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Cao M, Han Y, Feng T, Lu P, Wang Y, Sun Q, Zhao Z, Pan W. Impact of COVID-19 convalescence on pregnancy outcomes in patients undergoing IVF/ICSI during fresh ART cycles: a retrospective cohort study. Front Endocrinol (Lausanne) 2024; 14:1298995. [PMID: 38348053 PMCID: PMC10860335 DOI: 10.3389/fendo.2023.1298995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/20/2023] [Indexed: 02/15/2024] Open
Abstract
Objective The aim was to study the impact of coronavirus disease 2019 (COVID-19) convalescence on female fertility and laboratory and clinical outcomes in fresh assisted reproductive technology (ART) cycles. Methods In this retrospective cohort study, we analyzed data from 294 patients who had recovered from COVID-19 and who underwent fresh ART cycles between January and March 2023 (COVID-19 group). This group was compared with 631 patients who underwent similar ART cycles in the same period in 2022 but without having been infected with COVID-19 (non-COVID-19 group). The analysis focused on comparison of basic demographic characteristics and laboratory parameters of patients in each group. The primary outcome measure was the clinical pregnancy rate, which was examined to assess the impact of COVID-19 infection on the efficacy of ART treatment. Results Basal follicle-stimulating hormone (FSH) levels were significantly lower and antral follicle count (AFC) was markedly higher in the COVID-19 group compared to the non-COVID-19 group (P<0.001 and P=0.004, respectively). The predominant ovarian stimulation protocol in the COVID-19 group was GnRH antagonists (64.85%, P<0.001), with a reduced gonadotropin (Gn) dosage and duration in comparison to the non-COVID-19 group (P<0.05). Although the number of blastocysts formed was lower in the COVID-19 group (P=0.017), this group also exhibited a higher blastocyst freezing rate and a higher rate of high-quality embryos per retrieved oocyte (P<0.001 and P=0.023, respectively). Binary logistic regression analysis indicated that COVID-19 convalescence did not significantly impact clinical pregnancy rates in fresh transfer cycles (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.68-1.96, P=0.5874). However, smooth curve-fitting and threshold effect analysis revealed an age-related decline in clinical pregnancy rates in both groups, more pronounced in the COVID-19 group, for women aged over 38 years, with the likelihood of clinical pregnancy decreasing by 53% with each additional year of age (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.61-1.08, P=0.1460; odds ratio [OR] = 0.47, 95% CI = 0.21-1.05, P=0.0647). Conclusions Our findings present no substantial evidence of adverse effects on clinical pregnancy outcomes in fresh ART cycles in patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) during the period of convalescence from COVID-19. However, age emerges as a significant factor influencing these outcomes. Notably, for women above 38 years of age, the likelihood of clinical pregnancy in patients with a prior COVID-19 infection decreased by 53% with each additional year. This highlights the importance of considering maternal age, especially in the context of COVID-19, when evaluating the likelihood of successful pregnancy following ART treatments.
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Affiliation(s)
- Mingya Cao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yan Han
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tengfei Feng
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Peiyang Lu
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yue Wang
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qingyun Sun
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiming Zhao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wensen Pan
- Second Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Iranifard E, Yas A, Mansouri Ghezelhesari E, Taghipour A, Mahmoudinia M, Latifnejad Roudsari R. Treatment suspension due to the coronavirus pandemic and mental health of infertile patients: a systematic review and meta-analysis of observational studies. BMC Public Health 2024; 24:174. [PMID: 38218778 PMCID: PMC10787415 DOI: 10.1186/s12889-023-17628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/31/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Access to fertility treatments is considered a reproductive right, but because of the quarantine due to the coronavirus pandemic most infertility treatments were suspended, which might affect the psychological and emotional health of infertile patients. Therefore, this study was conducted to review the mental health of infertile patients facing treatment suspension due to the coronavirus pandemic. METHODS This study was conducted based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guideline. The Web of Science, PubMed, Embase, Scopus, and Cochrane library databases were searched by two independent researchers, without time limitation until 31 December 2022. All observational studies regarding the mental health of infertile patients facing treatment suspension including anxiety, depression, and stress were included in the study. Qualitative studies, editorials, brief communications, commentaries, conference papers, guidelines, and studies with no full text were excluded. Quality assessment was carried out using Newcastle-Ottawa Scale by two researchers, independently. The random effects model was used to estimate the pooled prevalence of mental health problems. Meta-regression and subgroup analysis were used to confirm the sources of heterogeneity. RESULTS Out of 681 studies, 21 studies with 5901 infertile patients were systematically reviewed, from which 16 studies were included in the meta-analysis. The results of all pooled studies showed that the prevalence of anxiety, depression, and stress in female patients was 48.4% (95% CI 34.8-62.3), 42% (95% CI 26.7-59.4), and 55% (95% CI 45.4-65), respectively. Additionally, 64.4% (95% CI 50.7-76.1) of patients wished to resume their treatments despite the coronavirus pandemic. CONCLUSION Treatment suspension due to the coronavirus pandemic negatively affected the mental health of infertile patients. It is important to maintain the continuity of fertility care, with special attention paid to mental health of infertile patients, through all the possible measures even during a public health crisis.
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Affiliation(s)
- Elnaz Iranifard
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Yas
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Taghipour
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Mahmoudinia
- Maternal and Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Eckstein V, Glaß K, Leßmann ME, Schaar J, Klimova A, Wimberger P, Goeckenjan M. Assisted reproduction after SARS-CoV-2-infection: results of a single-center cohort-study. Arch Gynecol Obstet 2024; 309:305-313. [PMID: 37815640 PMCID: PMC10769908 DOI: 10.1007/s00404-023-07228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/06/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE The effects of SARS-CoV-2 infections on the outcome of assisted reproduction techniques (ART) were studied in a retrospective cohort study. METHODS The outcome of 1581 treatment cycles with embryo transfer at a university fertility center in Germany was compared in years before and during the COVID-19 pandemic. For 335 treatment cycles in 2022 a detailed analysis was carried out depending on infection and immunization status of both partners. RESULTS ART cycles did not differ in most of the parameters examined between 2018-2022. In spite of comparable clinical pregnancy rates, there was a significantly higher miscarriage rate at 34.6% (27/78) in 2022, compared to 19.7% (29/147) in the pre-pandemic years of 2018-2019 (p = 0.014). In 37.0% of the treatment cycles (124/335) 2022 at least one partner reported a SARS-CoV-2-Infection 6 months before ART, mostly with the virus variant Omicron. Clinical pregnancy rates were lower in cycles without infection. Comparing women with confirmed infection to no infection, a significantly higher risk of miscarriage was seen (62.5% vs. 26.2%, p = 0.009). In treatment cycles of partners with basic immunization against SARS-CoV-2 a statistically significant increase of pregnancy rates was seen comparing to cycles with both unvaccinated partners (p = 0.011). CONCLUSION The results indicate a negative impact of SARS-CoV-2-infections up to 6 months on ART treatment, in particular an increased risk of miscarriage. Vaccination was associated with a better outcome of ART treatment.
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Affiliation(s)
- Violet Eckstein
- Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Katrin Glaß
- Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Marie-Elisabeth Leßmann
- Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Jessica Schaar
- Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Anna Klimova
- Institute for Medical Informatics and Biometry, Technische Universität Dresden, Fetscherstraße 74, Dresden, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Maren Goeckenjan
- Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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Carbone L, Raffone A, Travaglino A, Saccone G, Di Girolamo R, Neola D, Castaldo E, Iorio GG, Pontillo M, Arduino B, D'Alessandro P, Guida M, Mollo A, Maruotti GM. The impact of COVID-19 pandemic on obstetrics and gynecology hospitalization rate and on reasons for seeking emergency care: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2023; 36:2187254. [PMID: 36894183 DOI: 10.1080/14767058.2023.2187254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
BACKGROUND During the lockdown due to COVID-19 pandemic, utilization of emergency care units has been reported to be reduced for obstetrical and gynaecological reasons. The aim of this systematic review is to assess if this phenomenon reduced the rate of hospitalizations for any reason and to evaluate the main reasons for seeking care in this subset of the population. METHODS The search was conducted using the main electronic databases from January 2020 to May 2021. The studies were identified with the use of a combination of: "emergency department" OR "A&E" OR "emergency service" OR "emergency unit" OR "maternity service" AND "COVID-19" OR "COVID-19 pandemic" OR "SARS-COV-2" and "admission" OR "hospitalization". All the studies that evaluated women going to obstetrics & gynecology emergency department (ED) during the COVID-19 pandemic for any reason were included. RESULTS The pooled proportion (PP) of hospitalizations increased from 22.7 to 30.6% during the lockdown periods, in particular from 48.0 to 53.9% for delivery. The PP of pregnant women suffering from hypertensive disorders increased (2.6 vs 1.2%), as well as women having contractions (52 vs 43%) and rupture of membranes (12.0 vs 9.1%). Oppositely, the PP of women having pelvic pain (12.4 vs 14.4%), suspected ectopic pregnancy (1.8 vs 2.0), reduced fetal movements (3.0 vs 3.3%), vaginal bleeding both for obstetrical (11.7 vs 12.8%) and gynecological issues (7.4 vs 9.2%) slightly reduced. CONCLUSION During the lockdown, an increase in the proportion of hospitalizations for obstetrical and gynecological reasons has been registered, especially for labor symptoms and hypertensive disorders.
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Affiliation(s)
- Luigi Carbone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Raffaella Di Girolamo
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Daniele Neola
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Emanuele Castaldo
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Gabriele Iorio
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Martina Pontillo
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Bruno Arduino
- Maternal-Child Department, AOU Federico II hospital, Naples, Italy
| | | | - Maurizio Guida
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Giuseppe Maria Maruotti
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
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Correa Rancel M, Sosa Comino E, Leon-Larios F, Suárez Hernández Y, Carballo Lorenzo J, Gomez-Baya D, Baez Quintana D. Emotional Distress Caused by the Measures Taken in Assisted Reproductive Treatments during the COVID-19 Confinement in Spain. J Clin Med 2023; 12:7069. [PMID: 38002682 PMCID: PMC10672169 DOI: 10.3390/jcm12227069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
During the pandemic, assisted reproductive treatments suffered from major disruptions in their terms due to the restrictions imposed. The objective of this study is to evaluate the level of anxiety of women whose treatments were either suspended or delayed. METHODS Descriptive cross-sectional study conducted between April and May 2020. The State-Trait Anxiety Inventory was applied by telephone in a Spanish adapted version. The research also included social, personal, and work aspects which may be involved in the challenging situation. RESULTS A total of 115 patients participated in the study (73.7%). Women showed a mean in trait anxiety of 17.79 (SD = 8.80) and a mean in state anxiety of 19.95 (SD = 9.08). Neither the type of treatment nor the time of infertility were predictors of trait anxiety or state anxiety. Greater age pressure and more worry were associated to greater trait and state anxiety (p < 0.001). The most common emotional reactions to discontinuation of fertility treatments were sadness and anxiety. CONCLUSIONS Discontinuation of fertility treatments due to confinement restrictions had a negative impact on the mental health of women who were following a process of assisted reproduction treatment, increasing their levels of emotional distress and anxiety.
