Suspension of fertility treatment during the COVID-19 pandemic: views, emotional reactions and psychological distress among women undergoing fertility treatment
Abstract:Research question: What are the patients' views and emotional reactions towards fertility treatment suspension during the COVID-19 pandemic as well as the factors affecting their psychological distress? Design: A cross-sectional study conducted in an academic fertility center. Online questionnaires were distributed between April 18 th to April 23 rd 2020 to patients whose treatment cycle had been postponed or discontinued. The outcome measures included (a) Agreement with the reproductive society guidelines to … Show more
“…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.…”
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.
“…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.…”
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.
“…The sudden outbreak disrupted the normal medical treatment plan of infertility patients. Suspension of fertility treatment during the pandemic was taxing and as a result, negative emotional reactions were triggered ( 17 , 18 ). For infertile patients, repeated treatment failures and long-term treatments can bring about psychological problems such as anxiety, especially for patients who have been identified as the infertility caused by female causes, they will experience more serious anxiety levels ( 19 , 20 ).…”
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.
“…While most studies on reproductive care during the COVID-19 pandemic focused on patient well-being, [5] , [6] , [7] our study is the first to quantify the effect of the pandemic on availability of fertility services. The key findings of our study demonstrate that there was a modest reduction in delivered fertility services or procedures (IUI/DI -10.3%, IVF/ICSI -31.0%, and FET -39.4%) attributable to the COVID-19 pandemic.…”
Section: Discussionmentioning
confidence: 99%
“…Omission of holiday closures to compensate for expected losses started the new year at an advantage. From a patient perspective, the literature suggests there was a high degree of patient anxiety regarding cycle cancellation, [5] , [6] , [7] and this may explain increased volumes on reopening. Figure 3 Ishikawa diagram enumerating factors that contributed to improved procedural efficiencies in the first quarter of 2021.…”
Section: Discussionmentioning
confidence: 99%
“…The effect of centre closures on the patient experience has been well documented. [5] , [6] , [7] However, the impact of these closures as well as adapted reopenings on procedural volume and efficiency have yet to be examined.…”
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