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Iranifard E, Yas A, Mansouri Ghezelhesari E, Taghipour A, Mahmoudinia M, Latifnejad Roudsari R. Treatment suspension due to the coronavirus pandemic and mental health of infertile patients: a systematic review and meta-analysis of observational studies. BMC Public Health 2024; 24:174. [PMID: 38218778 PMCID: PMC10787415 DOI: 10.1186/s12889-023-17628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/31/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Access to fertility treatments is considered a reproductive right, but because of the quarantine due to the coronavirus pandemic most infertility treatments were suspended, which might affect the psychological and emotional health of infertile patients. Therefore, this study was conducted to review the mental health of infertile patients facing treatment suspension due to the coronavirus pandemic. METHODS This study was conducted based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guideline. The Web of Science, PubMed, Embase, Scopus, and Cochrane library databases were searched by two independent researchers, without time limitation until 31 December 2022. All observational studies regarding the mental health of infertile patients facing treatment suspension including anxiety, depression, and stress were included in the study. Qualitative studies, editorials, brief communications, commentaries, conference papers, guidelines, and studies with no full text were excluded. Quality assessment was carried out using Newcastle-Ottawa Scale by two researchers, independently. The random effects model was used to estimate the pooled prevalence of mental health problems. Meta-regression and subgroup analysis were used to confirm the sources of heterogeneity. RESULTS Out of 681 studies, 21 studies with 5901 infertile patients were systematically reviewed, from which 16 studies were included in the meta-analysis. The results of all pooled studies showed that the prevalence of anxiety, depression, and stress in female patients was 48.4% (95% CI 34.8-62.3), 42% (95% CI 26.7-59.4), and 55% (95% CI 45.4-65), respectively. Additionally, 64.4% (95% CI 50.7-76.1) of patients wished to resume their treatments despite the coronavirus pandemic. CONCLUSION Treatment suspension due to the coronavirus pandemic negatively affected the mental health of infertile patients. It is important to maintain the continuity of fertility care, with special attention paid to mental health of infertile patients, through all the possible measures even during a public health crisis.
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Affiliation(s)
- Elnaz Iranifard
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Yas
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Taghipour
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Mahmoudinia
- Maternal and Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Tippett A. Reproductive rights where conditions apply: an analysis of discriminatory practice in funding criteria against would-be parents seeking funded fertility treatment in England. HUM FERTIL 2023; 26:483-493. [PMID: 36628623 DOI: 10.1080/14647273.2022.2164746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/17/2022] [Indexed: 01/12/2023]
Abstract
Access to in vitro fertilisation (IVF) funding in England is limited by a range of local criteria set out historically by Clinical Commissioning Groups (CCGs) (now superseded by Integrated Care Boards (ICBs)). Many of these criteria discriminate on the grounds of sexual orientation, relationship status and existing family structure. Contrary to increasing rates of IVF treatment across the UK, NHS funding for IVF treatment has decreased, in some cases rapidly, across most areas of England. This article reviews the eligibility criteria previously developed by CCGs and critically examines three major discrepancies in entitlement to funding: (i) the postcode lottery; (ii) restrictions placed upon lesbians and single women; and (iii) existing family structures as less deserving of funding. Inconsistencies in IVF funding are framed within broader discussions of discrimination and inequality within fertility funding. Recommendations for social and political change are made, alongside areas for future research engagement.
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Affiliation(s)
- Anna Tippett
- Hertfordshire Law School, University of Hertfordshire, Hatfield, UK
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Foti FL, Karner-Huţuleac A, Maftei A. The value of motherhood and psychological distress among infertile women: The mediating role of coping strategies. Front Public Health 2023; 11:1024438. [PMID: 36817897 PMCID: PMC9931740 DOI: 10.3389/fpubh.2023.1024438] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction The present study investigated psychological distress and coping strategies among infertile women during the COVID-19 pandemic using a multi-dimensional model of infertility-related stress. We explored the associations between individual (i.e., age) and situational characteristics related to infertility (i.e., duration of infertility, cause of infertility, number of lost pregnancies, and assisted reproductive techniques [ART] status), and perceived-infertility-related factors (i.e., the perceived importance of motherhood). Methods Our total sample consisted of 193 women aged 20 to 46 (M= 33.23, SD = 4.58), out of which 102 were undergoing ART procedures (M = 33.60, SD = 4.23), and 91 were not (M= 32.81, SD = 4.94). Participants filled in questionnaires measuring psychological distress, coping strategies, and the importance of motherhood. Results Correlation analyses suggested that the importance of motherhood was positively associated with psychological distress and negative coping strategies. Mediation analysis results indicated that both in the overall sample and in the sample of women undergoing ART procedures, the negative self-perception fully mediated the link between the importance of motherhood on psychological distress. In the non-ART sample, we found a significant mediation effect of denial on the link between the importance of motherhood and psychological distress. Discussion We discuss the theoretical and practical implications of the present findings, focusing on the mental health-related consequences of the social stigma of infertility heightened by the pressure of parenthood.
