Evaluation of attitude among infertile couples about continuing assisted reproductive technologies therapy during novel coronavirus outbreak

Abstract

Study question: Does the fear of the coronavirus disease 2019 (COVID-19) pandemic reduce the desire of infertile couples to continue treatment? Summary answer: Most of the participants in this study wanted to continue treatment. What is known already: The effect of the prevalence of infectious diseases including the Zika virus on the attitude of infertile couples has been studied in very few studies. However, the effect of the outbreak of COVID-19 on the attitude of infertile couples has not been investigated. Study design, size, duration: We conducted a prospective longitudinal study on forty-six infertile couples (n=92) who referred to our infertility clinic from 4 March 2020 through 20 June 2020. Participants/materials, settings, methods: This study is based on potential infertile couples for treatment with assisted reproductive technology (ART) who referred to our infertility clinic, Sari, Iran (median age of 35.5 years). All individuals with primary infertility, as defined by the World Health Organization (WHO) and candidates for ART, were included in the study. People who did not agree to participate in the study were excluded. Subjects were surveyed using a researcher-made questionnaire. This questionnaire has four sections as follows: The first part included demographic information and clinical characteristics, the second part included medical records, the third part included questions related to assessing the level of awareness regarding coronavirus infection, and the fourth part included questions related to the attitude towards continuing infertility treatment. The validity of this questionnaire was assessed by three infertility specialists and was confirmed with Cronbachs alpha of 0.78. A P-value of less than 0.05 was considered statistically significant. Main results and the role of chance: There is no significant relationship between COVID-19 symptoms and the level of awareness (P-value <0.05). Thirty-two patients (33.33%) had decreased motivation to continue treatment during COVID-19 pandemic. Fear of transmission to the fetus (28.13%) had the highest frequency among the causes of decreased motivation to continue treatment (P-value = 0.011). Confidence in support of the treatment team (56.67%) was the most common reason for lack of motivation in people without decreased motivation (P-value <0.001). The majority of patients had a very high or high tendency (65.22%) to continue or start treatment during the COVID-19 pandemic (P-value <0.001). Most people had an average fear of getting the disease (39.13%) (value <0.001). Examining the relationship between the presence of COVID-19 symptoms and attitude level variables showed that there is only a significant relationship between the greater desire to have a child and the continuation or initiation of treatment with the presence of COVID-19 symptoms (P-value = 0.032). Limitations, reasons for caution: We were not able to fully assess patients' deep feelings and cultural beliefs, due to the use of questionnaires and the lack of interviews. Wider implications of the findings: Our results showed for the first time that patients' knowledge about COVID-19 and trust in the treatment staff played an effective role in selecting and continuing infertility treatment. To clarify this issue, studies with the larger statistical community in the form of interviews are needed. Study funding/completing interest(s): The study received financial support from the Mazandaran University of Medical Sciences (Grant number: 7903). None of the funders had any role in the study design, collection, analysis, or interpretation of data, writing of the paper, or publication decisions. The authors have nothing to declare. Trial registration number: N/A

Impact of COVID-19 on mental health of infertile couple: A rapid systematic review

“…So that women who were well aware of COVID 19, this decrease in desire and interest was observed in them less. [ 32 ] Furthermore, to prevent the spread of coronavirus, childbirth preparation classes, which have played an important role in raise awareness and reducing the fears and anxieties of pregnant mothers, are not held. [ 31 ]…”

“…[ 22 30 ] On the other hand, studies have shown that depression in men reduces the volume and quality of sperm, which exacerbates the problems of infertile couples. [ 32 ]…”

The Effect of Coronavirus Disease 2019 on Reproduction System and Fertility

“…However, recently, with mitigation strategies that have worked in several areas and the presence of additional data, as well as resistance to this policy, infertility therapy has resumed. ASRM, ESHRE, and International Federation of Fertility Societies have come asserted the importance of serial reproductive care during the COVID-19 pandemic [20], [23], [24], [25].…”