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.
Conclusion
COVID-19 pandemic was an unprecedented situation which have changed daily life and future perspective.
According to this study, stopping ART treatments during COVID19 lockdown contributed to increase stress and anxiety. Women aged over 35 years old and those whose treatment was interrupted before oocyte puncture or embryo transfer seemed to have a higher rate of psychological distress. Despite the lack of knowledge about the COVID-19 and the consequences on pregnancy and fetus wellbeing at the time of the survey, desire of getting pregnant and starting over ART treatments clearly showed up.
Psychological impact of COVID-19 pandemic on infertile women must not be neglected. Specific psychological counseling should be proposed to women and her partners. In the light of our findings, a new suspension of ART care should be avoided, as far as possible.