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Affiliation(s)
- Florentina Larisa Foti
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iaşi, Romania
| | - Adina Karner-Huţuleac
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iaşi, Romania
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Săndulescu MS, Văduva CC, Siminel MA, Dijmărescu AL, Vrabie SC, Camen IV, Tache DE, Neamţu SD, Nagy RD, Carp-Velişcu A, Manolea MM. Impact of COVID-19 on fertility and assisted reproductive technology (ART): a systematic review. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:503-510. [PMID: 36588488 PMCID: PMC9926143 DOI: 10.47162/rjme.63.3.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The appearance of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a major obstacle for the performing of current medical activities throughout the world. COVID-19 has affected humanity in many ways, thus causing a great medical, social, economic, and political instability. The aim of this study was to make an analysis of the scientific data obtained by so far to highlight the impact that COVID-19 has had on fertility and assisted reproductive technology (ART). Infection with SARS-CoV-2 alters the normal immune response by local and systemic damage to tissues and organs. After the virus enters the body, the first lesions are produced in the respiratory tract. Extrapulmonary lesions specific to COVID-19 include acute renal lesions/acute kidney damage, hepatocellular lesions, neurological diseases, myocardial dysfunction and arrhythmia, gastrointestinal diseases but also genital impairment. The possible impairment of the male reproductive system is because angiotensin-converting enzyme 2 (ACE2) receptors are in an increased number in the testes, seminiferous duct cells, spermatogonia, Leydig cells and Sertoli cells. Many published studies to date have pointed out that COVID-19 could also affect female fertility and disrupt the functions of the female reproductive system. The theory that this virus can also be transmitted sexually and can cause infertility or testicular damage is supported by the fact that the virus can be isolated in the semen of COVID-19 patients but only during the disease. Choosing the best method of treating infertility during the COVID-19 pandemic is multifactorial, but the risk of infection and compliance with specific ART hygiene protocols must always be considered. Currently, there is no scientific basis regarding the fact that the COVID-19 vaccination would influence fertility.
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Affiliation(s)
- Maria Sidonia Săndulescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;
| | - Constantin-Cristian Văduva
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Mirela Anişoara Siminel
- Department of Neonatology, University of Medicine and Pharmacy of Craiova, Romania , Department of Neonatology, Filantropia Municipal Hospital, Craiova, Romania
| | - Anda Lorena Dijmărescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Sidonia Cătălina Vrabie
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Ioana Victoria Camen
- Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania , PhD Student, Doctoral School, University of Medicine and Pharmacy of Craiova, Romania
| | - Daniela Elise Tache
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Romania
| | - Simona Daniela Neamţu
- Department of Hematology and Immunology, University of Medicine and Pharmacy of Craiova, Romania
| | - Rodica Daniela Nagy
- Department of Obstetrics and Gynecology, Emergency County Hospital, Craiova, Romania
| | - Andreea Carp-Velişcu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania , Department of In Vitro Fertilization, Prof. Dr. Panait Sîrbu Clinical Hospital of Obstetrics and Gynecology, Bucharest, Romania
| | - Maria Magdalena Manolea
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
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Hezavehei M, Shokoohian B, Nasr-Esfahani MH, Shpichka A, Timashev P, Shahverdi AH, Vosough M. Possible Male Reproduction Complications after Coronavirus Pandemic. CELL JOURNAL 2021; 23:382-388. [PMID: 34455712 PMCID: PMC8405085 DOI: 10.22074/cellj.2021.7982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/29/2021] [Indexed: 12/23/2022]
Abstract
Coronavirus disease 2019 (COVID-19), as a severe respiratory disease, affects various tissues and organs. The
specific SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2), is highly expressed in male gonads. Thus,
male reproductive tissues could be a potential target for virus colonization. We performed a comprehensive search in
PubMed and Google Scholar to retrieve relevant articles published till 15 April 2021. The keywords used were: male
fertility, male reproductive health, semen parameters, sex hormones, SARS-CoV-2, and COVID-19. Validated evidence
about the adverse effects of the SARS-CoV-2 infection on the male reproductive system is limited and few studies have
reported semen analysis results or presence of viral RNA in semen samples of infected men. Nevertheless, alterations
in reproductive hormones such as decreased level of testosterone (T) with raised luteinizing hormone (LH) have been
reported in some patients. Although the impact of SARS-CoV-2 infection on the male reproduction health remains
unclear, evidence suggests that male gonads may be potentially vulnerable to SARS-CoV-2 infection. In this article,
we discussed the possible impacts of COVID-19 on male gonads, sex hormones, and semen quality and suggested
preventive solutions.
