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It Takes a Team: Preparing for Natural Disaster at a Fertility Clinic
November 2, 2012
Hurricane Sandy shook the east coast Monday, devastating the geography of the Jersey Shore, flooding lower Manhattan and the basins of local rivers, and taking pieces of our lives with her. Amongst the turmoil, fertility clinics opened their doors, their doctors and staff risking their own lives to give patients a shot at parenthood. While we make emergency preparations at home, fertility clinics prepare for storms in a very different way.
Fertility clinics typically rely on generators as backup power in instances of local power outages. Susan Treiser, M.D., Ph.D., of IVF New Jersey says “All fertility centers have generators for backup power. This is important as embryos that are in incubators during fresh cycles do need power to maintain the appropriate temperatures and environment. Satellite offices assess their ability to stay open during a storm. If the satellite offices must close, the main office absorbs the patient load as it is fully operable on generator power.
The staff stays in close contact with patients when inclement weather is anticipated. They bring home schedules for several days in advance and front office staff provides updates on delays and rescheduled appointments. Some clinics, like Treiser’s use social media as another outlet for updating their patients. “We try to keep our patients updated with posts on our website and Facebook page”, she says.
Treatment team staff makes overnight accommodations at local hotels, usually provided by their employer, to ensure they can arrive safely and on time for the next day’s procedures. Miguel Damien, M.D. of Damien Fertility Partners says, “It is important that our patient care team is close to the office so that we can be available daily to our patients. Our patients need monitoring either daily or every few days unlike other types of medical practices. Our IUIs, retrievals and transfers are time dependent”. Inclement weather causes unpredictable travel conditions. It is much safer for staff to stay nearby than to navigate the roads. Damien continues, “During Hurricane Sandy, we had trouble finding open gas stations, so staying closer to the office and carpooling allowed us to maintain our staffing and conserve gas”.
Should the power go out and generator become inoperable, emergency cryopreservation via vitrification can be performed to preserve egg and embryo viability until a later date when whether and power is stable. This procedure provides a rapid freeze for the sensitive eggs and embryos that would otherwise perish without incubation. Typically, the lab will maintain eggs and embryos at a temperature akin to that of the mother’s uterus. Lower temperatures risk the likelihood of the cycle-a tremendous concern for fertility providers and patients alike. “Once frozen, they can last for years and do not need power to maintain the liquid nitrogen tanks. Clinics always do what is safest and in the best interest of the patients and embryos”, says Treiser.
Despite the precautions taken by the clinic, patients should make preparations of their own. Something as simple as ordering medication in advance can be overlooked, but is critical if shipping companies are unable to deliver during a storm. Local pharmacies may not carry the type or quantity of medication required. Patients should also ensure proper refrigeration of medications if the power does go out.
Another consideration might be to stay overnight in a hotel near the fertility clinic. Treiser explains, “Retrievals are very time sensitive and cannot simply be rescheduled for another day or several hours later. Once a patient receives her trigger shot she must have her retrieval of eggs within 36-37 hours at most. If this does not occur, ovulation and release of the eggs from the follicles may occur and therefore nothing left for retrieval”.
Both Damien and Treiser have seen their fair share of unforeseen situations. Dr. Damien recalls a fire that erupted during an embryo transfer, while Dr. Treiser remembers a time she has personally driven a patient to their procedures. “The important thing is to prepare in advance for potential emergency situations”, Damien says.