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Affiliation(s)
- Marta Correa Rancel
- Human Reproduction Unit, Gynecology Service, University Hospital of the Canary Islands, 38320 Tenerife, Spain; (M.C.R.); (E.S.C.); (Y.S.H.); (J.C.L.); (D.B.Q.)
- Departamento de Obstetricia-Ginecología, Pediatría, Preventiva, Medicina Legal y Forense, Microbiología, Parasitología, Universidad de la Laguna, 38200 Santa Cruz de Tenerife, Spain
| | - Elena Sosa Comino
- Human Reproduction Unit, Gynecology Service, University Hospital of the Canary Islands, 38320 Tenerife, Spain; (M.C.R.); (E.S.C.); (Y.S.H.); (J.C.L.); (D.B.Q.)
| | | | - Yaiza Suárez Hernández
- Human Reproduction Unit, Gynecology Service, University Hospital of the Canary Islands, 38320 Tenerife, Spain; (M.C.R.); (E.S.C.); (Y.S.H.); (J.C.L.); (D.B.Q.)
| | - Janet Carballo Lorenzo
- Human Reproduction Unit, Gynecology Service, University Hospital of the Canary Islands, 38320 Tenerife, Spain; (M.C.R.); (E.S.C.); (Y.S.H.); (J.C.L.); (D.B.Q.)
| | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, 21007 Huelva, Spain;
| | - Delia Baez Quintana
- Human Reproduction Unit, Gynecology Service, University Hospital of the Canary Islands, 38320 Tenerife, Spain; (M.C.R.); (E.S.C.); (Y.S.H.); (J.C.L.); (D.B.Q.)
- Departamento de Obstetricia-Ginecología, Pediatría, Preventiva, Medicina Legal y Forense, Microbiología, Parasitología, Universidad de la Laguna, 38200 Santa Cruz de Tenerife, Spain
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Cathelain A, Simon V, Wattier JM, Robin G, Ramdane N, Decanter C, Plouvier P, Rubod C. Pain assessment in women with or without endometriosis during the IVF process: a prospective study. Reprod Biomed Online 2023; 47:103250. [PMID: 37748370 DOI: 10.1016/j.rbmo.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 09/27/2023]
Abstract
RESEARCH QUESTION How does the typology and effect of pain vary between infertile patients with or without endometriosis during the different stages of the IVF process? DESIGN A prospective, monocentric, observational cohort study was conducted at Lille University Hospital between November 2019 and June 2021. The study was proposed to all patients starting an IVF cycle. Pain assessment questionnaires using validated scales (about type of pain, without specific location), were completed by patients at key points during IVF: before starting treatment, at the end of stimulation and on the day of oocyte retrieval. RESULTS A total of 278 patients were analysed: 73 patients with endometriosis and 205 without. At the start of the IVF process, patients with endometriosis had higher pain scores than disease-free women (mean numerical scale score 3.47 versus 1.12 [P < 0.0001]) and 17.81% of patients with endometriosis had neuropathic pain. For mental disorders before starting treatment, 22% of patients with endometriosis had suspected or confirmed depression, and 33% had anxiety compared with 8% and 20% in patients without endometriosis, respectively. During IVF, for patients without endometriosis, pain increased significantly between the baseline, the end of stimulation and on the day of retrieval (P ≤ 0.05). In patients with endometriosis, however, pain did not significantly vary during these times. CONCLUSION Endometriosis is associated with higher pain scores, but no increase in pain was observed during IVF for these patients. It seems essential to screen and characterize pain phenotypes in all patients before starting treatment and during stimulation to improve pain management.
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Affiliation(s)
- Alice Cathelain
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France; CHU Lille, Gynaecology Surgery Department, F-59000, Lille, France.
| | - Virginie Simon
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Jean Michel Wattier
- CHU Lille, Department of Anesthesiology and Intensive Care-Section of Pain, Claude Huriez University Hospital, F-59000, Lille, France
| | - Geoffroy Robin
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France; University of Lille, Faculty of Medicine, F-59000, Lille, France
| | - Nassima Ramdane
- CHU Lille, EA 2694, public health: epidemiology and quality of care, Lille University, F-59000 Lille, France
| | - Christine Decanter
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Pauline Plouvier
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Chrystele Rubod
- CHU Lille, Gynaecology Surgery Department, F-59000, Lille, France; University of Lille, Faculty of Medicine, F-59000, Lille, France
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Soloff MA, Keel T, Nizam A, Goldberg GL, Sakaris A, Diefenbach MA, DePeralta DK, Frimer M. Stress, anxiety, and illness perception in patients experiencing delay in operative care due to the COVID-19 pandemic. Gynecol Oncol Rep 2023; 48:101245. [PMID: 37576353 PMCID: PMC10422101 DOI: 10.1016/j.gore.2023.101245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Background Amid the height of the COVID-19 pandemic in the US, the US Surgeon General ordered hospitals and healthcare systems to stop all elective surgical procedures. The aim of our study was to evaluate the additional mental health impact of surgical delay on patients awaiting surgery for benign, pre-malignant and malignant conditions within the context of the COVID-19 pandemic. Study design All patients over the age of 18 awaiting surgery for benign, pre-malignant or malignant conditions within the gynecologic oncology, surgical oncology and colorectal services across Northwell Health were eligible for participation. Upon successful enrollment, participants completed a baseline questionnaire consisting of the Generalized Anxiety Disorder Questionnaire, the Penn State Worry Questionnaire, and Brief-Illness Patient Questionnaire. Results The surgical delay was considered moderately to extremely concerning by 72 % of survey respondents, with one third indicating the highest (10/10) level of concern. Fifty-five percent of patients with a pre-operatively suspected/confirmed cancer or pre-malignant condition demonstrated mild to severe anxiety in their completion of the GAD-7 scale. The average time awaiting surgery was 117 days (range 8-292); and 63 % of respondents indicated that the delay had a moderate to severe impact on their daily life. Conclusions Patients awaiting surgery for confirmed, suspected or pre-malignant conditions expressed decreased sense of control and increased levels of distress compared to patients awaiting procedures for benign conditions (p < 0.05, 95 % CI [-2.65, -0.08]). Future research will focus on the effects of COVID-19 related delays in operative care on clinical outcomes, including cancer morbidity and mortality.
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Affiliation(s)
- Michelle A. Soloff
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States
| | - Trey Keel
- Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, United States
| | - Aaron Nizam
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States
| | - Gary L. Goldberg
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States
- Karches Center for Oncology Research, Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY 11030, United States
| | - Antoinette Sakaris
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States
| | - Michael A. Diefenbach
- Department of Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, United States
| | - Danielle K. DePeralta
- Division of Surgical Oncology, Department of General Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States
| | - Marina Frimer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States
- Karches Center for Oncology Research, Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY 11030, United States
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Shafierizi S, Basirat Z, Nasiri-Amiri F, Kheirkhah F, Chehrazi M, Pasha H, Faramarzi M. The prevalence of adjustment disorder and predisposing factors in infertile women. BMC Psychol 2023; 11:142. [PMID: 37131228 PMCID: PMC10152011 DOI: 10.1186/s40359-023-01193-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 04/27/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women. METHOD In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022. RESULT The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p < 0.001), coronavirus anxiety (β = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (β = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women. CONCLUSIONS The findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors.
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Affiliation(s)
- Shiva Shafierizi
- Counselling in Midwifery, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Reproductive Health, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Pasha
- Department of Reproductive Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of Psychology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Arbağ E, Aluş Tokat M, Özöztürk S. Emotions, thoughts, and coping strategies of women with infertility problems on changes in treatment during Covid-19 pandemic: A qualitative study. WOMENS STUDIES INTERNATIONAL FORUM 2023; 98:102735. [PMID: 37192957 PMCID: PMC10166642 DOI: 10.1016/j.wsif.2023.102735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/18/2023]
Abstract
This study assesses the emotions, thoughts, and coping strategies of women with infertility problems associated with the changes in treatment during the COVID-19 pandemic using Lazarus and Folkman's Transactional Model of Stress and Coping. This qualitative study was based on two Internet forums between October-December 2020, and the comments of 30 women. Four themes were assessed: psychological changes, cognitive changes, changes in social life, and coping strategies. Women reported that the closure of fertility clinics negatively impacted their lives. They experienced despair, uncertainty, disappointment, anger, sadness, and exhaustion from waiting. The expressions of women about coping strategies mostly include emotion-based coping strategies. This study illustrated the importance of using qualitative methods to describe and specify stress and coping strategies in women whose infertility treatment was delayed. It is believed that approaches based on Lazarus and Folkman's model could help healthcare professionals to determine potential stressors for women with infertility during the pandemic, and to identify areas that required improved personal coping strategies.
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Affiliation(s)
- Esra Arbağ
- Dokuz Eylul University, Institute of Health Sciences, Izmir, Turkey
| | - Merlinda Aluş Tokat
- Dokuz Eylul University Faculty of Nursing, Obstetric and Gynecologic Nursing Department, Izmir, Turkey
| | - Sevcan Özöztürk
- Gynecological and Obstetric Nursing, Independent Scholar, Izmir, Turkey
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10
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Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey.,ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
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11
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Chen X, Shi H, Li C, Zhong W, Cui L, Zhang W, Geng L, Hu K, Fang M, Wei D, Yan J, Sun Y, Wu K, Zhao H, Chen ZJ. The effect of SARS-CoV-2 infection on human embryo early development: a multicenter prospective cohort study. SCIENCE CHINA. LIFE SCIENCES 2023:10.1007/s11427-023-2291-0. [PMID: 36795183 PMCID: PMC9933004 DOI: 10.1007/s11427-023-2291-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Xiaolei Chen
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Huangcong Shi
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Cheng Li
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Wanxia Zhong
- Center for reproductive medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127 China ,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200127 China
| | - Linlin Cui
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China ,Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Wenjun Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Ling Geng
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China
| | - Kuona Hu
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China
| | - Mei Fang
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China
| | - Daimin Wei
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Yun Sun
- Center for reproductive medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200127, China.
| | - Keliang Wu
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, China. .,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, China. .,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China.
| | - Han Zhao
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, China. .,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, China. .,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, China. .,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, China. .,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China. .,Center for reproductive medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200127, China.
