The impact of the COVID-19 pandemic on women seeking fertility treatment: the patient’s perspective

Abstract

Purpose This study sought the views of women with impaired fertility on the impact of the COVID-19 pandemic on their fertility treatment and psychological wellbeing. Methods A cross-sectional, anonymous, online questionnaire was completed in June–December 2020 by 249 women attending fertility clinics across Germany. All women seeking treatment in fertility clinics were eligible to participate. The online survey covered questions about the patient’s quality of life, their opinions about the professional societies’ recommendations and their effects as well as any concerns about infection with SARS-CoV-2. Results Three-quarters of participants disagreed with the pausing of fertility treatments. Women who participated from October to December 2020, when the incidence rate was high, were as likely to disagree as participants that participated from June to September 2020 (73% vs 79%, p = 0.3). Seventy-two participants (29%) had their appointments cancelled. Nearly all (97%) reported being upset by this, with 40 (56%) reporting that they were extremely or very disappointed about the cancellation. Women who had to wait 10 weeks or longer were more likely to be upset by the postponement or cancellation of their appointment than women who had to wait a shorter amount of time (p = 0.01). Many participants (41%) were worried about possible negative effects a SARS-CoV-2 infection might have related to their fertility, pregnancy or unborn child. Conclusion Postponement of treatments increased distress among patients and should be avoided when possible. Fertility clinics must provide information about the current state of knowledge of SARS-CoV-2 infections in pregnancies and options for immunization.

COVID‐19 infection after oocyte retrieval did not have detrimental effects on embryo implantation for frozen embryo transfer

“…The COVID‐19 crisis has brought a great psychological burden for infertile couples, and concerns about the impact of COVID‐19 infection on fertility remain 16 . A number of studies have been performed to assess the effect of COVID‐19 infection on ovarian stimulation and the pregnancy outcomes of fresh IVF cycles in recent years.…”

Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth

“…There is a need for national guidelines establishing measures that fertility clinics should take to prepare for future pandemics, as the emotional toll on individuals and couples with infertility is significant, 14 , 15 , 16 , 17 , 18 , 19 , 20 and delays in fertility treatment can lower the success rate in older women and those with diminished ovarian reserve. On the other hand, the characteristics of the pandemic‐causing pathogen are typically unknown in the early pandemic period and potential risks to pregnant women and their offspring have to be balanced with the risks associated with the delay in fertility treatments.…”

“…14 Similar emotional distress was observed among individuals and couples dealing with infertility in other countries. [15][16][17][18][19][20] Irrespective of ART use, women may have chosen to postpone conception and childbirth due to pandemic-related uncertainty and financial instability, lack of support from family members due to travel restrictions, and anxiety about the unknown, potentially harmful effects of SARS-CoV-2 infection. 21 ART is a risk factor for adverse birth outcomes, primarily due to elevated rates of multiple pregnancy, although the incidence of ART-conceived multiple pregnancies has declined in recent years…”

“… 14 Similar emotional distress was observed among individuals and couples dealing with infertility in other countries. 15 , 16 , 17 , 18 , 19 , 20 Irrespective of ART use, women may have chosen to postpone conception and childbirth due to pandemic‐related uncertainty and financial instability, lack of support from family members due to travel restrictions, and anxiety about the unknown, potentially harmful effects of SARS‐CoV‐2 infection. 21 …”

“…A survey of US women who were planning or undergoing fertility treatment during the beginning of the pandemic showed a large negative emotional impact of the interruption of the reproductive services, predominantly among women of advanced age and those with diminished ovarian reserve 14 . Similar emotional distress was observed among individuals and couples dealing with infertility in other countries 15–20 . Irrespective of ART use, women may have chosen to postpone conception and childbirth due to pandemic‐related uncertainty and financial instability, lack of support from family members due to travel restrictions, and anxiety about the unknown, potentially harmful effects of SARS‐CoV‐2 infection 21…”