Anxiety Level During the Second Localized COVID-19 Pandemic Among Quarantined Infertile Women: A Cross-Sectional Survey in China

Abstract

Infertility usually causes mental health problems for patients and unfavorable emotions such as anxiety and depression can have an adverse effect on women's normal pregnancy. We aimed to compare the anxiety level between infertile female patients in quarantined and non-quarantined areas during the second wave of COVID-19 epidemic. A total of 759 infertile women were included in this cross-sectional study conducted through an online survey. Anxiety was measured by the State-Trait Anxiety Inventory (STAI) tool. Participants were divided into the quarantined group (QG) and non-quarantined group (Non-QG). Independent sample T-test and chi-square test were performed to examine the difference between the two groups. There was no significant difference in the average STAI score of the two groups of infertile women, but responses to the emotional state showed that women in the QG had a higher tendency to be anxious. Participants in QG spent more time paying attention to the dynamics of the epidemic every day, and their sleep (p < 0.01) and mood conditions were worse (p < 0.01) than in the Non-QG. The family relationship of QG is more tense than non-QG. Through the research on the infertility treatment information of the overall research population, it is found the average STAI-State (STAI-S) (p = 0.031) score and STAI-Trait (STAI-T) (p = 0.005) score of women who were infertile for more than 3 years were significantly higher than those of women with <2 years. The STAI-T score of infertile women who underwent in vitro fertilization (IVF) was higher than that of non-IVF women (p = 0.007), but no significant difference was observed with the STAI-S score. To conclude, although the second wave of quarantine during COVID-19 epidemic did not significantly increase anxiety in infertile women, it did lead to an increase in other negative emotions and worse family relationships. Patients with long-term infertility treatment and those who have had IVF are more anxious subgroups.

Impact of COVID-19 on mental health of infertile couple

“…Anxiety scores were higher in women who underwent IVF than in women who did not undergo IVF ( P = 0.007). [ 26 ] The effects of cancellation of the couple's infertility treatment cycle were observed in the form of mood disorders, anxiety, sleep disorders, and depressive symptoms. [ 27 ] The mental health scores of participants in the COVID-19 disease control period were lower than those in the outbreak period.…”

“…[ 12 24 ] Furthermore, infertile couples think that they themselves have no control over the infertility treatment process and this is emotionally damaging them, they will feel helpless if treatment is suspended, which is directly related to depression and anxiety. [ 24 26 ] Women who had been trying to conceive for a longer time reported a greater negative mental health effect of treatment suspensions. [ 12 ]…”

Psychological status of infertile men during the Coronavirus Disease 2019 Pandemic in China: a cross-sectional investigation

“…To the best of our knowledge, numerous studies have examined women with infertility (Table 3 ). Ceasing infertility treatment was the primary problem affecting patients [ 27 , 41 , 42 ], while changes in working environment and style [ 43 ], quarantine [ 44 ], and financial concerns [ 45 ] increase the psychological burden of patients. Negative emotions were found to reduce the quality of couples’ relationships [ 28 ] and lower expectations of future pregnancy [ 46 ] during the pandemic.…”

Evaluation of depression, stress, and anxiety among women with subfertility during the COVID‐19 pandemic: A cross‐sectional study in Ahvaz, Iran

“…However, it is clear that subfertile women have more depression and anxiety, and this may negatively affect their conception 20 . Cao et al 9 reported that women who were in the home quarantine had more anxiety, and women with a longer infertility duration were more likely to have anxiety.…”

“…For example, Lablanche et al 8 found that during the COVID‐19 pandemic, subfertile women had more perceived stress compared to anxiety and depression (27 ± 6.75 vs. 7.58 ± 3.85 and 4.51 ± 3.48, respectively). Also, Cao et al 9 reported that the rate of anxiety among women who were in home quarantine was significantly more than that in subfertile women without home quarantine. Another study revealed that the infertility treatment of most subfertile women was stopped or postponed during COVID‐19 pandemic and this may be the cause for stress and anxiety, especially among older patients (older than 35 years old) 10 .…”