Psychological distress and postponed fertility care during the COVID-19 pandemic

Lawson, Angela K.; McQueen, Dana B.; Swanson, Amelia; Confino, Rafael; Feinberg, Eve C.; Pavone, Mary Ellen

doi:10.1007/s10815-020-02023-x

Cited by 54 publications

(73 citation statements)

References 24 publications

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“…Overall, approximately 1 in 3 participants reported a change in fertility preference because of the pandemic, among which the majority reported that they were now TTC later than previously intended. This finding is consistent with other recent studies reporting that approximately a third of their respondents had altered their fertility preference, mostly abandoning or pushing back TTC ( 8 , 9 ).…”

Section: Discussionsupporting

confidence: 93%

“…[ 16 ]), whereas increased social support from family and friends is positively associated with fertility intention ( 17 ). Qualitative studies also have found higher anxiety in general, specifically about financial issues, and these issues decrease people’s desire for more children ( 18 ), and changes in fertility treatment are correlated with both anxiety and depressive symptoms ( 8 ).…”

Section: Methodsmentioning

confidence: 99%

“…However, people who were TTC before the pandemic may already have begun altering their lifestyle, health behaviors, and finances, and seeking medical care to prepare for the future child. Thus, the impact of the COVID-19 pandemic on fertility preferences may have been heightened further among those who were TTC ( 8 ). Identifying disparities in this group is especially important so that the clinical providers can be aware of those who may need extra support and care on their “TTC journey” during the pandemic.…”

mentioning

confidence: 99%

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Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

Naya

Saxbe

Dunton

2021

Fertility and Sterility

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Objective To explore early disparate impacts of the COVID-19 pandemic on fertility preferences Design Cross-sectional study Setting Online survey questionnaire Patient(s) A total of 440 female participants who were trying to conceive (TTC) in the past year or currently are TTC. Intervention(s) No interventions administered. Main Outcome Measure(s) Change in fertility preference Result(s) Approximately 1 in 3 participants reported changing their fertility preferences because of the COVID-19 pandemic. Of those that reported changing their fertility preferences, 23.9% reported TTC earlier and 61.6% reported TTC later. Preliminary findings show the odds of changing fertility preferences in black or African American women were 5.45 (95% confidence interval [CI], 1.50–19.90) times that of white women and in nonheterosexual women were 2.76 (95% CI, 1.41–5.42) times that of heterosexual women. Furthermore, every 1 unit increase in state anxiety and depressive symptoms was associated with a 26% (95% CI, 3%–54%) or 17% (95% CI, 5%–31%) increase in odds of pushing back TTC, respectively. Conclusion(s) This exploratory study highlights how the fertility preferences of racial and ethnic minorities, sexual minorities, and those experiencing mental health issues may be disparately influenced by the pandemic. Research is needed to examine further the disparate effect of the COVID-19 pandemic on fertility preferences.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

Naya

Saxbe

Dunton

2021

Fertility and Sterility

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“…In another study conducted in 627 Italian infertile couples who were candidates for assisted reproduction treatments, confinement had produced a moderate/severe psychological impact, with these women reporting higher levels of anxiety and depression (33). Studies carried out during the pandemic on infertile women from other countries, such as the US (55,56), Turkey (57), the United Kingdom (58), or Canada (59) also showed results consistent with an increase in anxiety and depression. When the reproductive service was reopened, we observed a significant decrease in the overall HADS questionnaire score.…”

Section: Discussionmentioning

confidence: 96%

Impact of the COVID-19 Pandemic on the Lifestyles and Quality of Life of Women With Fertility Problems: A Cross-Sectional Study

