IMPACT OF THE COVID-19 PANDEMIC ON THE SEXUAL FUNCTION OF PATIENTS SEEKING FERTILITY CARE

ABSTRACT

Introduction: The COVID-19 pandemic and subsequent public health response resulted in unprecedented changes to society, including recommendations for social and physical distancing. Sexual dysfunction is best understood within a biopsychosocial framework, and it is reasonable to predict that biological, psychological, and social aspects of the COVID-19 pandemic may impact sexual function, particularly in a patient population actively planning pregnancy. Objective: The aim of this study was to understand the impact of the COVID19 pandemic - including COVID-19 infection, COVID-19 vaccination, and psychosocial conditions of the pandemic - on the sexual function of women receiving fertility care. Methods: Eligible patients aged 18 or older were identified using ICD codes related to female infertility and fertility testing and invited to complete an online survey regarding COVID-19 infection and vaccination status, fertility planning, and the impact of pandemic conditions on sexual function. Participants were recruited from a large academic-based fertility center and received care between April 2020 and April 2021. χ2 was used for between-group comparisons. Results: Of the 738 eligible patients, 197 participants completed the survey. Seventy-four (37.5%) participants had been pregnant within the past year and 168 (85.3%) participants had attempted to conceive in the past year. Forty-four (22.3%) participants reported prior COVID-19 infection, with 29 confirmed diagnoses and 15 suspected diagnoses. Further, 107 (54.2%) participants had been vaccinated against COVID-19, 35 (17.8%) were planning on being vaccinated, and 52 (26.4%) were not planning on being vaccinated. Participants declining vaccination cited concerns with health, fertility, pregnancy, breastfeeding, and a lack of vaccine safety data as common reasons for declining. Most (n = 180;91.4%) participants were sexually active at the time of survey, but only 25 (12.7%) reported their sex life was improved as a result of the pandemic;this did not differ in patients with or without a prior COVID-19 infection (15.9% vs. 11.8%, P=NS). These participants cited having more time with their partner, working from home, fewer outside stressors and social obligations, improved relationship dynamics and emotional bonding, and shared feelings about pandemic-related policies as reasons for improved sexual function. Of the 44 participants who had experienced COVID-19 infection, the majority (52.3%) expressed interest in returning to sexual activity within two weeks of infection. An additional 20.5% reported interest in sexual activity between two and four weeks after infection. Most (81.8%) stated that they were “not at all” or “not really” concerned about infecting their partner through intimacy or intercourse and 70.5% stated that their interest in sex was “not at all” or “not really” affected by their COVID-19 infection. Finally, 68.2% of participants reported that their ability to enjoy sex was “not at all” or “not really” affected by their COVID-19 infection. Conclusions: The majority of participants in this study did not experience improved sexual function during the pandemic, but those who did may offer insight into psychosocial and environmental factors that contribute to sexual function. The majority of participants who experienced COVID-19 infection did not report significant disruption to their sexual function as a result of their infection.