Emotions, Stress and Coping among Healthcare Workers in a Reproductive Medicine Unit during the First and Second COVID-19 Lockdowns.

The impact of the COVID-19 pandemic on global healthcare workers' (HCWs) mental health has been well documented in the last two years; however, little is known regarding HCWs working in specific healthcare fields. During two subsequent periods of national lockdown in Italy (June-July 2020, T1, and November-December 2020, T2), a total sample of 47 HCWs working in a reproductive medicine hospital unit completed an ad hoc questionnaire for assessing emotional reactions to the pandemic, stress symptoms, and ways of coping. Moderate-high levels of anger and sadness were experienced by 65.9% and 68.1% of the HCWs, respectively, while moderate-high levels of anxiety and fear were experienced by 51.1% and 56.8%, respectively. Higher stress symptoms experienced by HCWs were hypervigilance, avoidance of thoughts and memories, and tiredness/low energy. At T2, levels of hypervigilance, irritability, intrusive thoughts, and detachment were higher than at T1, while avoidance of external triggers decreased. Moderate-high levels of anxiety resulted significantly associated with several symptoms of stress: irritability/fearfulness, depression/hopelessness, tiredness/low energy, problems with concentration, and intrusive thoughts. Regarding coping strategies, HCWs tended to adopt more problem-focused coping (e.g., contributing to improving a situation) and this tendency was higher at T2. Overall findings suggest a risk for the persistence of stress symptoms and, therefore, a risk for a chronic course, which might interfere with the global quality of mental health at work and the care provided to patients. Clinical implications highlight the relevance of implementing support programs for this category of HCWs focused on the elaboration of negative emotions and on fostering adaptive coping strategies.

Spontaneous pregnancies among infertile couples during assisted reproduction lockdown for COVID-19 pandemic.

BACKGROUND: The worldwide spread of the SARS-CoV-2 infection has profoundly affected all aspects of human life, with tangible consequences in several contexts, including reproduction. However, evidences on the inter-relation between psychological distress and reproductive medicine are still conflicting. METHODS: The national lockdown imposed in Italy in March-May 2020 and the consequent assisted reproductive techniques (ART) activity blockage allowed to evaluate the conception ability of couples who suffered the postponement of ART cycles. In particular, we collected anamnestic, anthropometrical and demographic data of those women attending ART straddling the lockdown period attending to the Fertility Centre of Reggio Emilia. RESULTS: Among the 431 couples recalled to reschedule ART cycles, 34 couples (7.9%) obtained a spontaneous pregnancy during the lockdown. Comparing spontaneously pregnant to non-pregnant women, the pregnant group resulted younger (P = 0.009) and with a shorter infertility history (P = 0.029). Interestingly, the sexual activity frequency was significantly higher in pregnant women compared to non-pregnant ones (P < 0.001). In a multivariate logistic analysis, number of sexual intercourses per week and the infertility history duration were significantly related to pregnancy (P < 0.001 and P = 0.030, respectively). In addition, the application of neural network technology including data about women age, body mass index, infertility duration, weekly sexual intercourses and infertility causes allowed to correctly classify pregnant women with an accuracy of 92.7%. CONCLUSION: The high pregnancy rate observed in a very short time-frame interval probably revealed an under-explored cause of idiopathic infertility, that is the frequency of sexual intercourses, resulting the best predictive variable on achieving a spontaneous pregnancy. This factor is commonly under-investigated during the anamnestic workup of infertile couples. Clinicians involved in ART should better investigate the sexual habits of infertile couples, with the aim to correctly apply ART to those couples who really need it, avoiding unnecessary over-treatment for those couples able to conceive spontaneously.