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12
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Lisonkova S, Bone JN, Muraca GM, Razaz N, Boutin A, Brandt JS, Bedaiwy MA, Ananth CV, Joseph KS. Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth. Paediatr Perinat Epidemiol 2023; 37:117-127. [PMID: 36038519 PMCID: PMC9539106 DOI: 10.1111/ppe.12925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/29/2022] [Accepted: 08/14/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The initial COVID-19 pandemic response-related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre-pandemic period, have been understudied. OBJECTIVES To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART-conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period. METHODS Population-based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015-2019. RESULTS Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART-conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART-conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non-ART group. Maternal characteristics of women who conceived in the early pandemic versus pre-pandemic period differed and included an increased prevalence of pre-pregnancy obesity class 3 and chronic hypertension. CONCLUSIONS The early pandemic closure of ART clinics resulted in a substantial decline in ART-conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART-conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.
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Affiliation(s)
- Sarka Lisonkova
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Jeffrey N. Bone
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
| | - Giulia M. Muraca
- Department of Obstetrics and Gynecology, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Clinical Epidemiology Division, Department of MedicineSolna, Karolinska InstitutetStockholmSweden
| | - Neda Razaz
- Clinical Epidemiology Division, Department of MedicineSolna, Karolinska InstitutetStockholmSweden
| | - Amelie Boutin
- Department of Pediatrics, Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
- Reproduction, Mother and Youth Health and Population Health and Optimal Health Practices UnitsCHU de Québec‐Université Laval Research CenterQuebec CityQuebecCanada
| | - Justin S. Brandt
- Division of Maternal‐Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive SciencesRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Mohamed A. Bedaiwy
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
| | - Cande V. Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive SciencesRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Cardiovascular Institute of New Jersey and Department of MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthPiscatawayNew JerseyUSA
- Environmental and Occupational Health Sciences InstituteRutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - K. S. Joseph
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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13
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Bio-Psycho-Social Approach to Reproductive Mental Health and Reproductive Decisions. Behav Sci (Basel) 2023; 13:bs13010075. [PMID: 36661647 PMCID: PMC9855049 DOI: 10.3390/bs13010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
The reproductive period in the human life cycle covers a great part of a person's existence and is associated with many significant life changes [...].
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14
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Pappa K, Xydias EM, Ziogas AC, Bimba K, Tsakos E, Kolibianakis E. The Impact of Coronavirus Disease 2019 Pandemic on Female Patients Seeking or Undergoing Fertility Treatment in a Single In vitro Fertilisation Clinic in Greece: An International, Cross-sectional Study. J Hum Reprod Sci 2023; 16:50-56. [PMID: 37305776 PMCID: PMC10256943 DOI: 10.4103/jhrs.jhrs_11_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/13/2023] Open
Abstract
Background The temporary delay in fertility treatments due to the coronavirus disease 2019 (COVID-19) pandemic, in combination with the imposed lockdowns, has created psychological distress and anxiety amongst infertile patients. Aims The aim of this study was to evaluate how the pandemic has influenced assisted reproduction technology (ART) patients in Greece, during the second wave of the pandemic. An additional aim was to examine the effects of the pandemic on cross-border patients in particular, compared to national ones. Settings and Design This study was a cross-sectional, questionnaire-based study, distributed to 409 patients of a single in vitro fertilisation (IVF) clinic in Greece, during the period between January until the end of April 2021. Materials and Methods The survey was conducted online via E-mail and was distributed to national and international female patients of a single IVF clinic in Greece, who were undergoing ART treatment during the second wave of the COVID-19 pandemic. Patient participation was anonymous, and participants provided informed consent for collection and publication of data. Statistical Analysis Used The mean values of baseline characteristics, along with answer percentages per questionnaire item, were calculated. Collected data were cross-tabulated, and the Chi-square test was used as a measurement of the differences between national and cross-border patients. A P value lower than 0.05 was considered statistically significant. All analyses were conducted using the SPSS Statistics software. Results From 409 initial candidates, 106 women, with a mean age of 41.2 years, completed the questionnaire (26% response rate). The majority of national patients did not experience any delays in their fertility plans (62%), while cross-border patients experienced over 6 months of delays (54.7%). The main reason for fertility postponement was travel restrictions due to COVID-19 for cross-border patients (62.5%), while national patients cited additional reasons. The majority of patients experienced a degree of stress (65.2%) due to the delays, however were not fearful of COVID-19 infection (54.7%). Most patients were aware of the protective measures taken by IVF clinics (80.2%), and this was a determinant factor (71.7%) for their decision to restart their fertility treatment. Conclusion The COVID-19 pandemic lockdowns had a significant emotional impact on patient receiving or undergoing ART treatment in Greece. This impact was more pronounced on cross-border patients. This highlights the need for continuation of ART care, with the appropriate protective measures, during the pandemic, as well as during similar times of crisis in the future.
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Affiliation(s)
| | - Emmanouil M. Xydias
- Embryo Clinic IVF, Thessaloniki, Greece
- Department of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Apostolos C. Ziogas
- Department of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | | | | | - Efstratios Kolibianakis
- First Department of Obstetrics and Gynecology, Unit of Human Reproduction, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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15
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Irani M, Bashtian MH, Soltani N, Khabiri F. Impact of COVID-19 on mental health of infertile couple: A rapid systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:404. [PMID: 36824404 PMCID: PMC9942163 DOI: 10.4103/jehp.jehp_1655_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/05/2022] [Indexed: 06/18/2023]
Abstract
Infertile couples experience a lot of psychological stress due to the inability to achieve the desired social role. Couples who decide to continue assisted reproductive therapy (ART) during the epidemic also experience the psychological impact of the COVID-19 epidemic, which affects their daily lives due to social isolation, quarantine, travel restrictions, and cancellation of treatment. Therefore, the purpose of this study was to assess the mental health of infertile couple pausing or delaying their treatment due to the COVID-19 pandemic. PubMed, Scopus, Cochrane, Embase, Web of Science, ScienceDirect, Google Scholar, Research Gate, and the World Health Organization databases and websites were systematically searched for original studies concerning abortion in the era of COVID-19 pandemic published by August 15, 2021. We used the following keywords: "COVID-19 Corona virus, infertility, reproductive technique, fertilization, assisted reproduction, pregnant termination, psychological, in vitro mental status, depressive symptoms, and anxiety." In sum, after automatically and manually search and excluding duplicates, 269 articles were found. In final, after screening, 18 articles were selected. Most patients experienced negative emotions during the COVID-19 epidemic. When reproductive services were re-established, participants showed higher levels of anxiety and lower quality of life than before quarantine. Women who thought pregnancy was more important than getting COVID-19 had higher levels of anxiety than women who thought otherwise (P < 0.05). The COVID-19 pandemic has negative impacts on the mental health and quality of life of patients seeking fertility services and coping with it requires timely and appropriate psychological intervention, accurate information, and social and organizational support.
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Affiliation(s)
- Morvarid Irani
- Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Maryam Hassanzadeh Bashtian
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Narges Soltani
- Department of Midwifery, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Khabiri
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
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16
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Rasekh Jahromi A, Daroneh E, Jamali S, Ranjbar A, Rahmanian V. Impact of COVID-19 pandemic on depression and hopelessness in infertile women. J Psychosom Obstet Gynaecol 2022; 43:495-501. [PMID: 35659431 DOI: 10.1080/0167482x.2022.2082279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION COVID-19 has negative and sometimes irreversible effects on infertile women. This study aimed to investigate hopelessness and depression in infertile women whose treatment has been delayed due to COVID-19. METHODS This case-control study was conducted online on 172 infertile women. The case group included infertile women under treatment whose treatment was delayed during the COVID-19 pandemic, and the control group was selected from infertile women who were not under infertile treatment. This study was conducted between April and December 2021 in Jahrom, Iran. Beck hopelessness standard questionnaire (BHS) and Beck Depression Inventory (BDI) were used to collect data, and p < 0.05 was considered significant. RESULTS The mean score of hopelessness in women in the case group was 9.48 ± 1.80 compared to the control group 8.66 ± 1.34 (OR = 1.39 95% CI = 1.13-1.71), and its areas (OR = 1.33 95% CI = 1.003-2.43), Emotions and expectations score (OR = 1.59 95% CI = 1.07-2.37), Motivation loss score (OR = 2.02 95% CI = 1.49-2.73), Hope score, and depression in women in the case group was 40.33 ± 10.87to 36.72 ± 11.40 compared to the control (OR = 1.17 95% CI = 1.11-1.23). All these variables showed an increase in the case group compared to the control group (p < 0.05). CONCLUSION The results showed that infertile women whose treatment was delayed were more frustrated and depressed than women in the control group. COVID-19 epidemic and discontinuation of infertile treatments in infertile women seem to have negative psychological effects. Therefore, the psychological effects of this epidemic on infertile women should not be ignored, so planners should put social and family support at the top of the program.
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Affiliation(s)
- Athar Rasekh Jahromi
- Department of Gynecology & Obstetrics, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Safieh Jamali
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Afsaneh Ranjbar
- Department of Physiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Vahid Rahmanian
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
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17
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Venkatesh A, Boots CE, Anderson J, Anderson D, Citro L, Lawson AK. Patients' views of delayed fertility care during the COVID-19 pandemic as a conception catastrophe: the experience of U.S. FertilityIQ users. J Psychosom Obstet Gynaecol 2022; 43:198-204. [PMID: 34889702 DOI: 10.1080/0167482x.2021.2011855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Assessment of psychological reactions to delays in fertility treatment have often utilized single clinic samples during the time that fertility treatments were paused. We, therefore, assessed emotional reactions to treatment cancelations due to COVID-19 in infertility patients across the United States after treatments had begun to resume. STUDY DESIGN Cross-sectional survey emailed on 27 May 2020 and closed on 30 June 2020, to 53,600 FertilityIQ.com website users inquiring about their experience since the COVID-19 pandemic. A subset of FertilityIQ users (n = 13,490) opened the survey invitation and 1806 respondents participated in the survey (13.4% response rate). RESULTS The majority of respondents (female, 67.4%; male, 61.7%) were 31-40 years old; most were planning to start treatment immediately (women, 42.6%; men, 44.7%) or were undergoing treatment (women, 34.9%; men, 29.8%) at the time of treatment cancelation. Patients (women, 21.1%; men 19.1%) or clinics (women, 57.7%; men, 40.4%) canceled treatment. Most clinics had resumed treatment at the time of the study (women, 90.0%; men, 73.7%). Cancelation resulted in sadness (women, 83.9%; men 86.7%) and anger (women, 45.4%; men, 36.7%); greater than half of the participants whose treatment was canceled (women: 66.8%, n = 630; men: 73.7%, n = 14) agreed with cancelations. Greater than 70% of respondents were at least somewhat concerned about reproductive chances (women, 84.7%; men, 72.4%) and exclusion of partners (women, 73.3%; men, 72.4%). Distress/concern was associated with clinic cancelation, disagreement with delays, age, diagnosis, and concern about delays and pregnancy chances (p <.05). CONCLUSIONS Respondents were distressed/concerned about the effect of the pandemic on their fertility. Distress was highest in women with a poorer fertility prognosis, no control over treatment cancelation, and high concern about the effect of treatment delay on pregnancy chances. Emotional support, education regarding treatment delay and fertility, and efforts where possible, to include patients in decisions to delay treatment are warranted in future treatment delays.
