The influence of neurovegetative and psychological characteristics of infertile patients with long-term COVID-19 on the effectiveness of assisted reproductive technologies

Abstract

The connection of the long-COVID-19 symptom with violations of various systemic factors, in particular with the female reproductive system, is considered, but the number of such studies is not large. The purpose of the study is the influence of neurovegetative and psychological characteristics of infertile patients with long-term COVID-19 on the effectiveness of assisted reproductive technologies (ART). Materials and methods. The main group consisted of 80 women with infertility and "long-COVID", the comparison group - 40 patients without a history of COVID-19. In the main group, 2 subgroups were distinguished: 1 - 64 women with unsuccessful ART and 2 - 16 patients in whom ART was successful (a live birth was obtained). Socio-economic status and stress factors (questionnaire), fear of stress-19 (FCV-19S scale), autonomic dysfunction were assessed using the O.M. questionnaire. Wayne (1998), Anxiety and Depression Levels on the Hospital Anxiety and Depression Scale (HADS). The used methods of variational statistics using the Student's t-test and Fisher's angular transformation with a critical significance level of p<0.05 were used to calculate the odds ratio (OR) and its confidence interval (CI). Results. Women with infertility and "long-COVID-19" are characterized by a relatively low level of socio-economic status: a lower level of income, a smaller share of entrepreneurs and housewives, not comfortable enough living conditions. These patients have a higher level of stressogenic load: comorbidity with chronic somatic pathology (58.8%), conflict situations in the family (31.3%), dissatisfaction with their sexual relationships (58.7%), a significantly higher level of fear of COVID -19 (29.73±1.31 points). Vegetative dysfunction is diagnosed in 82.5% of patients. Symptoms that are typical for "long-COVID-19" are most often noted: reduced work capacity/fatigue (82.5%), attack-like headaches (72.5%), difficulty breathing (47.5%), sleep disturbances (47 .5%). Unfavorable medico-social and psychological risk factors for the failure of ART programs in patients with "long-COVID-19" can be a point assessment of the autonomic dysfunction syndrome above 25 (OR=5.80, CI 1.22-27.64), anxiety (OR=5.80, CI 1.56-21.62), presence of depression (OR=4.20, CI 1.27-13.89), chronic somatic disease (OR=4.20, CI 1.30-13.62), conflict situations (OR=3.86, CI 1.24-12.04). Conclusions. Women with infertility and "long-COVID-19" need additional examinations to assess the medical and social status, vegetative function and psychological state, correction of detected violations. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research. No conflict of interests was declared by the authors.