Authors
1 Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran, Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
2 Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran, Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran,
3 Department of Midwifery, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
4 Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
Abstract
Infertile couples experience a lot of psychological stress due to the inability to achieve the desired
social role. Couples who decide to continue assisted reproductive therapy (ART) during the epidemic
also experience the psychological impact of the COVID-19 epidemic, which affects their daily lives
due to social isolation, quarantine, travel restrictions, and cancellation of treatment. Therefore, the
purpose of this study was to assess the mental health of infertile couple pausing or delaying their
treatment due to the COVID-19 pandemic. PubMed, Scopus, Cochrane, Embase, Web of Science,
ScienceDirect, Google Scholar, Research Gate, and the World Health Organization databases and
websites were systematically searched for original studies concerning abortion in the era of COVID-19
pandemic published by August 15, 2021. We used the following keywords: “COVID-19 Corona
virus, infertility, reproductive technique, fertilization, assisted reproduction, pregnant termination,
psychological, in vitro mental status, depressive symptoms, and anxiety.” In sum, after automatically
and manually search and excluding duplicates, 269 articles were found. In final, after screening, 18
articles were selected. Most patients experienced negative emotions during the COVID-19 epidemic.
When reproductive services were re-established, participants showed higher levels of anxiety and
lower quality of life than before quarantine. Women who thought pregnancy was more important
than getting COVID-19 had higher levels of anxiety than women who thought otherwise (P < 0.05).
The COVID-19 pandemic has negative impacts on the mental health and quality of life of patients
seeking fertility services and coping with it requires timely and appropriate psychological intervention,
accurate information, and social and organizational support.
Keywords
prevalence of infertility in Canada. Hum Reprod 2012;27:738‑46.
2. DomarAD, Rooney K, HackerMR, SakkasD, DodgeLE. Burden of
care is the primary reason why insured women terminate in vitro
fertilization treatment. Fertil Steril 2018;109:1121‑6.
3. Katz P, Showstack J, Smith JF, Nachtigall RD, Millstein SG,
Wing H, et al. Costs of infertility treatment: Results from an
18‑month prospective cohort study. Fertil Steril 2011;95:915‑21.
4. Kong L, Shao Y, Xia J, Han J, Zhan Y, Liu G, et al. Quantitative and
qualitative analyses of psychological experience and adjustmentof in vitro fertilization‑embryo transfer patients. Med Sci Monit
2019;25:8069‑77.
5. Stewart LM, Holman CD, Hart R, Finn J, Mai Q, Preen DB. How
effective is in vitro fertilization, and how can it be improved? Fertil
Steril 2011;95:1677‑83.
6. Greil AL, Slauson‑Blevins K, McQuillan J. The experience
of infertility: A review of recent literature. Sociol Health Illn
2010;32:140‑62.
7. Galst JP. The elusive connection between stress and infertility:
A research review with clinical implications. J Psychother Integr
2018;28:1.
8. La Rosa VL, Barra F, Chiofalo B, Platania A, Di Guardo F,
Conway F, et al. An overview on the relationship between
endometriosis and infertility: The impact on sexuality and
psychological well‑being. J Psychosom Obstet Gynaecol
2020;41:93‑7.
9. Vitale SG, La Rosa VL, Rapisarda AM, Laganà AS. Endometriosis
and infertility: The impact on quality of life and mental health. J
Endometr Pelvic Pain Disord 2017;9:112-5.
10. Banitalebi S, Mohammadi K, Marjanian Z, Rabiei L, Masoudi R.
The effect of COVID‑19 epidemic on the mental health of nurses’
family members. J Educ Health Promot 2021;10:368.
11. Esposito V, Rania E, Lico D, Pedri S, Fiorenza A, Strati MF,
et al. Influence of COVID‑19 pandemic on the psychological
status of infertile couples. Eur J Obstet Gynecol Reprod Biol
2020;253:148‑53.
12. Gordon JL, Balsom AA. The psychological impact of fertility
treatment suspensions during the COVID‑19 pandemic. PLoS
One 2020;15:e0239253.
13. Boivin J, Harrison C, Mathur R, Burns G, Pericleous‑Smith A,
Gameiro S. Patient experiences of fertility clinic closure during
the COVID‑19 pandemic: Appraisals, coping and emotions. Hum
Reprod 2020;35:2556‑66.
14. Gathiya N, Kumar S. Psychosocial implication of quarantine and
lockdown during COVID‑19 pandemic in India. J Educ Health
Promot 2020;9:363.
15. Torales J, O’Higgins M, Castaldelli‑Maia JM, Ventriglio A. The
outbreak of COVID‑19 coronavirus and its impact on global
mental health. Int J Soc Psychiatry 2020;66:317‑20.
