The impact of COVID-19 mitigation measures on fertility patients and clinics around the world
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ABSTRACT: RESEARCH QUESTION
What is the impact of the response to COVID-19 on the management of fertility treatments and clinical practice around the world. DESIGN
We approached fertility clinic associates around the world. They completed an online survey containing 33 questions focused on the country's response to the COVID-19 pandemic. Known fertility clinic associates were contacted comprising scientific directors, medical directors, and lab managers. RESULTS
We obtained 43 individual country responses from Asia (13), Africa (3), Europe (17), North America (3), Oceania (2) and South America (5). In 9 countries, clinics followed their government body recommendations, in 22 countries there was a combination of recommendations, in 3 countries changes were made by clinic initiative and 9 countries did not specify. In 34 countries IVF/ICSI and FET treatments had an average delay of 59 days (IVF/ICSI) and 60 days (FET) (minimum 0, maximum 228 days). During the shutdown, the number of freeze-all cycles increased in 22 countries. Only 23 countries reported patients having to undergo a SARS-CoV-2 test, 20 countries did not report any COVID-19 testing in their clinic. Additional support counselling was offered in 28 countries, partner restrictions to clinics were reported in 41 countries and time between patients’ appointments was increased in 39 countries. CONCLUSION
The implications of COVID-19 mitigation measures proved the need for government societies to introduce a set protocol that includes requirements such as increased patient counselling and additional guidelines for prioritizing couples who need care most urgently.
SUBMITTER: Cutting E
PROVIDER: S-EPMC8712431 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPreterm birth is the leading cause of child mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that numbers of preterm births greatly reduced following implementation of policy measures aimed at mitigating the effects of the COVID-19 pandemic. We aimed to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on March 9, March 15, and March 23, 2020, on the incidence of preterm birth.MethodsWe used a national quasi-experimental difference-in-regression-discontinuity approach. We used data from the neonatal dried blood spot screening programme (2010-20) cross-validated against national perinatal registry data. Stratified analyses were done according to gestational age subgroups, and sensitivity analyses were done to assess robustness of the findings. We explored potential effect modification by neighbourhood socioeconomic status, sex, and small-for-gestational-age status.FindingsData on 1 599 547 singleton neonates were available, including 56 720 births that occurred after implementation of COVID-19 mitigation measures on March 9, 2020. Consistent reductions in the incidence of preterm birth were seen across various time windows surrounding March 9 (± 2 months [n=531 823] odds ratio [OR] 0·77, 95% CI 0·66-0·91, p=0·0026; ± 3 months [n=796 531] OR 0·85, 0·73-0·98, p=0·028; ± 4 months [n=1 066 872] OR 0·84, 0·73-0·97, p=0·023). Decreases in incidence observed following the March 15 measures were of smaller magnitude, but not statistically significant. No changes were observed after March 23. Reductions in the incidence of preterm births after March 9 were consistent across gestational age strata and robust in sensitivity analyses. They appeared confined to neighbourhoods of high socioeconomic status, but effect modification was not statistically significant.InterpretationIn this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a substantial reduction in the incidence of preterm births in the following months, in agreement with preliminary observations elsewhere. Integration of comparable data from across the globe is needed to further substantiate these findings and start exploring underlying mechanisms.FundingNone.
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