Live Birth Following a Two-Way Transport In Vitro Fertilization Using a Portable Incubator: A Novel Protocol Executed During the COVID-19 Pandemic.

ABSTRACT

This case presents a live birth of a complete "two-way transport IVF" using a portable incubator during the COVID-19 pandemic, allowing the patient to undergo both oocyte collection and embryo transfer in a satellite office located 30 miles, 2-h drive, away from the central IVF laboratory. A 30-year-old patient who lives on Long Island NY, with a history of unexplained infertility and previously failed intra-uterine inseminations (IUI), had a telehealth consultation for IVF. Because of the high prevalence of the COVID-19 virus in Manhattan-NYC where the central IVF laboratory is located, the patient was consented to undergo a two-way transport IVF. She was initiated on a controlled ovarian superovulation protocol, after which follicular aspiration of 11 large follicles was performed in a regular examination room, under local vaginal anesthesia at the satellite office. The follicular fluid aspirates were collected in the usual tubes which were immediately sealed and placed inside a portable incubator. The sperm sample was also produced at the satellite location, washed, and placed in the same incubator. The aspirate tubes and the washed sperm were shipped immediately to the central laboratory. A total of ten oocytes were retrieved, out of which six were mature, leading to three good-quality blastocysts that were cryopreserved. The following month, the patient was prepared for a frozen embryo transfer (FET) cycle at the satellite location. On the day of the FET, two blastocysts were thawed and loaded in a transfer catheter in the central IVF laboratory. The catheter containing the embryos was shipped to the satellite location by an experienced embryologist using the portable incubator. The FET was performed in the same initial examination room. A singleton smooth pregnancy resulted from the FET, leading to the delivery of a healthy baby at term. This novel approach, learned during the pandemic, was able to alleviate the psychological, physical, and financial burdens on the patient, while also carrying the potential to reduce the costs of setting up an IVF laboratory, lowering prices and making IVF available to a larger portion of the population, especially when staffing IVF laboratories could be a major hurdle.