Lo’s mental health. The negotiations about child schedules and hand-offs between households have been complex.

Lo has also been challenged by some of her loved ones about having non-immediate family members in her household “pod” during the pandemic. But, she was able to take that in stride.

She said being queer has given her a lot of practice with tough discussions: “I’m used to being outspoken about things that are unconventional. I’m done being in the closet about anything.”

Rachel Farr is an assistant professor of Psychology, and she runs the FAD (Families, Adoption, and Diversity) research lab at the University of Kentucky. She said that for LGBTQ2 families, this pandemic both feeds into existing patterns of resilience and creates new ones.

“Some of the emotional dynamics I think are true for any family trying to negotiate [this pandemic],” she told HuffPost, “but there are added layers of sensitivity and vulnerability for queer families, who also face stigma and various forms of silencing through institutional discrimination or lack of legal protections.”

Huffingtonpost.ca by Brianna Sharpe, April 23, 2020

Click here to read the entire article.

Coronavirus upends years of planning for international adoptions and surrogacy births

Coronavirus upends years of planning for international adoptions and surrogacy births

Coronavirus upends years of planning for international adoptions and surrogacy births.  Andrea Hoffmann’s mad dash to America began shortly after 2 a.m. on March 12 in Munich, when her husband roused her from sleep and said, “We have to get on a plane now.”Coronavirus adoptions surrogacy

The Hoffmanns both wanted to be in Maryland for the birth of their son to a surrogate who was due in late May. But Christian Hoffmann realized their plans had to be changed after watching President Trump on television as he announced travel restrictions on Europeans to limit the spread of the novel coronavirus.

When Christian left Andrea at the Munich airport at 6 a.m., they expected he would join her in a few weeks.

More than a month later, Christian Hoffmann is still in Munich, working at home for a pharmaceutical company. His wife is living temporarily in an apartment in Frederick, Md., doing administrative tasks on her laptop for her job as an air traffic controller. She has spent countless hours watching the news and the first five seasons of “Game of Thrones” on Netflix, and bonding with their surrogate, who has brought her three daughters to the parking lot of Andrea’s building so she can watch them dance from a second-floor balcony.

“We are just so glad one of us is here,” she said. “I didn’t think it would come to this. I thought, ‘It will be all right; they cannot lock down everything.’ I never would have imagined this situation.”

The sweeping travel restrictions, imposed with little advance notice, have interrupted plans for prospective new families around the world. The United States has imposed restrictions on travelers who have been in China, Iran and most of Europe, as well as Canada and Mexico. Nine of 10 people in the world live in countries that have closed their borders because of the covid-19 outbreak, narrowing international travel to a trickle.

As a result, many people overseas with surrogates in the United States are either stranded thousands of miles away or stuck in the United States, unable to bring their newborns home. And Americans who were about to fly abroad for international adoptions cannot enter the countries where children wait for them, often in orphanages.

“We literally had 15 families who had tickets purchased to leave the next day or in few days, and 10 families ready to purchase tickets,” said Susan Cox, vice president for policy at Holt International, an Oregon-based Christian organization that arranged more than 500 adoptions from other countries last year.

“In some cases, their adoptions had been in process for two or three years. They were finally at the point where the child was ready to travel, and the adoption was ready to be completed. They were so close.”

Thomas Mitchell and his wife, Callie, had been waiting for eight months to bring a 3-year-old boy home from an orphanage in northern China. Mitchell built him a bed that his daughters painted and decorated his room at their home in Chattanooga, Tenn., with a mural of pandas and pagodas. They had plane tickets to China in early February, but 12 days before their departure date, the adoption was put on indefinite hold.

“At first, we thought it would be a couple weeks’ delay,” said Thomas Mitchell, a real estate transaction coordinator. “Then it snowballed. Now, nobody knows when we can go.”

Washington Post, April 16, 2020, by Carol Morello

Click here to read the entire article.

How Coronavirus Is Affecting Surrogacy, Foster Care and Adoption

How Coronavirus Is Affecting Surrogacy – The pandemic is not just impacting parents and pregnant people — all prospective parents are facing new challenges.

How Coronavirus Is Affecting Surrogacy – Covid-19, the disease caused by the novel coronavirus, has upended life for those who are or hope to become pregnant in the United States. Fertility doctors have indefinitely postponed all advanced fertility treatments, and some major hospitals in hard-hit areas are trying to ban partners and doulas from delivery rooms.

