Obstet Gynecol Sci.  2022 Mar;65(2):197-206. 10.5468/ogs.21254.

Psychological impact of suspension/postponement of fertility treatments on infertile women waiting during COVID pandemic

Affiliations
  • 1Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
  • 2Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

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.

Keyword

Infertility; COVID-19; Mental health; Health services accessibility; fertilisation

Figure

  • Fig. 1 (A) Correlation of psychosocial factors with socio-economic status. (B) Correlation of increasing age with self-reported anxiety due to delay in treatment. IVF, in-vitro fertilisation.


Reference

References

1. World Health Organization. WHO Director-General’s opening remarks at the mission briefing on COVID-19 [Internet]. Geneva (CHE): WHO;c2020. [cited 2021 May 10]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-mission-briefing-on-COVID-19 .
2. American Society for Reproductive Medicine. Patient management and clinical recommendations during the coronavirus (COVID-19) pandemic [Internet]. Washington, D.C. (USA): American Society for Reproductive Medicine;c2020. [cited 2021 May 10]. Available from: https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covid-19/covidtaskforce.pdf .
3. Ćosić K, Popović S, Šarlija M, Kesedžić I. Impact of human disasters and COVID-19 pandemic on mental health: potential of digital psychiatry. Psychiatr Danub. 2020; 32:25–31.
Article
4. Slade P, O’Neill C, Simpson AJ, Lashen H. The relationship between perceived stigma, disclosure patterns, support and distress in new attendees at an infertility clinic. Hum Reprod. 2007; 22:2309–17.
Article
5. El Kissi Y, Romdhane AB, Hidar S, Bannour S, Ayoubi Idrissi K, Khairi H, et al. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women. Eur J Obstet Gynecol Reprod Biol. 2013; 167:185–9.
Article
6. Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003; 157:98–112.
7. Irudaya Rajan S, Sivakumar P, Srinivasan A. The COVID-19 Pandemic and internal labour migration in india: a ‘crisis of mobility’. Indian J Labour Econ. 2020; 63:1021–39.
Article
8. Boivin J, Harrison C, Mathur R, Burns G, Pericleous-Smith A, Gameiro S. Patient experiences of fertility clinic closure during the COVID-19 pandemic: appraisals, coping and emotions. Hum Reprod. 2020; 35:2556–66.
Article
9. Esposito V, Rania E, Lico D, Pedri S, Fiorenza A, Strati MF, et al. Influence of COVID-19 pandemic on the psychological status of infertile couples. Eur J Obstet Gynecol Reprod Biol. 2020; 253:148–53.
Article
10. Roy KK, Rai R, Zangmo R, Kumari A, Noor N, Garg D. Laparoscopic gynecological surgery in COVID-19 pandemic. Obstet Gynecol Sci. 2021; 64:322–6.
Article
11. Gupta M, Jaiswal P, Bansiwal R, Sethi A, Vanamail P, Kachhawa G, et al. Anxieties and apprehensions among women waiting for fertility treatments during the COVID-19 pandemic. Int J Gynaecol Obstet. 2021; 152:441–3.
Article
12. Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh’s scale updated for 2019. J Family Med Prim Care. 2019; 8:1846–9.
Article
13. Turocy J, Robles A, Hercz A, D’Alton M, Forman E, Williams Z. The emotional impact of the ASRM guidelines on fertility patients during the COVID-19 pandemic [Internet]. Fertility and Sterility. c2020. [cited 2021 May 19]. Available from: https://www.fertstertdialog.com/posts/65837-the-emotional-impact-of-the-asrm-guidelines-on-fertility-patients-during-the-covid-19-pandemic .
Article
14. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020; 17:1729.
Article
15. Kiani Z, Simbar M, Hajian S, Zayeri F, Shahidi M, Saei Ghare Naz M, et al. The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis. Fertil Res Pract. 2020; 6:7.
Article
16. Durankuş F, Aksu E. Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. J Matern Fetal Neonatal Med. 2022; 35:205–11.
Article
17. Vaughan DA, Shah JS, Penzias AS, Domar AD, Toth TL. Infertility remains a top stressor despite the COVID-19 pandemic. Reprod Biomed Online. 2020; 41:425–7.
Article
18. Dawel A, Shou Y, Smithson M, Cherbuin N, Banfield M, Calear AL, et al. The effect of COVID-19 on mental health and wellbeing in a representative sample of australian adults. Front Psychiatry. 2020; 11:579985.
Article
19. Blake P, Wadhwa D. 2020 year in review: the impact of COVID-19 in 12 charts [Internet]. Washington, DC (USA): World Bank Blog;c2020. [cited 2021 Jul 18]. Available from: https://blogs.worldbank.org/voices/2020-year-review-impact-covid-19-12-charts .
20. Marom Haham L, Youngster M, Kuperman Shani A, Yee S, Ben-Kimhy R, Medina-Artom TR, et al. Suspension of fertility treatment during the COVID-19 pandemic: views, emotional reactions and psychological distress among women undergoing fertility treatment. Reprod Biomed Online. 2021; 42:849–8.
Article
21. Ben-Kimhy R, Youngster M, Medina-Artom TR, Avraham S, Gat I, Marom Haham L, et al. Fertility patients under COVID-19: attitudes, perceptions and psychological reactions. Hum Reprod. 2020; 35:2774–83.
Article
22. Erdem K, Ejder Apay S. A sectional study: the relationship between perceived social support and depression in Turkish infertile women. Int J Fertil Steril. 2014; 8:303–14.
23. Seifer DB, Petok WD, Agrawal A, Glenn TL, Bayer AH, Witt BR, et al. 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.
Article
24. Pandey V, Nazmi S. Covid-19 in India: why second coronavirus wave is devastating [Internet]. London (UK): BBC News;c2021. [cited 2021 May 20]. Available from: https://www.bbc.com/news/world-asia-india-56811315 .
25. Roberts L, Renati S, Solomon S, Montgomery S. Women and infertility in a pronatalist culture: mental health in the slums of mumbai. Int J Womens Health. 2020; 12:993–1003.
Full Text Links
  • OGS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr