Delay in fertility treatment has caused anxiety and depression

The European Society for Human Reproduction and Embryology (ESHRE) Annual Congress took place virtually last week. Participants attending a special session of the conference were told that uncertainties in treatment have caused anxiety, depression and even in a small minority of cases suicidal thoughts in some patients.

ESHRE stated, “Evidence presented from surveys of UK and Italian patients have now found that delays and uncertainties in treatment have been and remain a source of anxiety and depression for many.”

The anxiety and depression experienced by some patients seems to relate to three key areas:

  • Changes in the delivery of their care
  • Delays in restarting their treating
  • The unknown impact of Covid19 on their potential pregnancy

The evidence for the studies came from the UK and Italy, where fertility services were temporarily suspended as a precautionary measure against COVID19.

Speaking for the UK, Dr. Babu Karavadra, University of East Anglia, presented a study of 422 patient experiences during the pandemic lockdown. He found the virus had had a negative impact on fertility treatment for 92% of patients. In addition:

  • Four out of five (62%) participants felt uncertainty over their treatments and the unknown impacts of the pandemic, such as pregnancy outcomes and gynaecology services
  • Many patients turned to online forums because of the variation in information received from clinics on when services might resume.

As UK clinics reopened after the pandemic restrictions, patients also felt fertility care should be prioritised according to advancing maternal age, socio-economic background and whether they had previous unsuccessful treatments.

Addressing the symposium, Dr. Karavadra said, “I hope that service providers will use the findings to appreciate the patient’s perspective when fully resuming their services and be mindful of patient concerns”.

Professor Jacky Boivin, Cardiff University presented a separate UK study of 450 participants, which revealed similar results.

In her study:

  • More than four in five (81.6%) had tests or treatments postponed

This left many feeling a sense of threat or harm.

  • One in ten felt unable to cope
  • A small number (1%) expressed suicidal thoughts.

A strong source of anxiety arose from not knowing when clinics would reopen. Those worse affected feared that they would be unable to conceive because of the delays. Professor Boivin said, “This shows we have to think who gets treatment first.”

The psychological impact of the COVID19 shutdown was also evident in Italy, which saw a sharp increase in mental health problems among patients whose IVF was interrupted.

Professor Fabio Barra, University of Genoa presented his study of 525 patients from his own centre, which showed:

  • A 22% rate of anxiety
  • An 18% rate of depression
  • Patients over the age of 35 were most affected.

Commenting on these studies, in her closing remarks at the end of the symposium, Co-Chair Professor Françoise Shenfield said, “Clinics should consider how best to manage patient uncertainty as they reopen. It’s important to realise how anxious patients are and to help them as much as possible.”