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DOI:10.1142/S2661318221500080

COVID-19 Pandemic Impacts Decision-Making and Psychosocial Behavior in Women Seeking Fertility Treatment in APAC—an ASPIRE Patient Experience Report

Budi Wiweko1,*, Tuong M. Ho2, Atsushi Tanaka3, Vanessa Raggio4, Jung-Ryeol Lee5, Milind Patil6, Carina Chi-Wai Chan7, Teraporn Wutayavanich8, Feiyang Diao9, Suresh Nair10,Rudie Frederick Mendiola11

1 Department Obstetric Gynecology Faculty of Medicine Universitas Indonesia — Dr. Cipto Mangunkusumo General Hospital, Indonesia Medical Education Research Institute (IMERI) Faculty of Medicine Universitas Indonesia
Jakarta, Indonesia
2 IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
3 Saint Mother Hospital & Juntendo University, Japan
4 Adora Fertility, Australia
5 Seoul National University, Bundang Hospital, Seongnam, South Korea
6 Shobha Test-Tube Baby Centre, Maharashtra, India
7 Hong Kong Reproductive Health Centre, Hong Kong
8 Chiangmai IVF, Thailand
9 Clinical Center of Reproductive Medicine, Key State Laboratory of Reproductive Medicine,
The First Affiliated Hospital with Nanjing Medical University, China
10 Seed of Life, Singapore
11 Kato Repro Biotech Center, Philippines

Abstract

Background: ASPIRE (Asia-Pacific Initiative on Reproduction) aims to develop a “patient-centered” guide to provide fertility treatment based on patient preferences, needs, and concerns during and beyond the SARS-Cov-2 pandemic.

Methods: Women, aged 20–45 years old, trying to conceive for more than 6 months and contemplating for pregnancy including IVF treatment. A country wise analysis of patient behavior, attitudes and concerns, reasons for disruption of treatment and availability of assistance from fertility clinics during SARS-Cov-2 pandemic was performed. Six problem statements addressing patient concerns were identified and corresponding solutions to improve patient experience were formulated. A two-tier recommendation was developed. Tier 1 comprises recommendations in which the rate of “absolutely agree” responses were ≥">60%, whereas tier 2 refers to recommendations in which the rate of “absolutely agree” plus “agree” together was >60%.

Results: Women in countries that have better infection control and are living a new normal were less worried about the pandemic influencing their lifestyle and finances. The proportion of women choosing not to continue IVF/IUI treatment during COVID-19 was similar across countries. Sixty-five percent of women in Group A intend to continue treatment during COVID-19 pandemic. Nine out of 10 patients are expected to resume or start treatment once fertility clinics are accessible. A patient-centered guide focusing on management of patient safety concerns, reduction in difficulty of access to hospitals, prioritization of patients, provision of emotional support, and improvement in patient education and acceptance of remote health services was developed.

Conclusion: This ASPIRE patient experience report highlights a patient-centered guide on provision of safe fertility treatment across the Asia-Pacific region, which can be adapted to suit country-specific requirements depending on the stage of the pandemic, local restrictions, and availability of resources.

KEYWORDS:

COVID-19; Pandemic; Assisted Reproductive Technology (ART); Asia Pacific; Decision-Making and Psychosocial Behavior.

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