THE ONGOING IMPACT OF COVID-19 ON STRESSORS DURING FERTILITY TREATMENT

ABSTRACT

OBJECTIVE: This study sought to determine how various stressors related to COVID-19 impacted the patient experience during fertility treatment. MATERIALS AND METHODS: An anonymous survey was distributed to patients at a private fertility clinic via the patient portal. Survey questions investigated patient demographics and feelings of anxiety regarding COVID-19 related stressors. Baseline levels of anxiety were measured by GAD-7, a 7-question generalized anxiety disorder scale. Patient confidence in their fertility treatment and potential changes to their treatment plan due to COVID-19 were assessed. Responses ranged from “not at all” to “all of the time”. Survey responses were analyzed at two different points, on Feb 5th with 290 participants and April 11th with 647 to determine average response and response frequencies. RESULTS: Of the initial 290 participants, 89% were women with an average age of 33.8. 58.9% reported pursuing fertility treatment for at least a year. The average GAD-7 Anxiety Severity Score for this cohort was 5.79, indicating an overall feeling of mild anxiety among respondents. 59% of respondents reported COVID-19 health concerns as one of their causes of stress, but only 29% reported considering or ultimately delaying treatment due to the pandemic. The data was again analyzed with 647 participants, of whom 80% were women with an average age of 34.5. 47.8% reported pursuing fertility treatment for at least a year. The average GAD-7 Anxiety Severity Score was 5.01 for this cohort, indicating a reduced overall feeling of mild anxiety. 52% of respondents reported COVID-19 health concerns as one of their causes of stress, but only 17% reported considering or deciding to delay treatment due to the pandemic. CONCLUSIONS: Individuals struggling to conceive often report feelings of depression and anxiety. Over the past year, the ongoing COVID-19 pandemic has been shown to cause increased stress, anxiety, and feelings of depression across almost all populations. For those already experiencing heightened levels of stress and anxiety prior to the pandemic, the effect of increased stress and worry may have detrimental effects on health outcomes. While the cause-and-effect relationship between stress and infertility is still unclear, it is important to consider how the COVID-19 pandemic leads to increased distress among infertility patients and how this may impact perceived treatment outcomes. In comparing results between data collection on Feb. 5th and April 11th, it appears that patients may be experiencing a reduction in stress regarding COVID-19. As the pandemic continues to evolve in terms of vaccine, treatment, and spread mitigation plans, patients continue to be resilient in adapting to COVID-19. Being aware of the increased levels of stress and anxiety experienced by patients during the ongoing COVID-19 crisis can help healthcare providers alleviate some of these worries. IMPACT STATEMENT Various stressors, particularly during COVID-19 may impact a patient's experience in their fertility treatment, allowing healthcare providers an opportunity to help mitigate these during care.