Influence of COVID-19 pandemic on the psychological status of infertile couples

Veronica Esposito, Erika Rania, Daniela Lico, Sara Pedri, Alessia Fiorenza, Marina Francesca Strati, Alessandro Conforti, Vinenzo Marrone, Andrea Carosso, Alberto Revelli, Fulvio Zullo, Costantino Di Carlo, Roberta Venturella, Veronica Esposito, Erika Rania, Daniela Lico, Sara Pedri, Alessia Fiorenza, Marina Francesca Strati, Alessandro Conforti, Vinenzo Marrone, Andrea Carosso, Alberto Revelli, Fulvio Zullo, Costantino Di Carlo, Roberta Venturella

Abstract

Objective(s): to evaluate the impact of the COVID-19 pandemic on infertile couples' emotions, anxiety and future plans.

Study design: An observational study was perfomed by Italian ART centers and online forums. In this study, infertile couples candidate to ART and whose treatment was blocked due to the COVID-19 lockdown were enrolled through an online survey. The psychological impact of COVID-19 was measured by Impact of Event Scale-Revised (IES-R) and by a short form of the Spielberger State-Trait Anxiety Inventory (STAI); Self-perceived anxiety related either to pregnancy safety and to economic crisis measured by VAS scale.

Results: 627 patients completed the survey. The COVID-19 lock-down had a moderate/severe psychological impact on infertile patients (mean IES-R score 36.4 ± 16.6). The mean STAI score was 49.8 ± 15.3, with an overall incidence of STAI > 36 of 71 %. The mean VAS scale for anxiety perception was 45.3 ± 15.3. Women were more emotionally distressed, anxious and depressed than men (36.8 ± 16.4 vs 31.0 ± 18.4 for IES-R, respectively; p = 0.03). Notwithstanding the uncertainty about pregnancy safety, 64.6 % of respondents chose to maintain their reproductive programme. Economic crisis induced 11.5 % of the surveyed patients to give up their ART program. Respondents who had at least one relative affected by COVID-19 had a significantly higher IES-R score and anxiety VAS, but not higher STAI scores, than patients belonging to unaffected families.

Conclusion(s): COVID-19 pandemic itself and the recommendation to stop ART program generated higher distress levels in infertile couples. The psychological impact of COVID-19 pandemic in infertility patients should not be underestimated, and a specific psychological support should be planned.

Keywords: Anxiety; COVID-19; Distress; Infertility; Pandemic; Psychological impact.

Conflict of interest statement

Declaration of Competing Interest The authors report no declarations of interest.

Copyright © 2020 Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
Age distributions of respondents. Patients were distributed in 6 classes according to their age (18-24, 25-30, 31-35, 36-39, 40-42 and over 43 years old), with most of respondents aged 31-39 years.
Fig. 2
Fig. 2
Respondents willing to start ART cycle. Despite the lack of data on pregnancy safety during COVID-19, 64.6 % of patients want to maintain their reproductive programme, while 6.4 % prefer to postpone any attempt, waiting for more evidence.
Fig. 3
Fig. 3
Length of infertility and willing to start ART cycle. Respondents with longer history of infertility are more willing to take the risks of getting pregnant during COVID-19 pandemic than infertile patients since less than 1 year.

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