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Affiliation(s)
- Anu Venkatesh
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina E Boots
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | | | | | | | - Angela K Lawson
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
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18
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Barra F, La Rosa VL, Vitale SG, Commodari E, Altieri M, Scala C, Ferrero S. Psychological status of infertile patients who had in vitro fertilization treatment interrupted or postponed due to COVID-19 pandemic: a cross-sectional study. J Psychosom Obstet Gynaecol 2022; 43:145-152. [PMID: 33252292 DOI: 10.1080/0167482x.2020.1853095] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To explore the psychological status of infertile women and men who had in-vitro fertilization (IVF) treatment interrupted or postponed because of the COVID-19 emergency. MATERIALS AND METHODS An electronic survey (NCT04395755) was e-mailed between April and June 2020 to couples whose IVF treatments have been interrupted or postponed due to the COVID-19 pandemic. The presence and severity of symptoms suggestive of anxiety and/or depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Subjects with preexisting psychiatric disorders were excluded. RESULTS Overall, 524 out of 646 patients completed the survey. The prevalence of anxiety and/or depression feelings was significantly higher in women, mainly if aged more than 35 years and with a previous IVF attempt. The occurrence of these psychological symptoms was significantly associated with the time spent on COVID-19 related news per day and partner with evidence of psychological disorder and, in females, with a diagnosis of poor ovarian reserve, diagnosis of endometriosis or uterine fibroids. CONCLUSIONS The psychological impact of the COVID-19 pandemic on the infertile couples who should have undergone IVF treatment has been significant. IVF centers should systematically offer these couples adequate psychological counseling to improve mental health.
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Affiliation(s)
- Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy, Genoa
| | | | - Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Michele Altieri
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy, Genoa
| | - Carolina Scala
- Division of Obstetrics and Gynecology, Gaslini Institute, Genoa, Italy.,Piazza della Vittoria 14 Srl, Piazza della Vittoria 14/26, Genoa, Italy
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy, Genoa.,Piazza della Vittoria 14 Srl, Piazza della Vittoria 14/26, Genoa, Italy
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19
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Rasouli MA, Sagun BK, Verma K, Duke CM. Black infertility and social media engagement: a mixed methodology analysis. F S Rep 2022; 3:55-61. [PMID: 35937449 PMCID: PMC9349246 DOI: 10.1016/j.xfre.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 01/20/2023] Open
Abstract
Objective To study social media engagement on Black infertility to better understand why there is lower utilization of in vitro fertilization by Black women despite higher infertility rates. Design The online analytics module BuzzSumo was used to quantify total engagements with the search term “Black infertility” across the commonly used social media platforms. The 10 article links with the highest engagement were selected from periods in 2020 and 2021. Sources cited in each article were reviewed to identify those that had citations of scientific peer-reviewed journals or national medical organizations. The contents of each article were reviewed for accuracy by comparing the article information against available scientific research and consensus data. Patient(s) Not applicable. Intervention(s) Not applicable. Main Outcome Measure(s) Not applicable. Result(s) After applying the exclusion criteria, nine article links remained in each date range. The highest engagement with the term “Black infertility” was found on Facebook for both 2020 and 2021. Ten percent of content regarding Black infertility in 2020 compared with 50% of content regarding Black infertility in 2021 referenced original studies in peer-reviewed journals. Links with greater social engagement were more likely to have academic sources in 2021 than in 2020 (odds ratio, 1.30). The highest user engagement was found for articles discussing the emotional toll of Black infertility. Conclusion(s) Social media users encounter misleading or inaccurate information regarding Black fertility at similar rates to accurate content. Social media can propagate misinformation, and this study identifies social media as an opportunity to improve education directed toward Black women to increase the utilization of in vitro fertilization services.
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Affiliation(s)
- Melody Ava Rasouli
- Department of Obstetrics and Gynecology, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), Las Vegas, Nevada
- Correspondence: Melody Ava Rasouli, M.D., M.B.A., Department of Obstetrics and Gynecology, Kirk Kerkorian School of Medicine at UNLV, 1701 W Charleston Blvd., Ste. 290, Las Vegas, Nevada 89102.
| | | | - Kajal Verma
- Department of Obstetrics and Gynecology, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), Las Vegas, Nevada
| | - Cindy M. Duke
- Department of Obstetrics and Gynecology, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), Las Vegas, Nevada
- Nevada Fertility Institute, Las Vegas, Nevada
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20
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Odeh-Natour R, Shapira M, Estrada D, Freimann S, Tal Y, Atzmon Y, Bilgory A, Aslih N, Abu-Raya YS, Shalom-Paz E. Does mRNA SARS-CoV-2 vaccine in the follicular fluid impact follicle and oocyte performance in IVF treatments? Am J Reprod Immunol 2022; 87:e13530. [PMID: 35220640 PMCID: PMC9111235 DOI: 10.1111/aji.13530] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 01/09/2023] Open
Abstract
Problem The COVID‐19 pandemic has many clinical manifestations. Rapid vaccine development raised concerns and speculations about future fertility outcomes and vaccine safety. We evaluated the effect of Pfizer‐BioNTech mRNA SARS‐CoV‐2 vaccine on IVF treatment, oocyte and embryo quality, and pregnancy outcomes. Method of study This prospective, observational cohort study was conducted in a referral IVF Unit, 3/2021‐5/2021. We aimed to recruit all women undergoing IVF/ICSI cycles from 3/1–4/30/2021, 2‐8 weeks after the second vaccination, and to analyze 50–60 samples in the 2‐month period. Patients were categorized according to serum antibody levels: positive for spike (S), positive for nucleotide (N), or negative for both. On the day of ovum pick‐up, follicular fluid and blood samples were analyzed for anti‐nucleotide (anti‐N) antibodies, and anti‐spike (anti‐S) antibodies, hormonal profile, C‐reactive protein (CRP) and other metabolic parameters. Results Of 59 women enrolled, 37 reported being vaccinated and 22 were not. We found 97% correlation between anti‐S and anti‐N in the blood and the follicular fluid. Follicular fluid was analyzed based on antibody categorization. All IVF treatment parameters in the follicular fluids and serum were comparable, except CRP was significantly elevated among patients with anti‐N antibodies (2.29 [1.42–6.08] vs. 4.11 [1.62–5.75] vs. 1.44 [.36–8.33]; p < .001). Pregnancy outcomes were comparable (44% vs. 33% vs. 50%; p = .97). Conclusion mRNA SARS‐CoV‐2 vaccine did not appear to affect treatment outcomes or ovarian reserves in the subsequent IVF cycle.
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Affiliation(s)
- Rasha Odeh-Natour
- Laniado Hospital, Department of Obstetrics and Gynecology, Netanya, Israel
| | - Maanit Shapira
- Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel
| | - Daniela Estrada
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Sarit Freimann
- Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yana Tal
- Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yuval Atzmon
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Asaf Bilgory
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nardin Aslih
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yasmin Shibli Abu-Raya
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Einat Shalom-Paz
- Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel.,IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
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21
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SCIENTIFIC STUDIES ON THE EFFECTS OF THE CHANGES IN TREATMENT PROCESSES DURING THE COVID-19 PANDEMIC ON INFERTILE COUPLES: LITERATURE REVIEW. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2022. [DOI: 10.33457/ijhsrp.1019063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Georgiou EX, Ryder V, Paget J, Banks R, Cheong YC. The new normal: a UK fertility clinic experience of universal RT-PCR SARS-CoV-2 testing. HUM FERTIL 2022:1-6. [PMID: 35196949 DOI: 10.1080/14647273.2022.2040750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Following the temporary closure of fertility clinics in 2020 in many countries across the world, the SARS-CoV-2 pandemic has meant that the sector has had to rapidly adapt to novel ways of operating. The aim of this study was to investigate the efficacy and feasibility of universal real-time polymerase chain reaction testing at an IVF clinic within a UK tertiary referral centre. Between March and December 2020, we performed 2,401 SARS-CoV-2 RT-PCR tests on 1,215 individual patients, of which eight were positive (0.3%). Appropriate positive case identification allowed for delay in treatment initiation or cancellation as applicable. This has allowed our unit to continue to operate safely and efficiently.
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Affiliation(s)
| | - Victoria Ryder
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
| | - Julia Paget
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
| | - Richard Banks
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
| | - Ying C Cheong
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK.,School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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23
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Psychological impact of suspension/postponement of fertility treatments on infertile women waiting during COVID pandemic. Obstet Gynecol Sci 2022; 65:197-206. [PMID: 35045244 PMCID: PMC8942756 DOI: 10.5468/ogs.21254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To assess the psychological impact of suspension/postponement of various fertility treatments on infertile women during the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a cross-sectional study conducted as an online survey among infertile women consulting either through teleconsultation or physical consultation at a fertility clinic of a tertiary care referral unit. A validated questionnaire was given as a WhatsApp link to the women who were consulting for the resumption of services. Questions asked were based on their socio-demographic parameters, fertility treatment at the time of suspension, anxiety (self-reported) and stress (perceived stress scale-4, PSS-4) due to delay in treatment, psychosocial effect of pandemic, and wishes regarding the resumption of fertility services. Results Of 430 patients who received the questionnaire, 250 completed the survey (response rate: 58%). The mean age of participants was 29.26±4.18 years and the majority (70.4%) had lower socioeconomic status. The average PSS-4 score was 7.8±0.71, and the prevalence of self-reported anxiety was 72%. Those who suffered migration during the pandemic had significantly higher PSS-4 scores, and increasing age was associated with increased self-reported anxiety due to the suspension of fertility services. The top three priorities reported were infertility and treatment delay (48.4%), job loss (19.2%), and the risk of contracting COVID-19 infection (16%). The degree of spousal support was significantly correlated with lower PSS-4 scores (r=−0.30, P<0.01). On multivariate logistic analysis, duration of infertility, delay in treatment due to suspension of services, and fear of COVID-19 infection were significant predictors of stress and anxiety. Conclusion This study emphasizes the need to investigate psychosocial health and to provide psychological support to this vulnerable population in addition to triaging fertility treatments in a phased manner.
