Perspectives and Psychological Impact of Infertile Couples on Postponement of Fertility Treatment Due to COVID-19 Pandemic: A Cross-Sectional Study

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) brought forth an unprecedented suspension of fertility treatment worldwide as part of a reallocation of hospital staff and resources to avoid a collapse in the healthcare system. As a nonessential service, postponement of fertility treatment due to the pandemic has impacted the mental health of infertile patients, which comprise 10%–15% of the Malaysian population. Objective: To establish the patient’s perspective on how the COVID-19 pandemic has affected their fertility treatment and to ascertain their psychological status. Methods: This was a cross-sectional study performed in a single academic center in Malaysia. This study was approved by the Universiti Malaya Medical Centre (UMMC) medical research ethics committee (MEC ID NO: 2021714-10376). Patients and partners who were planned for fertility treatment were approached and asked to answer an anonymous electronic survey between July 16, 2021 and December 17, 2021. All patients requiring fertility treatment were included. Results: One hundred and sixty-five patients were included, and 66.1% of patients did not agree with the Ministry of Health Malaysia’s recommendation to postpone fertility treatment; 97.6% would want to continue with treatment; 75.8% of patients are concerned about advancing age and 11.5% are concerned about reducing ovarian reserve if their treatment was postponed or suspended. From univariate analysis, mild, moderate, severe, and extremely severe levels of psychological disorders were found in our patients. According to multivariate logistic regression, mild stress was significant among 20–30 years old with p = 0.001 (OR 1.37, 95% CI 2.26–8.07). Patients from this age group also suffer from a significant moderate level of stress with p = 0.001 (OR 2.77, 95% CI 4.96–1.48). Other variables, when analyzed using multivariate analysis, had no significant findings. Conclusion: Stress related to COVID-19 and concerns about its effect on the fertility rate were found to be significant psychological distress among patients undergoing fertility treatment. Therefore, fertility centers should routinely monitor the mental health of patients and offer them psychological counseling.