Infertility and reproductive rights after the COVID-19 pandemic

Abstract

Coronavirus disease 2019 (COVID-19) was declared a pandemic on 11 March 2020 by the World Health Organization, halting the principal income activities worldwide. The International Monetary Fund predicts that the imminent economic recession will be worse than the global financial crisis of 2008, which severely affected the economy of Southern European countries such as Greece, Italy and Spain. There was then an abysmal drop in the Spanish yearly population growth curve as families could not afford to have children in that economic context; this only worsened the already existing demographic problems in that Spain has a constantly ageing population and one of the lowest fertility indicators in Europe. Taking into consideration that female age is the most important independent variable of success at the time of conception, probably thousands of potentially fertile couples were lost while waiting for more promising circumstances. With the COVID-19 pandemic a similar situation is being faced, where reproductive rights are imperiled by not being able to choose when to have children due to economic coercion. Therefore, governments worldwide should take measures to palliate the possible sociodemographic crisis that will follow the economic recession and try to ease the burden that many families might face during the following years.

Impact of COVID-19 on fertility and assisted reproductive technology (ART): a systematic review

“…This document was entitled “The fight for women’s rights to fertility treatment and evaluation” and contradicted the ASRM recommendations by mentioning that this type of treatment needs to be carried out at the right time, especially for older women, and also that the patient’s rights and decisions must be respected, especially in the case of women, considered a vulnerable category. Moreover, the observation that there are differences between the degrees of COVID-19 impact to an area in a certain period triggered the idea of clinic shutdowns done in a timely manner according to specific strategy [ 47 , 48 , 49 ]. Infertility is a chronic, time-sensitive disease associated with physical and psychological distress.…”

Life on pause: An analysis of UK fertility patients’ coping mechanisms after the cancellation of fertility treatment due to COVID-19

“…Several policy recommendations for fertility care have consequently emerged from this paper: (1) fertility clinics should maintain a line of communication with their patients during treatment postponement; (2) fertility clinics should seek feedback from patients during treatment postponement and establish what additional services could be provided during this time; (3) fertility clinics should use the internet more strategically, implementing measures of support which, in the context of the wider pandemic emergency, cannot be implemented in-person; and (4) the HFEA should work towards establishing a guidance for professionals on delivering support during treatment postponement in order to improve coping mechanisms for patients. Emerging research continues to highlight the adverse emotional responses that can arise from treatment postponement ( Barra et al, 2020 ; Boivin et al, 2020 ; Esposito et al., 2020 ; Gordon and Balsom, 2020 ; Trinchant et al, 2020 ). It is therefore essential that fertility care adopt transformative measures to ensure a more authentic commitment to the wellbeing of patients.…”

“…The emotional effects of infertility in the context of a global pandemic amplified what existing research has already revealed. As stated by Trinchant et al (2020 : 152), ‘reproductive rights are human rights’ and the negation of such rights for those facing infertility during the time of the initial COVID-19 outbreak served to increase emotional distress and anxiety, especially for those with longer infertility history. Research has shown that approximately two thirds of patients left waiting for ART treatment to resume expressed the will to proceed with their treatment during the pandemic ( Esposito et al, 2020 ), with 50% of respondents in another study reporting clinically significant depressive symptoms due to suspension of their treatment ( Gordon and Balsom, 2020 ).…”

Male infertility and COVID-19: Is there a relationship?

“…In addition to the pathophysiological aspects, the pandemic caused a severe economic recession, an increase in the unemployment rate and, consequently, a decline in the birth rate, considering that several couples are no longer able to financially support their offspring (Trinchant et al, 2020).…”