16. Vaughan DA, Shah JS, Penzias AS, Domar AD, Toth TL. Infertility
remains a top stressor despite the COVID‑19 pandemic. Reprod
Biomed Online 2020;41:425‑7.
17. Lawson AK, McQueen DB, Swanson AC, Confino R, Feinberg EC,
Pavone ME. Psychological distress and postponed fertility
care during the COVID‑19 pandemic. J Assist Reprod Genet
2021;38:333‑41.
18. Perone HR, Stump H, Herweck A, Levine H, Wong AJ, Carugno J.
Trends in social media topics during COVID‑19 among women
undergoing assisted reproductive technology treatments. Cureus
2020;12:e11049.
19. Seifer DB, Petok WD, Agrawal A, Glenn TL, Bayer AH, Witt BR,
et al. Psychological experience and coping strategies of patients in
the Northeast US delaying care for infertility during the COVID‑19
pandemic. Reprod Biol Endocrinol 2021;19:1‑16.
20. Cirillo M, Rizzello F, Badolato L, De Angelis D, Evangelisti P,
Coccia ME, et al. The effects of COVID‑19 lockdown on lifestyle
and emotional state in women undergoing assisted reproductive
technology: Results of an Italian survey. J Gynecol Obstet Hum
Reprod 2021;50:102079.
21. Haham LM, Youngster M, Kuperman Shani A, Yee S,
Ben‑Kimhy R, Medina‑Artom TR, et al. Suspension of fertility
treatment during the COVID‑19 pandemic: Views, emotional
reactions and psychological distress among women undergoing
fertility treatment. Reprod Biomed Online 2021;42:849‑58.
22. Barra F, La Rosa VL, Vitale SG, Commodari E, Altieri M, Scala C,
et al. Psychological status of infertile patients who had in vitro
fertilization treatment interrupted or postponed due to COVID-19
pandemic: A cross-sectional study. J Psychosom Obstet Gynaecol
2020;43:145-52.
23. Bortoletto P, Applegarth L, Josephs L, Witzke J, Romanski PA,
Schattman G, et al. Psychosocial response of infertile patients
to COVID-19-related delays in care at the epicenter of the
global pandemic. Minerva Obstet Gynecol 2021;(preprint). [doi:
10.23736/ S2724-606X.21.04852-1].
24. Ben‑Kimhy R, Youngster M, Medina‑Artom TR, Avraham S,
Gat I, Marom Haham L, et al. Fertility patients under COVID‑19:
Attitudes, perceptions and psychological reactions. Hum Reprod
2020;35:2774‑83.
25. Biviá‑Roig G, Boldó‑Roda A, Blasco‑Sanz R, Serrano‑Raya L,
DelaFuente‑Díez E, Múzquiz‑Barberá P, et al. Impact of the
COVID‑19 pandemic on the lifestyles and quality of life of women
with fertility problems: A cross‑sectional study. Front Public
Health 2021;9:686115.
26. Cao LB, Hao Q, Liu Y, Sun Q, Wu B, Chen L, et al. Anxiety
level during the second localized COVID‑19 pandemic among
quarantined infertile women: A cross‑sectional survey in China.
Front Psychiatry 2021;12:647483.
27. Kaur H, Pranesh GT, Rao KA. Emotional impact of delay in
fertility treatment due to COVID‑19 pandemic. J Hum Reprod
Sci 2020;13:317.
28. Qu P, Zhao D, Jia P, Dang S, Shi W, Wang M, et al. Changes
in mental health of women undergoing assisted reproductive
technology treatment during the COVID‑19 pandemic outbreak
in Xi’an, China. Front Public Health 2021;9:645421.
29. Şahin B, Şahin BU, Karlı P, Sel G, Hatırnaz Ş, Kara OF, et al. Level
of depression and hopelessness among women with infertility
during the outbreak of COVID-19: A cross-sectional investigation.
Clin Exp Obstet Gynecol 2021;48:594-600.
30. Tokgoz VY, Kaya Y, Tekin AB. The level of anxiety in infertile
women whose ART cycles are postponed due to the COVID-19
outbreak. J Psychosom Obstet Gynecol 2020;43:114-21.
31. Asai K, Wakashima K, Toda S, Koiwa K. Fear of novel coronavirus
disease (COVID‑19) among pregnant and infertile women in
Japan. J Affect Disord Rep 2021;4:100104.
32. Peivandi S, Razavi A, Shafiei S, Zamaniyan M, Orafaie A,
Jafarpour H. Evaluation of attitude among infertile couples about
continuing assisted reproductive technologies therapy during
novel coronavirus outbreak. medRxiv 2020; (preprint).
)