Fertility treatment delays during COVID-19: Profiles, feelings and concerns of impacted patients

Gürtin, Zeynep B.; Jasmin, Ephia; Silva, Philomena Da; Dennehy, Carmel; Harper, Joyce; Kanjani, Shirin

doi:10.1016/j.rbms.2021.12.004

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…In addition, fertility treatments are known to be physically and financially challenging and cause a significant psychological burden on patients. The COVID-19 pandemic, as well as the pandemic-related increased waiting time to start fertility treatment, has caused further anxiety, stress and sorrow among infertility patients ( Boivin et al , 2020 ; Esposito et al , 2020 ; Kaur et al , 2020 ; Rosielle et al , 2021 ; Barra et al , 2022 ; Gurtin et al , 2022 ). Especially the uncertainty regarding how long ART treatments would be suspended, how the pandemic would evolve, and how it would affect fertility treatment and pregnancy increased the psychological toll on patients.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2, fertility and assisted reproduction

Ata

Vermeulen

Mocanu

et al. 2022

Human Reproduction Update

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BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on ‘SARS-CoV-2’ and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients’ performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.

show abstract

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2, fertility and assisted reproduction

Ata

Vermeulen

Mocanu

et al. 2022

Human Reproduction Update

View full text Add to dashboard Cite

show abstract

“…To date, evidence confirms that implementing good practices in lifestyle significantly reduces fertility problems, improves pregnancy outcomes, and generally provides for a good state of health throughout life [ 14 , 15 ]. On the other hand, the COVID-19 pandemic affected personal freedom, led to uncertainty about ART procedures, and also had a negative impact on the psychological sphere and lifestyle [ 10 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on Women’s Health and Obstetric Outcomes after Assisted Reproduction: A Survey from an Italian Fertility Center

Cirillo

Basile

Mazzoli

et al. 2023

JPM

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Background: the restrictive measures that were adopted during three waves of the COVID-19 pandemic had an impact on both the emotional state and lifestyle of the general population. We evaluated the impact of COVID-19 pandemic on lifestyles and emotional states of women planning assisted reproductive technology (ART), and whether these changes affected ART outcomes. Methods: quantitative research, using a web-based survey, was performed on 289 Caucasian women. Results: In preconception, we observed higher percentage of women with positive obstetric outcomes who reduced body weight (52.4% vs. 27.2%, p = 0.09). Over 60% of women with positive outcomes practiced physical activity vs. 47% of women with negative outcomes (p = 0.03), as well as having better quality of sleep (45% vs. 35%), and a more solid relationships with their partners (65.1% vs. 51.7%, p = 0.03). Women who increased their intake of whole grains, fruits, vegetables, and legumes (p < 0.05), according to the Mediterranean diet, showed positive outcomes. We observed that participants who experienced “very much” or “extreme” anxiety, sadness, and fear (p < 0.05) during pandemic were clearly more numerous in the group with negative pregnancy outcomes. Conclusions: healthy lifestyle together with a positive emotional state in preconception can positively influence the obstetric outcomes after ART.

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“…The quality and quantity of sperm and its motility are reduced. This is of course not absolute but depends on the severity of the disease and its duration [35][36][37]. The results of researches investigating the psychological impact of the COVID-19 pandemic on infertility patients showed that during global pandemic of COVID-19, causing economic and societal uncertainty, the stress of infertility remains significant and is a comparable stressor to the pandemic itself.…”

Section: Introductionmentioning

confidence: 99%

Basic Social and Psychοlogical Determinants of Infertile Couples Health in Greece during the COVID-19 Pandemic

2023

Gynecol Obstet Open Acc

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Introduction: COVID-19 as an illness and a pandemic has had important repercussions at the individual, family, and social levels. We aimed to investigate basic social and psychological determinants of health in infertile couples in Greece during the Covid-19 pandemic such as the fear of Covid, the social relationships and the social support. Methods:The survey was conducted in a Greek private Fertility Center in Heraklion of Crete from April of 2022 to May 2022 after institutional ethics approval. A total of 75 infertile persons (men and women) participated in the study. Data were obtained through a questionnaire with socio-demographic characteristics of infertile couples, a Covid-19 fear assessment questionnaire (FCV-19 Scale) and one aimed at approximating participants' social relationships and social support during the Covid-19 pandemic. Results:The research showed that the more a) the social difficulties that an infertile person may face in trying to communicate and the b) the lack of support for his problem, the greater the fear of Covid-19. At the same time, the endurance of the social relations that he maintained until then, either with his family of with his friendly environment is decreasing. In addition, when the resilience of social relationships is strengthened, the fear of the virus is reduced, communication with other people is improved and the lack of support for the health problem in the infertile woman is reduced. Conclusion:That fear of Covid-19, the social relationships and the social support constitute basic determinants of infertile couple's health affecting their physical, mental and social health and finally their decision to obtain a child.

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Fertility treatment delays during COVID-19: Profiles, feelings and concerns of impacted patients

Cited by 10 publications

References 19 publications

SARS-CoV-2, fertility and assisted reproduction

SARS-CoV-2, fertility and assisted reproduction

Impact of COVID-19 Pandemic on Women’s Health and Obstetric Outcomes after Assisted Reproduction: A Survey from an Italian Fertility Center

Basic Social and Psychοlogical Determinants of Infertile Couples Health in Greece during the COVID-19 Pandemic

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