Ob/Gyn Dispatches During COVID-19: Paula Brady, MD

Each day during the COVID-19 pandemic, we'll share an update from a member of our team in the Department of Obstetrics and Gynecology at Columbia University Irving Medical Center. Today's note is from Paula Brady, MD, Director of Oncofertility at Columbia University Fertility Center and Assistant Professor of Ob/Gyn at NYP/CUIMC.

“as my last chances to bear a child / are falling through my body” – Sharon Olds, 35/10

Those last chances, those last eggs, keep reproductive endocrinologists up at night. And we have had many sleepless nights during the COVID-19 pandemic.

In mid-March, like the vast majority of area in vitro fertilization (IVF) programs, our center wrapped up ongoing fertility treatment cycles and put a hold on new ones. As director of oncofertility at Columbia Fertility, I was able to continue emergency fertility preservation cycles for patients newly diagnosed with cancer at the height of the pandemic. These young women, with rare and aggressive tumors, had one chance to freeze eggs before urgent fertility-threatening cancer treatment. Columbia Fertility was committed to accommodating this care, and I was grateful to stay busy on that mission.

But for the vast majority of our patients, all fertility diagnostics and treatments were delayed indefinitely. As March turned into April, I worried that for some patients, this delay — any delay — might prove to be too long. For women with severe “diminished ovarian reserve,” reproductive longevity may be measured in months, not years.

By mid-April, however, after enacting extensive procedural and infection-control measures (including universal COVID-19 screening before initiating IVF or egg freezing), our center has cautiously resumed treatment cycles, beginning with these very patients. Patients are immensely grateful, and many have said that the opportunity to restart treatment has been a point of light in a dark time.

Life will not be normal for a long time, if ever. But Columbia Fertility is negotiating a new normal, with urgency and a shared mission with our patients. The pandemic, while physically separating many families, have also brought many together — and redoubled many women and couples’ commitment to growing their families. For some, it is “now or never,” and for most, “now more than ever.” And it is with enormous relief – our patients’ and our own – that we can move forward.

Paula Brady, MD