P–512 When COVID–19 pandemic seems to be a never-ending story: Fear and anxiety do not discourage infertility patients to seek for the treatment
Authors: Maidarti M , Wiweko B , Harzief K , Pratama G , Sumapraja K , Natadisastra M 
Published: August 2021

Abstract

Study question
Do fear, anxiety and perceptions related to COVID–19 infection significantly impact infertility patients in seeking and continuing the treatment?

Summary answer
Despite fear and anxiety related to COVID–19 pandemic, 94.4% of infertility patients still decided to proceed with the infertility treatment. What is known already: It has been commonly acknowledged that infertility has a momentous impact on the psychological well-being of both partners. COVID–19 pandemic might significantly exacerbate the feeling of stress, anxiety and depression in patients with infertility problem. However, the concern that delaying the treatment may negatively impact the outcome has led to the continuation of infertility management during the pandemic era. In this context, social distancing and loss of social support could possibly be deepened, contributing to higher levels of distress. The patients may face a high level of uncertainty due to the inability to conceive and the spread of COVID–19 infection.

Study design, size, duration
This is a cross-sectional study utilising a questionnaire distributed to infertility patient in Jakarta. All the women gave their informed consent to collect and use their data for conducting this study. An anonymous electronic survey on Google Forms web application was e-mailed to infertile couples. The purpose of this survey was explained to all participants with a brief introduction. Survey participation was voluntary.

Participants/materials, setting, methods
This study utilising a questionnaire distributed to infertility patient in Jakarta. Patients were identified, and demographic data were collected between 1 September 2020 and 25 January 2021. The survey was distributed to a total of 178 patients with phone and email reminders.

Main results and the role of chance
A total of 178 patients were replied and filled the google form completely. The average age of the patients and the length of infertility were 32.6 ± 1.4 years and 60 ± 2.9 months, respectively. Most of the patients were University graduated (71.8%). Among all participants, 94.4% decided to proceed with the infertility treatment despite the COVID–19 pandemic. Ovulatory dysfunction was the most common type of infertility in women (46%). However, the percentage of the treatment delay due to hospital protocol or the patient’s decision was 39.5%. The age and the length of infertility were significantly associated with higher anxiety levels (p &lt; 0.05). Patients knowledge regarding the COVID–19 infection was not significantly impact the level of anxiety (p &gt; 0.05). It was demonstrated that 37.3% of the patients preferred fresh compared to frozen embryo transfer despite COVID–19 pandemic, and 33.4% of the participants admitted that they had a financial problem during the COVID–19 pandemic. However, 25.9% of the patients decided to continue the treatment during the pandemic regardless of this financial problem.

Limitations, reasons for caution
The use of a cross-sectional study may lead to limited information regarding patients’ characteristics prior to the COVID–19 pandemic. The length and implications of this pandemic are unpredictable that the outcomes of this study may not reflect sustained consequences of COVID–19 pandemic on psychological well being of women with infertility.
Wider implications of the findings: It is imperative to offer emotional support to reduce stress and concerns in women with infertility. As the willingness of infertility patients to continue the treatment despite pandemic COVID–19, the risks and consequences of COVID–19 infection should be addressed in managing patients with infertility during the pandemic era.

Trial registration number
Not applicable