Important Information Regarding the COVID-19 Pandemic:

Over the past few weeks, you have all seen or heard much about the 2019 Novel Coronavirus, also known as COVID-19. We recognize that situations such as this can create fear and anxiety and our best way to address that is through communication, education, and preparation.

Our reproductive medicine and immunology center is committed to providing our patients a unique care and helping them along their fertility journey to overcome the previous challenges and to achieve a successful outcome which is a live birth. This journey is long and treatment usually takes months to plan and implement.

Due to the unique nature of our specialty, we will continue providing care to our patients. We will be offering more telemedicine visits to minimize the risk of infection.

Please be assured that we are staying updated on the latest public and healthcare guidelines.

Please feel free to communicate with us through the portal or call 248-938-0141.

Below you will find information to answer any questions or concerns you might have.

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What is COVID-19? Why it’s so dangerous?

COVID-19 is a new coronavirus that has not previously identified. This virus has the ability of causing Acute Respiratory Distress Syndrome (ARDS) especially in older population, and people with chronic illness and weaker immune system, which can lead to death. Most people will have a mild infection and will recover fully if the virus was contracted, however around 20-30% of positive cases will need to be hospitalized and around 5-10% of positive cases will need ICU admission, leaving a death rate around 2-4% of total confirmed cases.

What are the symptoms of COVID-19?

The symptoms can range from mild symptoms such as sore throat, headache, body aches and fever, to shortness of breath, cough, chest pain and tightness. if you have any of those symptoms please alert us and contact your primary care doctor.

What emergency warning signs for COVID-19 require immediate medical attention?

If you have difficulty breathing or shortness of breath, persistent chest pain or tightness, you should seek medical attention immediately.

How does COVID-19 spread?

COVID-19 is generally thought to be spread from person-to-person through respiratory droplets from a cough or sneeze. Currently there is no evidence to support transmission of COVID-19 associated with food.

I am pregnant and currently taking an immunosuppressant medications (Prednisone, Hydroxychloroquine, Tacrolimus or IVIG) as part of my protocol, Am I considered at a high risk for COVID-19?

Yes, taking immunosuppressant medications such as prednisone during pregnancy will increase the risk of infection and more serious illness in general although no data has been reported specifically about the COVID-19 in pregnancy; however Research studies didn’t show increased risk of infection with Hydroxychloroquine, Tacrolimus or IVIG.

I am pregnant and/or taking immunosuppressant medication, How can I protect myself from getting COVID-19?

Our recommendation is self isolation  if possible and avoid people who are exposed or sick. Social distancing and wearing appropriate face mask are important if self isolation is not possible.

Some basic hygiene guidelines to decrease the potential for viral transmission:

  • Social distancing, at least 6 feet.
  • Washing your hands often with soap and water for at least 20 seconds.
  • Between hand washes, use sanitizer regularly, especially after touching doorknobs and keyboards in public places.
  • Avoid touching your face (nose, eyes, mouth) with unwashed or unsanitized hands.
  • Cover your nose and mouth with a tissue when you cough or sneeze, or cough into your elbow. Throw away any used tissues promptly and wash your hands immediately.
  • Wear mask if it’s absolutely necessary to go out of the house.

Do I need to cancel my IVF cycle?

Please contact your IVF doctor to check if they are cancelling or postponing the cycles. If they are continuing the IVF cycle, we will continue with our initial plan and patient should be under extreme isolation precautions.

What measures are taken in the office to lessen the risk of infection among our patients and staff?

  • Screening questions prior to visit and COVID-19 testing if indicated.
  • Our staff will be wearing a mask and using hand sanitizers.
  • Avoid handshaking.
  • Proper sanitation of the office.
  • Limiting visitors in the waiting area.
  • Screen patients for exposure.

Can COVID-19 be passed from a pregnant woman to the fetus or newborn? Will it hurt the baby?

We still do not know if a pregnant woman with COVID-19 can pass the virus that causes COVID-19 to her fetus or baby during pregnancy or delivery; however there are reported cases of COVID-19 transmission to newborn and the newborn should be evaluated, tested and possible separation if needed.

Is there a vaccine for COVID-19?

Scientists are working on developing a vaccine but it will not be available for quite some time. Because less is known about the virus and there is no vaccine for it, it is especially important that protective measures are taken to protect the public (mainly those who are medically susceptible).

Can I still travel?

Yes, essential travel only. Proper precautions should be taken.

The Immune System: a Friend or an Enemy for Reproduction?

 

 

The immune system is multi-functional. It is important in fighting infections as well as healing wounds, repairing tissue and beginning the process of pregnancy (implantation). There is evidence that the immune system is crucial for pregnancy implantation and the formation of the placenta. Without immune cells, pregnancy could have a poor outcome including pregnancy loss (miscarriage).

 

The activity of the immune system varies from one person to another. A balanced immune system is important for a healthy human body. An unbalanced immune system can range from underactivity (deficient) to overactivity. The underactive or deficient immune system can lead to increased susceptibility to infection. However, an overactive immune system can be associated with autoimmune disease. This is when the immune system attacks its own body. Pregnancy and reproduction in general can be affected by the unbalanced immune system, either under- or overactivity.

How the immune system is important in pregnancy implantation?

The placenta is an organ that starts forming within the uterus and grows with the pregnancy. The placenta provides adequate blood supply to the fetus (baby). Once the pregnancy starts implanting inside the uterus, the immune cells will play an important role in formation of the blood vessels feeding the fetus. A few of these immune cells include:

  • Natural killer cells
  • Dendritic cells
  • Macrophages
  • Mast cells

Unhealthy or lacking immune cells can negatively impact the growth of the fetus during pregnancy.

The fetus is considered half foreign for a women’s body. While it has 50% of its genetics from the mother, the other half is from the father. It’s very important for the pregnant woman’s immune system to maintaining tolerance to the fetus rather than rejecting the fetus. Other immune cells such as T-cells will play an important role in immune tolerance.

How can the immune system become an enemy?

Research showed that increased activity of those immune cells or absence of immune tolerance may lead to abnormal immune response. This can impact the implantation and pregnancy overall. Those women can have immune system abnormalities such as:

  • Overactive natural killer cells
  • Elevated T-helper 1 / T-helper 2 cytokines ratio
  • Autoimmune antibodies

A thorough medical investigation is important to identify the underlying problem(s).

How to treat this problem if immune abnormalities found?

Immune medications can be used to fine-tune the immune system. Some of these medications may include:

  • Prednisone
  • Plaquenil
  • Tacrolimus
  • IVIG

These medications can help make sure appropriate implantation occurs without any negative impact on the blood flow to the fetus.