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24
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Wedner-Ross S, Schippert C, von Versen-Höynck F. The impact of the COVID-19 pandemic on women seeking fertility treatment: the patient’s perspective. Arch Gynecol Obstet 2022; 305:1615-1624. [PMID: 35059794 PMCID: PMC8773402 DOI: 10.1007/s00404-021-06379-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/22/2021] [Indexed: 02/08/2023]
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. Supplementary Information The online version contains supplementary material available at 10.1007/s00404-021-06379-y.
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25
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Kostova D, Stoev S, Tachkov K, Petrova G. Cost-effectiveness of in vitro fertilization and controlled ovarian hyperstimulation before and after the COVID-19 outbreak. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2021.2022993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Diana Kostova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
- Hospital Pharmacy Department, Obstetrics and Gynecology Hospital for Active Treatment "Doctor Shterev", Sofia, Bulgaria
| | - Svetoslav Stoev
- Hospital Pharmacy Department, Obstetrics and Gynecology Hospital for Active Treatment "Doctor Shterev", Sofia, Bulgaria
- Department of Pharmaceutical sciences and Social Pharmacy, Faculty of Pharmacy, Medical University of Pleven, Pleven, Bulgaria
| | - Konstantin Tachkov
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
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26
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Carbone L, Di Girolamo R, Mappa I, Saccone G, Raffone A, Di Mascio D, De Vivo V, D'Antonio F, Guida M, Rizzo G, Maria Maruotti G. Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review. Eur J Obstet Gynecol Reprod Biol 2022; 268:144-164. [PMID: 34920272 PMCID: PMC8648617 DOI: 10.1016/j.ejogrb.2021.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND SARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy. OBJECTIVE To evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women. STUDY DESIGN We performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated. RESULTS 15 studies including 25,839 women were included in the analysis. The proportion of women actually willing to be vaccinated during pregnancy is 49.1% (95% CI, 42.3-56.0), and the proportion of breastfeeding women is 61.6% (95% CI, 50.0-75.0). CONCLUSION The cumulative SARS-CoV-2 vaccine acceptance rate among pregnant women appears still low. Vaccinal campaign are urgently needed to drive more confidence into the vaccine to help reducing the spread of the infection and the possible consequences during pregnancy.
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Affiliation(s)
- Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Raffaella Di Girolamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy; Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.
| | - Ilenia Mappa
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentino De Vivo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Francesco D'Antonio
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Giuseppe Rizzo
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy; Department of Obstetrics and Gynecology, The First I. M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
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27
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Domar AD, Shah JS, Gompers A, Meyers AJ, Khodakhah DR, Hacker MR, Penzias AS, Sakkas D, Toth TL, Vaughan DA. The Psychological Impact of the COVID-19 Pandemic on Women Pregnant Following Infertility Treatment: A Longitudinal Study. F S Rep 2022; 3:71-78. [PMID: 35098174 PMCID: PMC8786401 DOI: 10.1016/j.xfre.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 10/26/2022] Open
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28
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Carbone L, Di Girolamo R, Mappa I, Saccone G, Raffone A, Di Mascio D, De Vivo V, D'Antonio F, Guida M, Rizzo G, Maria Maruotti G. Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review. EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY 2021. [PMID: 34920272 DOI: 10.1016/j.ejogrb.2021.12.003.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND SARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy. OBJECTIVE To evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women. STUDY DESIGN We performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated. RESULTS 15 studies including 25,839 women were included in the analysis. The proportion of women actually willing to be vaccinated during pregnancy is 49.1% (95% CI, 42.3-56.0), and the proportion of breastfeeding women is 61.6% (95% CI, 50.0-75.0). CONCLUSION The cumulative SARS-CoV-2 vaccine acceptance rate among pregnant women appears still low. Vaccinal campaign are urgently needed to drive more confidence into the vaccine to help reducing the spread of the infection and the possible consequences during pregnancy.
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Affiliation(s)
- Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Raffaella Di Girolamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy; Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.
| | - Ilenia Mappa
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentino De Vivo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Francesco D'Antonio
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Giuseppe Rizzo
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy; Department of Obstetrics and Gynecology, The First I. M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
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29
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Arena A, Orsini B, Degli Esposti E, Raimondo D, Lenzi J, Verrelli L, Iodice R, Casadio P, Seracchioli R. Effects of the SARS-CoV-2 pandemic on women affected by endometriosis: a large cross-sectional online survey. Ann Med 2021; 53:1924-1934. [PMID: 34714186 PMCID: PMC8567944 DOI: 10.1080/07853890.2021.1991589] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients' characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 - 0.44; GAD-7: b = 1.71, 95% CI = 1.38 - 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = -4.79, 95% CI = -8.44 to - 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation.KEY MESSAGESThe COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD.Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD.Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution.
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Affiliation(s)
- Alessandro Arena
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Benedetta Orsini
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Eugenia Degli Esposti
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Diego Raimondo
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM), IRCCS Azienda Ospedaliero-Universitaria di Bologna a, Bologna, Italy
| | - Ludovica Verrelli
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Raffaella Iodice
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Paolo Casadio
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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The Relationship between the Infertility Specialist and the Patient during the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:healthcare9121649. [PMID: 34946375 PMCID: PMC8702128 DOI: 10.3390/healthcare9121649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/13/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
The doctor-patient relationship is fundamental in the treatment of infertility, due to the emotional implications of fertilization procedures. However, insufficient data are available specifically for this relationship. The general objective of the study is to establish the associations between the fundamental concepts that define the doctor-patient relationship: communication, empathy, trust, collaboration, compliance and satisfaction. A cross-sectional study was conducted between May and June 2020 and followed the methods of a quantitative analysis, collecting the data using questionnaires. The research plan was specific to path analysis with the mediation effect, in which the hypotheses were tested. The research group consisted of 151 women diagnosed with infertility, voluntarily recruited through online support communities. Findings demonstrate that affective empathy mediates the relationship between communication and trust in the doctor. In conclusion, this study draws attention to the importance of basic concepts in the relationship of infertility specialists with infertile patients. Thus, it is necessary for health care providers in assisted human reproduction to participate in programs for the continuous training of empathic communication skills, given the sensitivity of this diagnosis.
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Hart RJ, D'Hooghe T, Dancet EAF, Aurell R, Lunenfeld B, Orvieto R, Pellicer A, Polyzos NP, Zheng W. Self-Monitoring of Urinary Hormones in Combination with Telemedicine - a Timely Review and Opinion Piece in Medically Assisted Reproduction. Reprod Sci 2021; 29:3147-3160. [PMID: 34780023 PMCID: PMC8592080 DOI: 10.1007/s43032-021-00754-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/24/2021] [Indexed: 01/18/2023]
Abstract
Cycle monitoring via ultrasound and serum-based hormonal assays during medically assisted reproduction (MAR) can provide information on ovarian response and assist in optimizing treatment strategies in addition to reducing complications such as ovarian hyperstimulation syndrome (OHSS). Two surveys conducted in 2019 and 2020, including overall 24 fertility specialists from Europe, Asia and Latin America, confirmed that the majority of fertility practitioners routinely conduct hormone monitoring during MAR. However, blood tests may cause inconvenience to patients. The reported drawbacks of blood tests identified by the survey included the validity of results from different service providers, long waiting times and discomfort to patients due to travelling to clinics for tests and repeated venepunctures. Historically, urine-based assays were used by fertility specialists in clinics but were subsequently replaced by more practical and automated serum-based assays. A remote urine-based hormonal assay could be an alternative to current serum-based testing at clinics, reducing the inconvenience of blood tests and the frequency of appointments, waiting times and patient burden. Here we provide an overview of the current standard of care for cycle monitoring and review the literature to assess the correlation between urine-based hormonal assays and serum-based hormonal assays during MAR. In addition, in this review, we discuss the evidence supporting the introduction of remote urine-based hormonal monitoring as part of a novel digital health solution that includes remote ultrasound and tele-counselling to link clinics and patients at home.
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Affiliation(s)
- Roger J Hart
- Division of Obstetrics and Gynaecology, The University of Western Australia & Fertility Specialists of Western Australia, Perth, WA, Australia
| | - Thomas D'Hooghe
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Global Medical Affairs Fertility, R&D Healthcare, the healthcare business of Merck KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany
- Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA
| | - Eline A F Dancet
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
| | - Ramón Aurell
- IVF Unit, Fertility Campus Hospital Quirónsalud Barcelona, Barcelona, Spain
| | - Bruno Lunenfeld
- Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Raoul Orvieto
- Infertility and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | | | - Nikolaos P Polyzos
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus Mujer, Dexeus University Hospital, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wenjing Zheng
- Global Medical Affairs Fertility, R&D Healthcare, the healthcare business of Merck KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany.
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Expectant Management Before In vitro Fertilization in Women Aged 39 or Above and Unexplained Infertility Does Not Decrease Live Birth Rates Compared to Immediate Treatment. Reprod Sci 2021; 29:1232-1240. [PMID: 34724170 PMCID: PMC8559689 DOI: 10.1007/s43032-021-00767-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/05/2021] [Indexed: 11/04/2022]
Abstract
Unexplained infertile couples can have further expectant management before starting assisted reproductive treatments. However, ovarian reserve and in vitro fertilization (IVF) outcomes rapidly decline after 39 years or more. It is thus important to clarify whether a waiting policy is also appropriate for women of advanced age. Couples who had access to a waiting list for approximately 1 year before receiving reimbursed public IVF were compared with those paying for access to immediate treatment. To allow for comparisons between these two strategies, we followed up couples who opted to pay for 1 year after the last embryo transfer from their first cycle. We calculated the proportion of live births in both groups and compared these using logistic regression models and a two-sample Z test for equality of proportions. Six hundred thirty-five couples were evaluated. Out of 359 couples in the immediate group, 70 (19.5%) had a live birth of which 11 after natural conception and 59 after IVF. Out of 276 couples in the waiting group, 57 (20.7%) had a live birth of which 37 after natural conception and 20 after IVF. There was no statistically significant difference between the two strategies in terms of the crude cumulative live birth rate (cLBR). The adjusted odds ratio of 0.69 (95%CI:0.39–1.22) did not change this conclusion as our sensitivity analyses. The cLBR for the ‘waiting before IVF’ and the ‘immediate’ strategies were similar. Further studies are needed to better characterize couples affected by unexplained infertility in order to individualize treatment strategies.
