Delays and uncertainties in IVF treatment due to COVID-19 measures are a source of anxiety and depression for patients, new evidence suggests.
Results from three surveys of UK and Italian patients presented at the virtual 2020 meeting of the European Society of Human Reproduction and Embryology (ESHRE), show that changes in the delivery of care, delays in restarting treatment and an unknown impact on pregnancy are among major concerns for patients during the COVID-19 pandemic. These uncertainties have caused anxiety and depression in some - and even suicidal thoughts in a small minority of cases.
Presenter and author of one UK-based study, Dr Babu Karavadra, Norwich Medical School, told BioNews 'It was very important for us to explore service users' views and experiences during this unpredictable time. The voice of patients and service users should always be at the forefront when delivering care.'
Dr Karavadra's study which was co-authored by Professor Adam Balen from Leeds Teaching Hospital and Dr Eddie Morris, president of the Royal College of Obstetricians and Gynaecologists, found that for the 422 participant experiences gathered, treatment delays were reported to have a negative impact on fertility treatment for 92 percent of patients.
Online questionnaires showed that 62 percent of participants felt uncertainty over their treatments and the unknown impacts of the pandemic, such as pregnancy outcomes and gynaecology services.
Follow-up, in-depth interviews with some of these participants added that many patients turned to online forums because of the perceived inconsistencies in information received from clinics on when services might resume.
While acknowledging the small-scale nature of the study, Dr Karavadra said that service providers could use the findings to appreciate the patient's perspective when fully resuming their services and 'be mindful of patient concerns'.
Professor Balen told BioNews: 'During the lockdown it was very important for us to communicate with our patients and to keep them updated about what was happening as even the relatively short closure of IVF clinics resulted in immense stress, as illustrated in this large survey of patients across the UK. We have learned the power of social media and new ways to communicate better - important lessons for the future.'
A separate study by Professor Jacky Boivin from the school of psychology at Cardiff University, reported similar findings. Questionnaires completed anonymously by 450 UK patients indicated that that clinic closures have been perceived by some patients as a 'devastating and uncertain situation that has taxed coping abilities'.
In Italy, too, the pandemic had caused an increase in the prevalence of mental health problems among fertility patients whose IVF was interrupted, reported by Dr Fabio Barra from the department of Obstetrics and Gynaecology, University of Genoa, Italy. Dr Barra presented data based on 525 participants from his own centre showing a prevalence rate of 22 percent for anxiety and 18 percent for depression.
The researchers agreed that collaboration will be crucial to managing these reactions, while discussions will be needed to determine who should be first in line for treatment when it resumes. Dr Karavadra said, 'We hope that the findings from our study will help in the resumption of fertility services and encourage collaborative working amongst professionals'.