TO TREAT OR NOT TO TREAT: PERCEPTIONS OF THE INITIAL AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE COVID-19 RECOMMENDATIONS AMONG WOMEN'S HEALTH PROVIDERS

Objective: On March 17, 2020 ASRM published “Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic” a statement for clinical management of infertility care based on the anticipated burden of COVID-19 at that time Receptivity of these initial recommendations has varied across the media, patients, and women’s health providers Our objective is to evaluate the perception of the initial ASRM COVID-19 associated recommendations held by women’s health providers Design: Cross-sectional study Materials and Methods: After IRB exemption was obtained, an electronic survey was sent to all women’s health providers, including physicians, mid-level providers and nurses, in all subspecialties of obstetrics and gynecology at a single large academic center All data is being collected anonymously and stored in a REDCap database Preliminary analysis was done with REDCap to be followed by further statistical analysis once data collection is complete RESULTS:Of the 278 eligible providers, the survey response rate is 40% (n=112), representing 8 OB/GYN sub-specialties and all categories of providers The majority of respondents are female (81%) and ≤40 years of age (67%) Most providers view infertility treatment as elective, specifically defined as not a medical necessity (44%) Of the 29% of providers who reported provision of infertility care, 69% reported practice changes between March 16- 31and another 19% initiated practice changes after March 31st Six percent of the surveyed providers continued all fertility treatment in the same manner as before the pandemic;15% cancelled all fertility treatment immediately, 33% completed treatment for patients currently in cycle but cancelled new cycle starts and 30% continued some treatment on case-by case basis Safety concerns for the practice (94%), shared decision making with patients (84%), and ASRM guidance (69%) were amongst the most important factors to impact continuation of fertility treatment After reviewing a summary of initial ASRM recommendations provided within the survey, 67% of all participants viewed the recommendations as fair, and 71% as reasonable Most (43%) agreed that ASRM recommendations should be enforced for all patients despite patient opinion Sixty-six percent agreed that some degree of infertility treatment should be allowed currently, however the least supported treatment type was in vitro fertilization (32%) Regardless of infertility diagnosis, 70% did not feel that women should refrain from planned conception during the pandemic Conclusions: Considering the immediate and long term impact of the COVID-19 pandemic on fertility care delivery, a better understanding of perceptions regarding infertility management during this time is important In doing so, we must consider the full spectrum of women’s health providers Our study shows overall support for the initial ASRM recommendations from women’s health providers within our institution We intend to use the methods used for this study to conduct a larger assessment of women’s health providers nationwide