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Affiliation(s)
- Maryam Hezavehei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Bahare Shokoohian
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | | | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russian
| | - Abdol Hossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Tippett A. Life on pause: An analysis of UK fertility patients’ coping mechanisms after the cancellation of fertility treatment due to COVID-19. J Health Psychol 2021; 27:1583-1600. [PMID: 33685265 PMCID: PMC9092918 DOI: 10.1177/1359105321999711] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In March 2020, fertility clinics across the UK began cancelling all assisted
reproductive technology (ART) treatment, with the Human Fertilisation and
Embryology Authority (HFEA) stopping all ART treatment from going ahead beyond
the 15th April 2020 due to the COVID-19 pandemic. This article examines the
coping mechanisms adopted by fertility patients during this time, focussing on
the emotional support received from online fertility forums and fertility
clinics during the indeterminate wait for treatment to resume. The study draws
upon an online survey which assessed the mental health and wellbeing of 124
female fertility patients whose ART treatment was cancelled due to the
Coronavirus pandemic. The findings indicate a potential for improved
communication between fertility clinics and patients in order to reduce
psychological stress and isolation during the postponement of ART treatment,
alongside better utilisation of online platforms as mechanisms for support. This
article adds to the growing body of knowledge concerned with the implications of
denying reproductive rights to the infertility community during a global
pandemic. It also contributes to sociological discussions on the support
mechanisms available to those navigating infertility and the wider social
management of uncertainty.
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Hamidi F, Babapour F, Hamzehgardeshi Z. Infertility Distress Management in Couples Treated with Assisted Reproductive Techniques (ART) in COVID-19 Pandemic. J Reprod Infertil 2020; 21:312-313. [PMID: 33209743 PMCID: PMC7648875 DOI: 10.18502/jri.v21i4.4331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: World Health Organization estimates that 60–80 million couple worldwide currently suffer from infertility. Recurrent pregnancy loss (RPL) is also another major concern. Chromosomal rearrangements play a crucial role in primary and secondary infertility and RPL. Underlying genetic abnormalities like chromosomal abnormalities contribute to 5–10% of the reproductive failures. The aim of the study was to evaluate the chromosomal abnormalities in infertility and RPL cases to help obstetrician/fertility experts to carry out risk assessment and provide appropriate assisted reproductive techniques for better management of the problem. Methods: Karyotyping was performed for 414 cases with the history of infertility and RPL over a period of one year. Samples were processed according to procedures of AGT cytogenetic laboratory manual. Results: Chromosomal abnormalities were observed in 15% of cases. Robertsonian translocation, reciprocal translocation, inversion, derivatives, marker chromosomes, mosaics, aneuploidy and polymorphic variants each contributed 2%, 3%, 3%, 13%, 2%, 10%, 6% and 61%, respectively. Conclusion: Evaluation of chromosomal abnormalities in couple is warranted prior to planning pregnancy especially for assisted reproductive management cases. Chromosomal analysis can be used as one of the diagnostic tools by OBG/IVF specialists in association with geneticist/genetic counselor for proper reproductive counseling and management.
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Affiliation(s)
- Fatemeh Hamidi
- M.Sc., Student of Midwifery Counseling, Student Research Committee, Department of Midwifery, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzaneh Babapour
- M.Sc., Student of Midwifery Counseling, Student Research Committee, Department of Midwifery, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research Center, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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Borrás A, Guimerà M, Barral Y, Agustí I, Manau Trullàs MD. [SARS-CoV-2 pandemic and assisted reproduction]. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2020; 47:96-105. [PMID: 32834306 PMCID: PMC7303616 DOI: 10.1016/j.gine.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 01/10/2023]
Abstract
La pandemia por el nuevo virus SARS-CoV-2 ha provocado un proceso de adaptación a la nueva situación por parte de toda de la sociedad y, con ello, los centros de reproducción asistida. Tras la fase aguda de la crisis sanitaria, en la que se redujo de forma drástica la actividad, se han reanudado los ciclos, guiados por las recomendaciones de las sociedades científicas. En este artículo revisamos toda la información publicada respecto al virus y el sistema reproductivo, señalando la presencia de enzima convertidora de angiotensina tipo ii(angiotensin-converting enzyme 2, ACE2) en el sistema reproductivo femenino y masculino, a nivel testicular, ovárico, endometrial y a nivel embrionario. Además, realizamos un análisis comparativo entre las recomendaciones de las sociedades científicas en cuanto al cribado de la infección, las normas de funcionamiento y las medidas generales de laboratorio.
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Affiliation(s)
- A Borrás
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - M Guimerà
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - Y Barral
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - I Agustí
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - M D Manau Trullàs
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
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