Biviá-Roig

Boldó-Roda²,

Blasco-Sanz³

et al. 2021

Front. Public Health

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Background: The COVID-19 pandemic has implied worldwide the imposition of confinement measures and mobility restrictions, to a greater or lesser extent. It has also meant the closure of some public medical services such as reproductive care. This situation may have impacted the health-related behaviour and quality of life of women with fertility problems.Objective: The objective of this study was to analyse the effects of confinement and the suspension of reproductive medical care on the lifestyle (diet, physical exercise, and smoking habits), anxiety and depression, and quality of life of infertile women by comparing their pre- and post-confinement situations.Methods: We carried out a cross-sectional, internet-based study. Information was collected on these women's adherence to the Mediterranean diet (MEDAS questionnaire), physical exercise (IPAQ-SF), anxiety and depression (HADS), and quality of life related to fertility (FertiQol) before, during, and after confinement. The survey was conducted between 1 September and 28 October 2020.Results: A total of 85 women participated. There had been a significant increase in anxiety and depression levels (P < 0.001) and an increase in tobacco consumption among female smokers during confinement vs. pre-confinement (62.5% had increased their consumption). The participants had also increased the mean number of hours they spent sitting (P < 0.001). There had also been an increase in vigorous and moderate exercise levels by 40 and 30%, respectively (P = 0.004). However, no differences were observed in these patients' eating habits as a result of confinement (P = 0.416). When the reproduction service was resumed, the participants showed higher anxiety level scores (P = 0.001) with respect to the pre-confinement situation as well as lower mean FertiQol scale score (P = 0.008).Conclusions: Confinement had increased anxiety and depression levels among these infertile women as well as tobacco use among the participants who were smokers. The prolonged closure of reproductive care units decreased the quality of life of the participants of this study. These results suggest the need to implement online programs to improve healthy habits and quality of life of this population group.

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“…Further, patients have often faced a significant duration of infertility prior to pursuing treatment [6]. As a result, further delay for any reason and uncertainty of when cycles would resume causes anxiety and distress for all involved [7,8]. Finally, from a clinic management standpoint, IVF clinics are high overhead enterprises, and cessation of IVF treatment put many IVF programs in financial distress, as revenue slowed and practice owners were forced to furlough staff and potentially close their practices all together [9].…”

Section: Introductionmentioning

confidence: 99%

We are here for you: infertility clinic communication during the first wave of the COVID-19 pandemic

Mehr

Jackson-Bey

et al. 2021

J Assist Reprod Genet

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Purpose To study how SART-member fertility clinics communicated via clinic websites during the first wave of the COVID-19 pandemic following publication of ASRM COVID-19 Task Force recommendations. Methods SART-member fertility clinic websites were systematically surveyed for the presence of an REI-specific COVID-19 message (REI-CM) and analyzed for their adherence to ASRM guidance. Results Of the 381 active clinic websites, 249 (65.3%) had REI-specific COVID messaging. The presence of REI-CM was more common in private than in academic practices (73% vs 38%, p < 0.001) and with increasing practice volume: 38% of clinics with < 200 annual cycles vs 91% of clinics with > 1000 cycles ( p < 0.001). Adherence to ASRM guidance was more common in academic than in private practices (54% vs 31%, p = 0.02). Additionally, 9% of REI-CM ( n = 23) announced continued treatment regardless of a patient’s clinical urgency. This messaging was more common in groups doing > 1000 cycles a year (18%, p = 0.009) . Clinics treating all-comers were less likely to cite ASRM than other clinics (41% vs 62%, p = 0.045). However, 75% ( n = 14) cited COVID-19 guidance from WHO, CDC, and state and local governments. Conclusions Clinic response to ASRM recommendations during the first wave of COVID-19 pandemic was heterogeneous. Although academic practices were more likely to follow ASRM guidance, there was a lower extent of patient-facing messaging among academic practices than private clinics. In event of further escalations of this and future pandemics, clinics can learn from experiences to provide clear messaging to patients.

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Psychological distress and postponed fertility care during the COVID-19 pandemic

Cited by 54 publications

References 24 publications

Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

Impact of the COVID-19 Pandemic on the Lifestyles and Quality of Life of Women With Fertility Problems: A Cross-Sectional Study

We are here for you: infertility clinic communication during the first wave of the COVID-19 pandemic

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