Evaluation of attitude among infertile couples about continuing assisted reproductive technologies therapy during novel coronavirus outbreak
Authors: Peivandi Sepideh , Razavi Alireza , Shafiei Shervin , Zamaniyan Marzieh , Orafaie Asma , Jafarpour Hamed 
Published: September 2020

ABSTRACTStudy questionDoes the fear of the coronavirus disease 2019 (COVID-19) pandemic reduce the desire of infertile couples to continue treatment?Summary answerMost of the participants in this study wanted to continue treatment.What is known alreadyThe effect of the prevalence of infectious diseases including the Zika virus on the attitude of infertile couples has been studied in very few studies. However, the effect of the outbreak of COVID-19 on the attitude of infertile couples has not been investigated.Study design, size, durationWe conducted a prospective longitudinal study on forty-six infertile couples (n=92) who referred to our infertility clinic from 4 March 2020 through 20 June 2020.Participants/materials, settings, methodsThis study is based on potential infertile couples for treatment with assisted reproductive technology (ART) who referred to our infertility clinic, Sari, Iran (median age of 35.5 years). All individuals with primary infertility, as defined by the World Health Organization (WHO) and candidates for ART, were included in the study. People who did not agree to participate in the study were excluded. Subjects were surveyed using a researcher-made questionnaire. This questionnaire has four sections as follows: The first part included demographic information and clinical characteristics, the second part included medical records, the third part included questions related to assessing the level of awareness regarding coronavirus infection, and the fourth part included questions related to the attitude towards continuing infertility treatment. The validity of this questionnaire was assessed by three infertility specialists and was confirmed with Cronbach’s alpha of 0.78. A P-value of less than 0.05 was considered statistically significant.Main results and the role of chanceThere is no significant relationship between COVID-19 symptoms and the level of awareness (P-value <0.05). Thirty-two patients (33.33%) had decreased motivation to continue treatment during COVID-19 pandemic. Fear of transmission to the fetus (28.13%) had the highest frequency among the causes of decreased motivation to continue treatment (P-value = 0.011). Confidence in support of the treatment team (56.67%) was the most common reason for lack of motivation in people without decreased motivation (P-value <0.001). The majority of patients had a very high or high tendency (65.22%) to continue or start treatment during the COVID-19 pandemic (P-value <0.001). Most people had an average fear of getting the disease (39.13%) (value <0.001). Examining the relationship between the presence of COVID-19 symptoms and attitude level variables showed that there is only a significant relationship between the greater desire to have a child and the continuation or initiation of treatment with the presence of COVID-19 symptoms (P-value = 0.032).Limitations, reasons for cautionWe were not able to fully assess patients’ deep feelings and cultural beliefs, due to the use of questionnaires and the lack of interviews.Wider implications of the findingsOur results showed for the first time that patients’ knowledge about COVID-19 and trust in the treatment staff played an effective role in selecting and continuing infertility treatment. To clarify this issue, studies with the larger statistical community in the form of interviews are needed.Study funding/completing interest(s)The study received financial support from the Mazandaran University of Medical Sciences (Grant number: 7903). None of the funders had any role in the study design, collection, analysis, or interpretation of data, writing of the paper, or publication decisions. The authors have nothing to declare.Trial registration numberN/A