Suspension of fertility treatment during the COVID-19 pandemic: views, emotional reactions and psychological distress among women undergoing fertility treatment.

RESEARCH QUESTION: What are the views and emotional reactions of patients towards the suspension of fertility treatment during the COVID-19 pandemic, and what are the factors affecting their psychological distress? DESIGN: A cross-sectional study conducted in an academic fertility centre. Online questionnaires were distributed between 18 April 2020 and 23 April 2020 to patients whose treatment cycle had been postponed or discontinued. The outcome measures included agreement with the reproductive society guidelines to postpone treatments; willingness to resume treatments, given the choice; patients' emotional reactions; and psychological distress level, measured by the Mental Health Inventory validated scale. A multivariate linear regression was conducted to identify factors associated with psychological distress. RESULTS: Because of the small number of male respondents, only women were included in the analysis (n = 181). Forty-three per cent expressed disagreement with the guidelines and 82% were willing to resume treatments, given the choice. Sadness and anxiety were the most common emotional reactions expressed towards the guidelines. In the multivariate analysis, COVID-19-related anxiety (B = 0.145, P = 0.04) and disagreement with treatment suspension (B = -0.44, P = 0.001) were found to be significantly associated with patients' psychological distress. Background characteristics of patients did not contribute significantly to their distress. CONCLUSIONS: Suspension of fertility treatment during the initial phase of the COVID-19 pandemic was associated with patients' negative emotional reactions. Anxiety related to COVID-19 and disagreement with treatment suspension were found to be significantly associated with psychological distress among women undergoing fertility treatment, regardless of their background characteristics. Our findings suggest the need to monitor the mental health of patients and provide psychological support should a shutdown of fertility care re-occur.

Policy for reducing unplanned pregnancies and repeat unplanned pregnancies rates in Israeli Defense Force.

Israel has compulsory military service, beginning at the age of 18. Women serve about two years and men for about three years. However, de facto only some of the potential service entrants are recruited. Among women, those who enlist are mainly secular Jews who are unmarried; among men, most of the ultra-Orthodox Jews do not enlist. In addition, only a fraction of the recruits chooses to turn the military service into a career and sign up for additional service as professional military personal (officers and non-commissioned officers). Thus, military personnel are not representative of the general Israeli population, even after controlling for age.The rate of pregnancies among female soldiers (obligatory service) in the Israeli army is low, but almost all pregnancies in this group are unplanned and most result in termination of pregnancy. An unplanned pregnancy carries a direct impact on the service of that female soldier and consequently on the military's routine.In a recent article in the Israel Journal of Health Policy Research (IJHPR), Rottenstreich et al. (IJHPR 7:42, 2018) describe a retrospective cohort study designed to evaluate the prevalence and risk factors for repeated unintended pregnancies among this population of female soldiers.This commentary presents the current IDF policy intended to further reduce unplanned pregnancies and repeat unplanned pregnancies rates. We also suggest additional tools to support evidence-based strategy planning in this field.

Campylobacter coli infection causing second trimester intrauterine growth restriction (IUGR): a case report and review of the literature.

Campylobacter is a gram-negative, microaerophilic, curved rod and a normal resident of the gastrointestinal flora and may be the cause of disease in animals. Transmission to humans occurs by ingestion of contaminated food or by direct contact with infected animals. In the past few decades, an increasing number of reports have implicated the presence of this organism in human abortions as well. An infectious mechanism due to primary placental inflammatory damage followed by secondary damage to the fetus following placental insufficiency and ischemia was suggested. The most common species of Campylobacter are Campylobacter jejuni and Campylobacter coli, which are classically associated with enteritis in humans. We present a rare case of mid-gestation intrauterine growth restriction (IUGR) associated with maternal bacteremia caused by C. coli infection. Our literature review focuses on Campylobacter infections occurring in the second and third trimesters of pregnancy. In all cases, mild maternal symptoms consisting of fever and weakness were presented. However, associated adverse fetal outcome, including abortions, IUGR or preterm labor may occur more frequently than anticipated. Our report strengthens the importance of awareness to this finding and focuses the need to consume properly cooked meat during pregnancy.