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Mitrović M, Kostić JO, Ristić M. Intolerance of uncertainty and distress in women with delayed IVF treatment due to the COVID-19 pandemic: The mediating role of situation appraisal and coping strategies. J Health Psychol 2021; 27:2515-2528. [PMID: 34670414 DOI: 10.1177/13591053211049950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has caused delays of numerous medical procedures, including IVF. This study investigates the relationship between Intolerance of Uncertainty (IU), situation appraisal-the perceived threat that COVID-19 poses for infertility treatment, coping strategies, and general distress among women with a delayed IVF procedure. SEM showed that situation appraisal is a partial mediator of the relationship between IU and avoidance, as well as the relationship between IU and general distress. The connection between situation appraisal and general distress is partially mediated by avoidance. In this challenging context for mental health, situation appraisal and coping strategies determine the level of distress, where IU, as a dispositional variable, represents the main determinant of the entire reaction.
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Affiliation(s)
| | | | - Milica Ristić
- Pedagogical Faculty in Vranje, University of Nis, Serbia
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Li F, Zhang H, Shi W, Wu Y, Tian Y, Guo Y, Jin H, Li G. Controlled Ovarian Hyperstimulation Protocol in Infertile Patients During the COVID-19 Pandemic. Front Physiol 2021; 12:732709. [PMID: 34646157 PMCID: PMC8502809 DOI: 10.3389/fphys.2021.732709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/25/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: To explore the appropriate controlled ovarian hyperstimulation (COH) protocols in infertility patients who received the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments during the COVID-19 pandemic. Materials and Methods: This retrospective cohort study evaluated the efficiency of the early follicular-phase long-acting GnRH-agonist long (EFLL) protocol (a new protocol developed by Chinese clinicians), prolonged pituitary down-regulation of EFLL protocol (Pro-EFLL), and the GnRH-ant protocol for couples meeting the study criteria between February 2020 and June 2020 who were treated by the First Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic, and compared the pregnancy rates and miscarriage rates per fresh transfer cycle, number of retrieved oocytes, endometrial thickness on the day of hCG injection and the number of fertilized oocytes, mature oocytes, fertilized oocytes, and transferable embryos among the three protocols. Results: We found that the prolonged pituitary down-regulation during the COVID-19 pandemic by utilizing a full-dose of GnRH-a administrated in infertility patients were no differences in clinical outcomes than other protocols, The prolonged pituitary down-regulation protocol and EFLL protocol were associated with a higher Endometrial thickness on the day of hCG injection (12.67 ± 2.21 vs. 12.09 ± 2.35 vs. 10.79 ± 2.38, P < 0.001), retrieved oocytes (14.49 ± 6.30 vs. 15.02 ± 7.93 vs. 10.06 ± 7.63, P < 0.001), mature oocytes (11.60 ± 5.71 vs. 11.96 ± 6.00 vs. 7.63 ± 6.50, P < 0.001), fertilized oocytes (9.14 ± 5.43 vs. 8.44 ± 5.34 vs. 5.42 ± 5.20, P < 0.001), and transferable embryos (4.87 ± 2.96 vs. 6.47 ± 5.12 vs. 3.00 ± 3.28 vs. P < 0.001) in the GnRH-antagonist protocol. Conclusion: We recommend that patients start Gn injections 33–42 days after a pituitary downregulated full dose (3.75 mg) of gonadotropin-releasing hormone agonist during the COVID-19 pandemic, even a delay of 2–4 weeks does not affect the implantation rate. The study can provide a more detailed estimate and clinical management strategies for infertile couples during the COVID-19 pandemic.
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Affiliation(s)
- Fei Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Shangqiu, China
| | - HuiXia Zhang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - WeiYi Shi
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YiFang Wu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ye Tian
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YiHong Guo
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - HaiXia Jin
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Lablanche O, Salle B, Perie MA, Labrune E, Langlois-Jacques C, Fraison E. Psychological effect of COVID-19 pandemic among women undergoing infertility care, a French cohort - PsyCovART Psychological effect of COVID-19: PsyCovART. J Gynecol Obstet Hum Reprod 2021; 51:102251. [PMID: 34638007 PMCID: PMC8501520 DOI: 10.1016/j.jogoh.2021.102251] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022]
Abstract
Purpose: To assess psychological state of women who experienced postponement of ART care during the first COVID-19 wave in a French public ward of reproductive medicine. Methods: An online anonymous survey was emailed between July and August 2020 to all women whose infertility care, including the first consultation for infertility, have been delayed at the beginning of the COVID-19 pandemic. Anxiety, depression, and stress were assessed using Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS-10). Feelings about COVID-19 outbreak, lockdown and suspension of fertility care were assessed by Multiple-Choice Questions and Visual Analog Scales. Results: 435 women answered to the survey (response rate 34.6%). Mean levels of the HADS-A (anxiety), HADS-D (depression) and PSS10 were respectively 7.58(±3.85), 4.51(±3.48), and 27(±6.75). Prevalence of stress was 50.8% and almost half of women presented clear or suggestive anxiety symptoms (respectively 21.6% and 25.7%). Stress and anxiety rates were much higher than those expected in infertile population. Increased stress was observed in women above 35 years and those stopped ‘in cycle’ or during pre-treatment for in-vitro fertilization or frozen embryo transfer. Patient with history of depression or anxiety had a higher prevalence of perceived stress (p = 0.0006). Postponement was perceived as ‘unbearable’ for women experiencing stress (p = 0.0032). After the first wave of pandemic, pregnancy desire remained the same and 84.3% of women wanted to resume fertility care as soon as possible. Conclusion: Stopping fertility care during the COVID-19 pandemic had a significant psychological impact on women with an increase of stress, and anxiety. Psychological counseling should always be offered especially during this difficult period.
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Affiliation(s)
- Océane Lablanche
- Department of Obstetrics and Gynecology, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500 Bron, France
| | - Bruno Salle
- Department of Reproductive Medecine, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500 Bron, France; Faculté de Médecine Lyon Sud, 165 chemin du Petit Revoyet, Université Claude Bernard, Oullins, France; INSERM Unité 1208, 18 avenue Doyen Lépine, Bron, France
| | - Marie-Ange Perie
- Department of Reproductive Medecine, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500 Bron, France
| | - Elsa Labrune
- Department of Reproductive Medecine, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500 Bron, France; INSERM Unité 1208, 18 avenue Doyen Lépine, Bron, France; Faculté de Médecine Laennec, Université Claude Bernard, 7 rue Guillaume Paradin, Lyon, France
| | - Carole Langlois-Jacques
- Hospices Civils de Lyon, Service de Biostatistique et Bioinformatique, F-69003 Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69100 Villeurbanne, France
| | - Eloise Fraison
- Department of Reproductive Medecine, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500 Bron, France; INSERM Unité 1208, 18 avenue Doyen Lépine, Bron, France; Faculté de Médecine Laennec, Université Claude Bernard, 7 rue Guillaume Paradin, Lyon, France.
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Nobre Meirinhos J, Vattaire M, Barry F, Denjean L, Bouricha M, Gala A, Ferrières-Hoa A, Loup V, Gaspari L, Brouillet S, Hamamah S. [Impact of SARS-CoV-2 on fertility, gametes' quality and Assisted Reproduction Technology]. ACTA ACUST UNITED AC 2021; 50:173-181. [PMID: 34506995 PMCID: PMC8423662 DOI: 10.1016/j.gofs.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Indexed: 11/27/2022]
Abstract
Le contexte actuel de pandémie conduit à s’interroger sur les conséquences de la COVID-19 en Assistance médicale à la procréation (AMP). En effet, suite aux premières recommandations de l’Agence de la biomédecine en mars 2020, les centres d’AMP ont suspendu leurs activités. La reprise progressive des tentatives en mai 2020 s’est accompagnée de nombreux questionnements, concernant les effets directs et indirects du SARS-CoV-2 sur la qualité des gamètes, la gamétogenèse, la fertilité, la grossesse et la santé néonatale. L’objectif de cette revue de la littérature est de synthétiser les données disponibles, pour informer les patient(e)s pris(es) en charge et adapter les pratiques d’AMP en cette période de la COVID-19. La plupart des études récentes se basent sur l’évaluation des effets du syndrome infectieux, sur l’analyse des facteurs hormonaux, et sur l’expression des protéines d’entrée virale (ACE2 et TMPRSS2) au niveau des cellules impliquées dans la gamétogenèse pour évaluer les répercussions de la COVID-19. La transmission materno-fœtale du SARS-CoV-2 n’a pas pu être démontrée à ce jour, mais l’infection néonatale reste possible. Néanmoins, les hommes seraient plus à risque d’être infectés par le SARS-CoV-2, d’être symptomatiques et la spermatogenèse est vraisemblablement affectée. La présence du virus dans le sperme est un évènement rare, mais l’ensemble de ces paramètres sont à prendre en compte dans la prise en charge des couples en AMP. Cependant, aucune conséquence sur la qualité des gamètes féminins n’a été mise en évidence jusqu’à présent.
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Affiliation(s)
- Julie Nobre Meirinhos
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Margot Vattaire
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Fatima Barry
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Louise Denjean
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Molka Bouricha
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Anna Gala
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Alice Ferrières-Hoa
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Vanessa Loup
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Laura Gaspari
- Inserm 1203, développement embryonnaire précoce humain et pluripotence, Embryopluripotency, université de Montpellier, Montpellier, France; Service de pédiatrie, unité d'endocrinologie-gynécologie pédiatrique, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Sophie Brouillet
- Inserm 1203, développement embryonnaire précoce humain et pluripotence, Embryopluripotency, université de Montpellier, Montpellier, France; Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Samir Hamamah
- Inserm 1203, développement embryonnaire précoce humain et pluripotence, Embryopluripotency, université de Montpellier, Montpellier, France; Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France.
