Patients’ views of delayed fertility care during the COVID-19 pandemic as a conception catastrophe: the experience of U.S. FertilityIQ users

Venkatesh, Anu; Boots, Christina E.; Anderson, J.; Anderson, Deborah J.; Citro, Lauren; Lawson, Angela K.

doi:10.1080/0167482x.2021.2011855

Cited by 1 publication

(5 citation statements)

References 14 publications

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“…A survey of US women who were planning or undergoing fertility treatment during the beginning of the pandemic showed a large negative emotional impact of the interruption of the reproductive services, predominantly among women of advanced age and those with diminished ovarian reserve. 14 Similar emotional distress was observed among individuals and couples dealing with infertility in other countries. 15 , 16 , 17 , 18 , 19 , 20 Irrespective of ART use, women may have chosen to postpone conception and childbirth due to pandemic‐related uncertainty and financial instability, lack of support from family members due to travel restrictions, and anxiety about the unknown, potentially harmful effects of SARS‐CoV‐2 infection.…”

Section: Introductionmentioning

confidence: 57%

“…A survey of US women showed that only 12.7% of women (or couples) had continued with their infertility treatment during the early pandemic. 14 It is possible that women who continued the ART treatment may have had specific conditions that contributed to the urgency to proceed with the treatment, but also increased the risk of stillbirth (e.g., advanced age). It is also possible that the limited post‐conception follow‐up visits and access to obstetric services contributed to the increased risk of stillbirth among these women.…”

Section: Discussionmentioning

confidence: 99%

“…There is a need for national guidelines establishing measures that fertility clinics should take to prepare for future pandemics, as the emotional toll on individuals and couples with infertility is significant, 14 , 15 , 16 , 17 , 18 , 19 , 20 and delays in fertility treatment can lower the success rate in older women and those with diminished ovarian reserve. On the other hand, the characteristics of the pandemic‐causing pathogen are typically unknown in the early pandemic period and potential risks to pregnant women and their offspring have to be balanced with the risks associated with the delay in fertility treatments.…”

Section: Discussionmentioning

confidence: 99%

“…It is difficult to estimate what proportion of ART clinics followed the ASRM guidelines as compliance is not compulsory. A survey of US women showed that only 12.7% of women (or couples) had continued with their infertility treatment during the early pandemic 14 . It is possible that women who continued the ART treatment may have had specific conditions that contributed to the urgency to proceed with the treatment, but also increased the risk of stillbirth (e.g., advanced age).…”

Section: Discussionmentioning

confidence: 99%

“…This study further showed that changes occurred in all age groups, although lower utilisation rates and slower recovery rates of infertility care were observed among women aged 40 years and older. A survey of US women who were planning or undergoing fertility treatment during the beginning of the pandemic showed a large negative emotional impact of the interruption of the reproductive services, predominantly among women of advanced age and those with diminished ovarian reserve 14 . Similar emotional distress was observed among individuals and couples dealing with infertility in other countries 15–20 .…”

Section: Introductionmentioning

confidence: 93%

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Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth

Lisonkova

Bone

Muraca

et al. 2022

Paediatric Perinatal Epid

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Background The initial COVID‐19 pandemic response−related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre‐pandemic period, have been understudied. Objectives To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART‐conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period. Methods Population‐based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015–2019. Results Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART‐conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART‐conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non‐ART group. Maternal characteristics of women who conceived in the early pandemic versus pre‐pandemic period differed and included an increased prevalence of pre‐pregnancy obesity class 3 and chronic hypertension. Conclusions The early pandemic closure of ART clinics resulted in a substantial decline in ART‐conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART‐conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.

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