But the pandemic is affecting expectant parents forming families through surrogacy, foster care and adoption as well.

Global travel restrictions have left surrogacy agencies in the United States scrambling for exemptions for their international clients — particularly for those whose surrogates are scheduled to give birth in the next month or two.How Coronavirus Is Affecting Surrogacy

Circle Surrogacy, an agency based in Boston, has 15 international clients with due dates before May 1. “We’ve had our legal team prepare letters for each of these families, which has gotten many of them into the country despite travel bans,” said Sam Hyde, the agency’s president. Still, he said, his foreign clients were at the mercy of individual immigration officials. “Some have been sympathetic to the plight of our clients, others have not — it’s really been a case-by-case basis.”

 

Some intended parents, as clients of surrogacy agencies are known, who are currently struggling to gain entry into the United States are hoping to do so after completing a 14-day quarantine in a country with less severe travel restrictions.

Last week, for instance, Johnny and Patty — a Chinese couple working with a surrogate living in South Carolina — traveled from Shanghai to Phnom Penh, Cambodia, to begin two weeks in isolation at a local hotel. The couple, who work for an international company and use these westernized names, asked that their last name be withheld since surrogacy is still relatively uncommon in China. They hope to complete their quarantine in time to witness the birth of their daughter, who is due in mid-April, and claim guardianship over her.

But with travel restrictions tightening seemingly daily, they worry their effort may still be in vain. “First we bought plane tickets to travel through Thailand, but now travel is restricted there,” Johnny said in an interview from their hotel on the second day of his quarantine. “Then we tried Dubai, but that is now also restricted.” Traveling via Cambodia, he said, was the couple’s “last hope” to reach the United States in time for their daughter’s birth.

Though they would be disappointed to miss the delivery, the couple said they were even more concerned, in that scenario, about the baby’s well-being in the ensuing days before they are allowed to travel. “Who will take care of our baby if we can’t arrive before she’s born?” Patty said.

Will Halm, a managing partner at International Reproductive Law Group, said surrogacy agencies were creating contingency plans for clients living abroad who may be prohibited from entering the United States over the next few months. “Plan A is absolutely to have parents in the U.S., joyfully watching their child being born,” he said. “If they can’t get into the country in time, that’s when we look to plans B, C and D.”

 

In one of the better scenarios, agencies hope friends or family members living in the United States can temporarily assume guardianship of the baby until the intended parents are granted entry into the country. As a backup, however, caseworkers are also preparing strangers — health care professionals, child care providers and even surrogates themselves — to care for the newborns until travel restrictions are eased.

“These babies will not be abandoned,” said Dr. Kim Bergman, founder of Growing Generations, a surrogacy agency with dozens of international clients who may be impacted by travel bans in the coming months. “We have an army of former surrogates who are ready and eager to act as helpers and guardians for as long as necessary.”

The ongoing crisis has created an uncertain environment for foster care parents and children as well. “Basically, everything is on pause until things are back to normal,” said Trey Rabun, who works as a services supervisor at Amara, a foster care agency based in Seattle, Wash. — one of a growing number of states ordering its citizens to work from home.

Amara, whose staff members are included in the state’s proclamation, has been able to continue some aspects of the licensing process for foster parents online, such as initial interviews. But other critical components, like home inspections, need to be done in person, Rabun said.

As a result, the number of foster homes, already all too scarce in Washington before the crisis hit, will remain static for the state’s over 10,000 foster care children until the pandemic subsides and business returns to normal, Rabun said. Of bigger concern to him, and other foster care professionals throughout the country, is the impact that “stay at home” orders may have on children not yet accounted for in the system.

“We know abuse and neglect happen more in high-stress situations,” Rabun said. But the people who would normally notice and report these sorts of problem, like teachers and doctors, will be unable to do so in the days and weeks ahead. “No one has eyes on them,” he said.

With courts and other government offices closed in many states, parents who had hoped to finalize adoptions within the next couple of months are also now navigating a drastically changed landscape — particularly for parents completing adoptions abroad.

 

Early in the year, when the coronavirus was barely registering as a news story outside of Asia, Holt International — an agency that facilitates adoption placements between Chinese orphanages and adoptive parents in the United States — was already closely monitoring and responding to the outbreak.

NYTimes.com, by David Dodge, April 1, 2020

Click here to read the entire article.

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
 
Click here to read the entire article.

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