PATIENT PERCEPTIONS AND IMPACT OF FERTILITY TREATMENT CANCELLATION RELATED TO COVID-19

Abstract

Objective: To assess the knowledge, attitudes, and perception of burdens on patients after fertility treatment cancellations in response to the COVID-19 pandemic Design: A web-based survey involving people who experienced cancellations to fertility treatment due to COVID-19 precautions Materials and Methods: A survey link was disseminated though online infertility forums and groups in the USA Survey data was collected and stored via REDCap and then analyzed with descriptive statistics and Chi square test Results: A preliminary data set of 208 respondents was used 99% of respondents were female and either married or in a relationship The median age was 33 years (range 23-44 years) with 1-12 years of infertility (mode 2 years) Respondents included a wide range of infertility diagnoses and all common modes of treatment In this population, 78 8% reported that they were in the middle of their treatment when cycles were cancelled while 21 1% were cancelled prior to starting Most reported anxiety and stress (79 6%) but also understanding of the situation (68 9%) The major factors contributing to anxiety and stress were lost treatment time (50 7%), younger age (35 years, p value 0 024), and desire for increased communication and emotional support The data showed that only 20 2% of patients perceived the support from their clinics as adequate These patients who felt supported generally reported personal phone calls from their doctors and continued outlets of communication to ask questions and receive updates People reporting perceptions of less support were more likely to have reported getting a recorded message or email with some even stating that the lack of communication caused them to seek out other fertility clinics to feel more supported Additionally, 36% of patients desired more emotional support, and only 3 1% reported being provided additional resources such as mental health counseling 57 7% of patients had positive perceptions of telemedicine as a resource for the future even though most (75%) had not tried it in the past Finally, data showed that the type of cycle affected stress levels: ovulation induction reported most stress 89% followed by in vitro fertilization 80% then frozen embryo transfer 62 9% Patients even suggested a system to help prioritize more urgent patients over others Conclusions: Infertility patients suffered significant stress related to their cycle cancellation from COVID-19 Despite being most worried about lost treatment time, patients advocated for a triage system to prioritize those with poorer prognosis when planning for safe return of fertility treatment Additionally, consensus showed that personal and ongoing communication is key in patients’ perception of support Virtual support platforms and telemedicine may provide a valuable and supplemental outlet to improve patient communication, emotional support, and access to providers Moving forward, incorporating this technology into standard practice will likely enhance patient satisfaction and help decrease anxiety and stress particularly when patients need to delay fertility treatment