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Will Procreation Ever Be The Same After COVID-19? J Obstet Gynaecol India 2021; 71:1-6. [PMID: 34483511 PMCID: PMC8403817 DOI: 10.1007/s13224-021-01536-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022] Open
Abstract
Medically assisted procreation will never be the same again after this China Virus epidemic. With billions of lives being affected by this damaging global pandemic, medically assisted procreation services were not left unharmed with far-reaching consequences. New challenges are now emerging concerning COVID-19, such as associated reproductive implications and the consequences of assisted and natural procreation in the presence of acute SARS-CoV-2 infection and delayed consequences after patient recovery. There is a hypothesis that testicular damage and subsequent infertility may result following COVID-19 infection and the possibility of sexual transmission, as SARS-CoV-2 has been identified in the semen of infected patients. Vaccine hesitancy in young women planning pregnancies has been heightened because of the spread of misinformation on social media stating that COVID-19 vaccines will cause sterility in women. Reassuring data from accidental pregnancies that have occurred in the clinical trials of approved COVID-19 vaccines indicate that vaccination does not harm fertility or increase the rate of miscarriage. Scientists have quickly related to good tissue practices in vitro fertilization and a rethink is on about encouraging biopsies and focusing on safe vitrification protocols keeping in mind that ova, sperm, and embryos could be possible vectors for disease transmission with the limited research on the SARS-CoV-2 virus. Going ahead with segmented IVF without delay, freezing the generated embryos and pushing back the embryo transfer after the pandemic appears to be the best strategy at present. An international group of researchers have proposed a prognostic stratification of more vulnerable infertility cases in order to plan a progressive restart of worldwide fertility treatments.
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Biviá-Roig G, Boldó-Roda A, Blasco-Sanz R, Serrano-Raya L, DelaFuente-Díez E, Múzquiz-Barberá P, Lisón JF. Impact of the COVID-19 Pandemic on the Lifestyles and Quality of Life of Women With Fertility Problems: A Cross-Sectional Study. Front Public Health 2021; 9:686115. [PMID: 34350151 PMCID: PMC8326371 DOI: 10.3389/fpubh.2021.686115] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/22/2021] [Indexed: 01/18/2023] Open
Abstract
Background: The COVID-19 pandemic has implied worldwide the imposition of confinement measures and mobility restrictions, to a greater or lesser extent. It has also meant the closure of some public medical services such as reproductive care. This situation may have impacted the health-related behaviour and quality of life of women with fertility problems. Objective: The objective of this study was to analyse the effects of confinement and the suspension of reproductive medical care on the lifestyle (diet, physical exercise, and smoking habits), anxiety and depression, and quality of life of infertile women by comparing their pre- and post-confinement situations. Methods: We carried out a cross-sectional, internet-based study. Information was collected on these women's adherence to the Mediterranean diet (MEDAS questionnaire), physical exercise (IPAQ-SF), anxiety and depression (HADS), and quality of life related to fertility (FertiQol) before, during, and after confinement. The survey was conducted between 1 September and 28 October 2020. Results: A total of 85 women participated. There had been a significant increase in anxiety and depression levels (P < 0.001) and an increase in tobacco consumption among female smokers during confinement vs. pre-confinement (62.5% had increased their consumption). The participants had also increased the mean number of hours they spent sitting (P < 0.001). There had also been an increase in vigorous and moderate exercise levels by 40 and 30%, respectively (P = 0.004). However, no differences were observed in these patients' eating habits as a result of confinement (P = 0.416). When the reproduction service was resumed, the participants showed higher anxiety level scores (P = 0.001) with respect to the pre-confinement situation as well as lower mean FertiQol scale score (P = 0.008). Conclusions: Confinement had increased anxiety and depression levels among these infertile women as well as tobacco use among the participants who were smokers. The prolonged closure of reproductive care units decreased the quality of life of the participants of this study. These results suggest the need to implement online programs to improve healthy habits and quality of life of this population group.
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Affiliation(s)
- Gemma Biviá-Roig
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Ana Boldó-Roda
- Department of Gynecology and Obstetricia, La Plana University Hospital, Vila-Real, Spain
| | - Ruth Blasco-Sanz
- Department of Gynecology and Obstetricia, La Plana University Hospital, Vila-Real, Spain
| | - Lola Serrano-Raya
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain.,Department of Gynecology and Obstetricia, Hospital of Sagunto, Valencia, Spain
| | | | - Pedro Múzquiz-Barberá
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Juan Francisco Lisón
- Department of Biomedical Sciences, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain.,CIBER of Physiopathology of Obesity and Nutrition CIBERobn, Carlos III Health Institute, Madrid, Spain
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Galhardo A, Carolino N, Monteiro B, Cunha M. The emotional impact of the Covid-19 pandemic in women facing infertility. PSYCHOL HEALTH MED 2021; 27:389-395. [PMID: 33913772 DOI: 10.1080/13548506.2021.1922721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People facing infertility are inevitably affected by COVID-19 pandemic, having to delay their parental projects. This study aimed to explore the emotional impact (depression and anxiety symptoms and perceived stress) of the COVID-19 pandemic in Portuguese women pursuing assisted reproductive technology (ART). Results showed 67.4% of participants were in confinement but were dealing with it in a reasonably positive way. Women who continued to work at their workplace presented significantly higher levels of depressive and anxiety symptoms than those who stayed at home. No significant differences were found regarding depression and anxiety symptoms scores when comparing the current sample with an infertility reference sample and a community sample. Depressive and anxiety symptoms remained stable, but there was a significant decrease in perceived stress over the eight-week period. Although these findings do not suggest a worsening of psychological difficulties due to the COVID-19 pandemic, health professionals should be attentive to patients' long-term psychological consequences. It may be helpful to provide additional psychological support to women when restarting their ART treatments.
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Affiliation(s)
- Ana Galhardo
- Instituto Superior Miguel Torga, Psychology Department, Coimbra, Portugal.,Faculty of Psychology and Educational Sciences, Univ Coimbra, CINEICC, FPCEUC, Coimbra, Portugal
| | - Naír Carolino
- Instituto Superior Miguel Torga, Psychology Department, Coimbra, Portugal
| | - Bárbara Monteiro
- Instituto Superior Miguel Torga, Psychology Department, Coimbra, Portugal
| | - Marina Cunha
- Instituto Superior Miguel Torga, Psychology Department, Coimbra, Portugal.,Faculty of Psychology and Educational Sciences, Univ Coimbra, CINEICC, FPCEUC, Coimbra, Portugal
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Abir T, Kalimullah NA, Osuagwu UL, Nur–A Yazdani DM, Husain T, Goson PC, Basak P, Rahman MA, Al Mamun A, Permarupan PY, Khan MYH, Milton AH, Agho KE. Prevalence and Factors Associated with Mental Health Impact of COVID-19 Pandemic in Bangladesh: A Survey-Based Cross-Sectional Study. Ann Glob Health 2021; 87:43. [PMID: 33981590 PMCID: PMC8086734 DOI: 10.5334/aogh.3269] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Feelings of isolation, insecurity, and instability triggered by COVID-19 could have a long-term impact on the mental health status of individuals. Objectives The aim of this study was to examine the prevalence of mental health symptoms (anxiety, depression, and stress) in Bangladesh and the factors associated with these symptoms during the COVID-19 pandemic. Methods From 1 to 30 April 2020, we used a validated self-administered questionnaire to conduct a cross-sectional study on 10,609 participants through an online survey platform. We assessed mental health status using the Depression, Anxiety, and Stress Scale (DASS-21). The total depression, anxiety, and stress subscale scores were divided into normal, mild, moderate, severe, and multinomial logistic regression was used to examine associated factors. Findings The prevalence of depressive symptoms was 15%, 34%, and 15% for mild, moderate, and severe depressive symptoms, respectively. The prevalence of anxiety symptoms was 59% for severe anxiety symptoms, 14% for moderate anxiety symptoms, and 14% for mild anxiety symptoms, while the prevalence for stress levels were 16% for severe stress level, 22% for moderate stress level, and 13% for mild stress level. Multivariate analyses revealed that the most consistent factors associated with mild, moderate, and severe of the three mental health subscales (depression, anxiety, and stress) were respondents who lived in Dhaka and Rangpur division, females, those who self-quarantined in the previous seven days before the survey, and those respondents who experienced chills, breathing difficulty, dizziness, and sore throat. Conclusion Our results showed that about 64%, 87%, and 61% of the respondents in Bangladesh reported high levels of depression, anxiety, and stress, respectively. There is a need for mental health support targeting women and those who self-quarantined or lived in Dhaka and Rangpur during the pandemic.
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Affiliation(s)
- Tanvir Abir
- College of Business Administration (CBA), IUBAT-International University of Business, Agriculture and Technology, Dhaka, Bangladesh
| | | | - Uchechukwu Levi Osuagwu
- Diabetes, Obesity and Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW 2560, Australia; African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629, South Africa
| | - Dewan Muhammad Nur–A Yazdani
- College of Business Administration (CBA), IUBAT-International University of Business, Agriculture and Technology, Dhaka, Bangladesh
| | - Taha Husain
- Department of Gender and Development Studies, Begum Rokeya University, Rangpur 5404, Bangladesh
| | | | - Palash Basak
- School of Environment and Life Sciences (Environmental Science and Management), University of Newcastle, Callaghan 2308, Australia
| | - Md Adnan Rahman
- College of Business Administration (CBA), IUBAT-International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- Faculty of Business and Management, UCSI University, Kuala Lumpur 56000, Malaysia
| | | | - Md Yusuf Hossein Khan
- College of Tourism and Hospitality Management, IUBAT-International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Abul Hasnat Milton
- Research International, Dhaka, Bangladesh & Epidemiology Resource Centre, NSW, Australia
| | - Kingsley E. Agho
- School of Health Science, Western Sydney University, Campbelltown, NSW 2560, Australia; African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629, South Africa
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Tippett A. Life on pause: An analysis of UK fertility patients’ coping mechanisms after the cancellation of fertility treatment due to COVID-19. J Health Psychol 2021; 27:1583-1600. [PMID: 33685265 PMCID: PMC9092918 DOI: 10.1177/1359105321999711] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In March 2020, fertility clinics across the UK began cancelling all assisted
reproductive technology (ART) treatment, with the Human Fertilisation and
Embryology Authority (HFEA) stopping all ART treatment from going ahead beyond
the 15th April 2020 due to the COVID-19 pandemic. This article examines the
coping mechanisms adopted by fertility patients during this time, focussing on
the emotional support received from online fertility forums and fertility
clinics during the indeterminate wait for treatment to resume. The study draws
upon an online survey which assessed the mental health and wellbeing of 124
female fertility patients whose ART treatment was cancelled due to the
Coronavirus pandemic. The findings indicate a potential for improved
communication between fertility clinics and patients in order to reduce
psychological stress and isolation during the postponement of ART treatment,
alongside better utilisation of online platforms as mechanisms for support. This
article adds to the growing body of knowledge concerned with the implications of
denying reproductive rights to the infertility community during a global
pandemic. It also contributes to sociological discussions on the support
mechanisms available to those navigating infertility and the wider social
management of uncertainty.
