COVID-19 is a rapidly evolving pandemic. At this time, still little is known about COVID-19, particularly related to its effect on pregnant patients. The currently available data on COVID-19 does not indicate that pregnant patients are at increased risk. However, pregnant patients are more susceptible to and at greater risk of morbidity and mortality from other respiratory infections such as influenza and SARS-CoV. In addition, prior data suggest that some febrile illnesses on pregnancy may be associated with an increased risk of birth defects, miscarriage, stillbirth and preterm birth.
Adverse infant outcomes (e.g., preterm birth, miscarriage, intrauterine fetal demise) have been reported among infants born to patients positive for COVID-19 during pregnancy. However, this information is based on limited data and it is not clear whether these outcomes were related to pregnant patient infection or not. In a limited recent case, series of infants born to patient infected with COVID-19 published in peer reviewed literature, none of the infants have tested positive for COVID-19. Some of the medications used to treat COVID-19 may be contraindicated in pregnancy.
By signing below, I/we agree to the following statements:
1. At the present time, Fertility and Endocrine Associates and/or Louisville Reproductive Center do not offer routine testing for COVID-19.
2. If I/We are directly exposed, infected or diagnosed with COVID-19, or have symptoms with any febrile illness or have flu like symptoms which could possibly be COVID-19 (even in the absence of a positive COVID-19 test), my treatment cycle will be cancelled.
3. My/Our treatment cycle may be cancelled if Fertility and Endocrine Associates and/or Louisville Reproductive Center are not able to support treatment as a result of lack of essential staff or supply shortages.
4. My/Our treatment cycle may be cancelled if there is a change in regulations at the local, state or federal level such as an edict to stop providing services or procedures or if Fertility and Endocrine Associates and/or Louisville Reproductive Center are required to shut down.
5. I/We may become exposed to COVID-19 prior to or while receiving treatment at Fertility and Endocrine Associates and Louisville Reproductive Center.
6. The risk of COVID-19 on pregnancy, if any, are unknown but could include, but are not limited to, birth defects, miscarriage, stillbirth or preterm birth.
7. My/Our treatment cycle may be cancelled if, during treatment, new data arises that mandates cancellation of treatment for the safety of me or my future pregnancy.
If the cycle is cancelled for any reason, including but not limited to the statements above, this may affect My/Our insurance benefits. I/We will be financially responsible for any services performed up to cancellation, including any medication expenses incurred. Fertility and Endocrine Associates and/or Louisville Reproductive Center will only credit or refund fees for services not rendered.
I/We have discussed the implications of COVID-19 with my provider, have had the opportunity to ask questions and have them answered to my/our satisfaction. I understand that information regarding COVID-19 and the medical community’s understanding of this disease is rapidly evolving and that risks may come to light of which I/We were not presently aware
