Infertility Management Disruption During the COVID-19 Outbreak in a Middle-Income Country: Patients’ Choices, Attitudes, and Concerns

Nadia Muhaidat,1 Mohammad A Alshrouf,2 Abdulrahman M Karam,2 Mohammed Elfalah2 1Department of Obstetrics and Gynecology, School of Medicine, The University of Jordan, Amman, 11942, Jordan; 2School of Medicine, The University of Jordan, Amman, 11942, JordanCorrespondence: Nadia MuhaidatFaculty of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, JordanTel +962798385775Email nadiadat@hotmail.comPurpose: This study aims to assess the degree of infertility management service disruption during the pandemic from the patient’s point of view, as well as patients’ attitudes toward seeking investigations and management, and their thoughts on how appropriate it is for health establishments to continue offering these services during this period while assessing their concerns regarding the risk of COVID-19 infection during treatment or pregnancy.Methods: This study involved a cross-sectional survey of 213 women who were seeking infertility management in January 2021 in Jordan. An electronic questionnaire was designed and validated, which was then distributed on social media platforms.Results: Over half of the participants had experienced some form of voluntary or involuntary disruption of their infertility management journey. The decision to postpone treatment was significantly associated with fear of infection (p = 0.009) and was more likely if they had undergone two or more previous cycles of in vitro fertilization treatment (p = 0.004). The majority of participants agreed that infertility services should remain available during the pandemic for those who chose not to delay their treatment journey, as the delay may have negative financial and psychological implications and may affect the chance to achieve a successful pregnancy in the future.Conclusion: The patients have faced uncertainty regarding the achievability of their long-term fertility goals amidst an atmosphere of general unpredictability for the duration and extent of disruption of their treatment, combined with the fear of infection. Therefore, it is necessary to highlight the need to address how infertility services can be maintained for those who decide to seek treatment during an outbreak while minimizing the risk of contracting COVID-19 in the process.Keywords: subfertility, assisted reproduction services, pandemic, Jordan, cross-sectional study, contagion anxiet