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Seifer DB, Petok WD, Agrawal A, Glenn TL, Bayer AH, Witt BR, Burgin BD, Lieman HJ. Psychological experience and coping strategies of patients in the Northeast US delaying care for infertility during the COVID-19 pandemic. Reprod Biol Endocrinol 2021; 19:28. [PMID: 33618732 PMCID: PMC7899935 DOI: 10.1186/s12958-021-00721-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/17/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND On March 17, 2020 an expert ASRM task force recommended the temporary suspension of new, non-urgent fertility treatments during an ongoing world-wide pandemic of Covid-19. We surveyed at the time of resumption of fertility care the psychological experience and coping strategies of patients pausing their care due to Covid-19 and examined which factors were associated and predictive of resilience, anxiety, stress and hopefulness. METHODS Cross sectional cohort patient survey using an anonymous, self-reported, single time, web-based, HIPPA compliant platform (REDCap). Survey sampled two Northeast academic fertility practices (Yale Medicine Fertility Center in CT and Montefiore's Institute for Reproductive Medicine and Health in NY). Data from multiple choice and open response questions collected demographic, reproductive history, experience and attitudes about Covid-19, prior infertility treatment, sense of hopefulness and stress, coping strategies for mitigating stress and two validated psychological surveys to assess anxiety (six-item short-form State Trait Anxiety Inventory (STAl-6)) and resilience (10-item Connor-Davidson Resilience Scale, (CD-RISC-10). RESULTS Seven hundred thirty-four patients were sent invitations to participate. Two hundred fourteen of 734 (29.2%) completed the survey. Patients reported their fertility journey had been delayed a mean of 10 weeks while 60% had been actively trying to conceive > 1.5 years. The top 5 ranked coping skills from a choice of 19 were establishing a daily routine, going outside regularly, exercising, maintaining social connection via phone, social media or Zoom and continuing to work. Having a history of anxiety (p < 0.0001) and having received oral medication as prior infertility treatment (p < 0.0001) were associated with lower resilience. Increased hopefulness about having a child at the time of completing the survey (p < 0.0001) and higher resilience scores (p < 0.0001) were associated with decreased anxiety. Higher reported stress scores (p < 0.0001) were associated with increased anxiety. Multiple multivariate regression showed being non-Hispanic black (p = 0.035) to be predictive of more resilience while variables predictive of less resilience were being a full-time homemaker (p = 0.03), having received oral medication as prior infertility treatment (p = 0.003) and having higher scores on the STAI-6 (< 0.0001). CONCLUSIONS Prior to and in anticipation of further pauses in treatment the clinical staff should consider pretreatment screening for psychological distress and provide referral sources. In addition, utilization of a patient centered approach to care should be employed.
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Affiliation(s)
- David B. Seifer
- grid.47100.320000000419368710Department Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | - William D. Petok
- grid.265008.90000 0001 2166 5843Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA USA
| | - Alisha Agrawal
- grid.413480.a0000 0004 0440 749XDepartment of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire USA
| | - Tanya L. Glenn
- grid.47100.320000000419368710Department Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | - Arielle H. Bayer
- grid.251993.50000000121791997Department Obstetrics & Gynecology and Women’s Health, Albert Einstein School of Medicine, Bronx, NY USA
| | - Barry R. Witt
- grid.47100.320000000419368710Department Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | - Blair D. Burgin
- grid.258857.50000 0001 2227 5871Department of Psychology, La Salle University, Philadelphia, PA USA
| | - Harry J. Lieman
- grid.251993.50000000121791997Department Obstetrics & Gynecology and Women’s Health, Albert Einstein School of Medicine, Bronx, NY USA
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Villani MT, Morini D, Spaggiari G, Simoni M, Aguzzoli L, Santi D. Spontaneous pregnancies among infertile couples during assisted reproduction lockdown for COVID-19 pandemic. Andrology 2021; 9:1038-1041. [PMID: 33427417 PMCID: PMC8014815 DOI: 10.1111/andr.12973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/18/2020] [Accepted: 01/07/2021] [Indexed: 02/06/2023]
Abstract
Background The worldwide spread of the SARS‐CoV‐2 infection has profoundly affected all aspects of human life, with tangible consequences in several contexts, including reproduction. However, evidences on the inter‐relation between psychological distress and reproductive medicine are still conflicting. Methods The national lockdown imposed in Italy in March‐May 2020 and the consequent assisted reproductive techniques (ART) activity blockage allowed to evaluate the conception ability of couples who suffered the postponement of ART cycles. In particular, we collected anamnestic, anthropometrical and demographic data of those women attending ART straddling the lockdown period attending to the Fertility Centre of Reggio Emilia. Results Among the 431 couples recalled to reschedule ART cycles, 34 couples (7.9%) obtained a spontaneous pregnancy during the lockdown. Comparing spontaneously pregnant to non‐pregnant women, the pregnant group resulted younger (P = 0.009) and with a shorter infertility history (P = 0.029). Interestingly, the sexual activity frequency was significantly higher in pregnant women compared to non‐pregnant ones (P < 0.001). In a multivariate logistic analysis, number of sexual intercourses per week and the infertility history duration were significantly related to pregnancy (P < 0.001 and P = 0.030, respectively). In addition, the application of neural network technology including data about women age, body mass index, infertility duration, weekly sexual intercourses and infertility causes allowed to correctly classify pregnant women with an accuracy of 92.7%. Conclusion The high pregnancy rate observed in a very short time‐frame interval probably revealed an under‐explored cause of idiopathic infertility, that is the frequency of sexual intercourses, resulting the best predictive variable on achieving a spontaneous pregnancy. This factor is commonly under‐investigated during the anamnestic workup of infertile couples. Clinicians involved in ART should better investigate the sexual habits of infertile couples, with the aim to correctly apply ART to those couples who really need it, avoiding unnecessary over‐treatment for those couples able to conceive spontaneously.
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Affiliation(s)
- Maria Teresa Villani
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Daria Morini
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Lorenzo Aguzzoli
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
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Muhaidat N, Alshrouf MA, Karam AM, Elfalah M. Infertility Management Disruption During the COVID-19 Outbreak in a Middle-Income Country: Patients' Choices, Attitudes, and Concerns. Patient Prefer Adherence 2021; 15:2279-2288. [PMID: 34675492 PMCID: PMC8502047 DOI: 10.2147/ppa.s327055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aims to assess the degree of infertility management service disruption during the pandemic from the patient's point of view, as well as patients' attitudes toward seeking investigations and management, and their thoughts on how appropriate it is for health establishments to continue offering these services during this period while assessing their concerns regarding the risk of COVID-19 infection during treatment or pregnancy. METHODS This study involved a cross-sectional survey of 213 women who were seeking infertility management in January 2021 in Jordan. An electronic questionnaire was designed and validated, which was then distributed on social media platforms. RESULTS Over half of the participants had experienced some form of voluntary or involuntary disruption of their infertility management journey. The decision to postpone treatment was significantly associated with fear of infection (p = 0.009) and was more likely if they had undergone two or more previous cycles of in vitro fertilization treatment (p = 0.004). The majority of participants agreed that infertility services should remain available during the pandemic for those who chose not to delay their treatment journey, as the delay may have negative financial and psychological implications and may affect the chance to achieve a successful pregnancy in the future. CONCLUSION The patients have faced uncertainty regarding the achievability of their long-term fertility goals amidst an atmosphere of general unpredictability for the duration and extent of disruption of their treatment, combined with the fear of infection. Therefore, it is necessary to highlight the need to address how infertility services can be maintained for those who decide to seek treatment during an outbreak while minimizing the risk of contracting COVID-19 in the process.
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Affiliation(s)
- Nadia Muhaidat
- Department of Obstetrics and Gynecology, School of Medicine, The University of Jordan, Amman, 11942, Jordan
- Correspondence: Nadia Muhaidat Faculty of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, JordanTel +962798385775 Email
| | | | | | - Mohammed Elfalah
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
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Cao LB, Hao Q, Liu Y, Sun Q, Wu B, Chen L, Yan L. Anxiety Level During the Second Localized COVID-19 Pandemic Among Quarantined Infertile Women: A Cross-Sectional Survey in China. Front Psychiatry 2021; 12:647483. [PMID: 34366908 PMCID: PMC8339465 DOI: 10.3389/fpsyt.2021.647483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/28/2021] [Indexed: 11/29/2022] Open
Abstract
Infertility usually causes mental health problems for patients and unfavorable emotions such as anxiety and depression can have an adverse effect on women's normal pregnancy. We aimed to compare the anxiety level between infertile female patients in quarantined and non-quarantined areas during the second wave of COVID-19 epidemic. A total of 759 infertile women were included in this cross-sectional study conducted through an online survey. Anxiety was measured by the State-Trait Anxiety Inventory (STAI) tool. Participants were divided into the quarantined group (QG) and non-quarantined group (Non-QG). Independent sample T-test and chi-square test were performed to examine the difference between the two groups. There was no significant difference in the average STAI score of the two groups of infertile women, but responses to the emotional state showed that women in the QG had a higher tendency to be anxious. Participants in QG spent more time paying attention to the dynamics of the epidemic every day, and their sleep (p < 0.01) and mood conditions were worse (p < 0.01) than in the Non-QG. The family relationship of QG is more tense than non-QG. Through the research on the infertility treatment information of the overall research population, it is found the average STAI-State (STAI-S) (p = 0.031) score and STAI-Trait (STAI-T) (p = 0.005) score of women who were infertile for more than 3 years were significantly higher than those of women with <2 years. The STAI-T score of infertile women who underwent in vitro fertilization (IVF) was higher than that of non-IVF women (p = 0.007), but no significant difference was observed with the STAI-S score. To conclude, although the second wave of quarantine during COVID-19 epidemic did not significantly increase anxiety in infertile women, it did lead to an increase in other negative emotions and worse family relationships. Patients with long-term infertility treatment and those who have had IVF are more anxious subgroups.
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Affiliation(s)
- Lian-Bao Cao
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qianjie Hao
- Department of Obstetrics and Gynecology, The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yan Liu
- Department of Obstetrics and Gynecology, The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Qiang Sun
- Department of Obstetrics and Gynecology, Zaozhuang Municipal Hospital, Zhaozhuang, China
| | - Bing Wu
- Department of Obstetrics and Gynecology, The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Lili Chen
- Department of Obstetrics and Gynecology, The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Lei Yan
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Obstetrics and Gynecology, The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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