Original Articles

Attitudes and Knowledge of Infertile Iranian Couples Among Treatment With Assisted Reproductive Technologies During COVID-19 Pandemics


Objective: The coronavirus disease 2019 (COVID-19) pandemic affected the continuation of all non-emergency medical treatment and patients potentially suffer from restrictions including patients under infertility treatment. This study aimed to evaluate the knowledge and attitudes of infertile couples about continuing assisted reproductive technologies (ARTs) therapy during the COVID-19 outbreak, in Sari, Iran.
Materials and methods: We conducted a prospective longitudinal investigation on potential infertile couples for treatment with ARTs referred to our infertility clinic from March 2020 to June 2020. Ninety-two patients were studied voluntarily and anonymously in this study. A self-developed structured questionnaire was used to assess the attitude towards continuing infertility treatment. A P-value of less than 0.05 was considered statistically significant.
Results: Thirty-two patients (33.33%) had decreased motivation to continue treatment during the COVID-19 pandemic. Fear of transmission to the fetus (28.13%) had the highest frequency among the causes of decreased motivation to continue treatment (P-value = 0.011). Trust on the support of the treatment team (56.67%) was the most common reason for not reducing motivation in patients without decreased motivation (P <0.001).
Conclusion: Despite the COVID-19 pandemy, in Iran most infertile patients tended to continue ARTs. Although many patients had passable knowledge on COVID-19, the stress of infertility and the high desire of infertile couples to have children did not deter them from continuing their therapy.

1. Razavi A, Davoodi L, Shojaei L, Jafarpour H. COVID-19 in children: a narrative review. Open Access Macedonian J Med Sci 2020; 8: 23-31.
2. Davoodi L, Oladi Z, Jafarpour H, Zakariaei Z, Soleymani E, Razavi A. A 33-year-old man with COVID-19 presented with subacute thyroiditis: A rare case report and literature review. New Microbes New Infect 2021; 41: 100871.
3. Davoodi L, Jafarpour H, Oladi Z, Zakariaei Z, Tabarestani M, Ahmadi BM, et al. Atorvastatin therapy in COVID-19 adult inpatients: A double-blind, randomized controlled trial. Int J Cardiol Heart Vasc 2021; 36: 100875.
4. Davoodi L, Jafarpour H, Taghavi M, Razavi A. COVID-19 Presented With Deep Vein Thrombosis: An Unusual Presenting. J Investig Med High Impact Case Rep 2020; 8: 2324709620931239.
5. Davoodi L, Jafarpour H, Kazeminejad A, Soleymani E, Akbari Z, Razavi A. Hydroxychloroquine-induced Stevens–Johnson syndrome in COVID-19: a rare case report. Oxf Med Case Reports 2020; 2020: omaa042.
6. Sullivan EA, Zegers-Hochschild F, Mansour R, Ishihara O, de Mouzon J, Nygren KG, et al. International Committee for Monitoring Assisted Reproductive Technologies (ICMART) world report: assisted reproductive technology 2004. Hum Reprod 2013; 28: 1375-90.
7. Vuong, LN, Ho, VN, Pham, TD, et al. (2020) Fertility and Sterility Dialog. Attitudes to infertility work-up and treatment during the COVID-19 pandemic: Survey of couples from Vietnam. Available at: https://www.fertstertdialog.com/posts/attitudes-to-infertility-work-up-and-treatment-during-the-covid-19-pandemic-survey-of-couples-from-vietnam (accessed 6 May 2021).
8. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol 2020; 222: 415-26.
9. Rodriguez‐Wallberg KA, Wikander I. A global recommendation for restrictive provision of fertility treatments during the COVID‐19 pandemic. Acta Obstet Gynecol Scand 2020; 99: 569-70.
10. Maroufizadeh S, Karimi E, Vesali S, Omani Samani R. Anxiety and depression after failure of assisted reproductive treatment among patients experiencing infertility. Int J Gynaecol Obstet 2015; 130: 253-6.
11. Greil AL, Slauson‐Blevins K, McQuillan J. The experience of infertility: a review of recent literature. Sociol Health Illn 2010; 32: 140-62.
12. Verhaak CM, Smeenk JM, Nahuis MJ, Kremer JA, Braat DD. Long-term psychological adjustment to IVF/ICSI treatment in women. Hum Reprod 2007; 22: 305-8.
13. Cassidy T, Sintrovani P. Motives for parenthood, psychosocial factors and health in women undergoing IVF. Journal of Reproductive and Infant Psychology 2008; 26: 4-17.
14. Ben-Kimhy R, Youngster M, Medina-Artom TR, Avraham S, Gat I, Marom Haham L, et al. Fertility patients under COVID-19: attitudes, perceptions and psychological reactions. Hum Reprod 2020; 35: 2774-83.
15. Afshani SA, Abdoli AM, Hashempour M, Baghbeheshti M, Zolfaghari M. The attitudes of infertile couples towards assisted reproductive techniques in Yazd, Iran: A cross sectional study in 2014. Int J Reprod Biomed 2016; 14: 761-8.
16. El Kissi Y, Romdhane AB, Hidar S, Bannour S, Ayoubi Idrissi K, Khairi H, et al. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women. Eur J Obstet Gynecol Reprod Biol 2013; 167: 185-9.
17. Vaiarelli A, Bulletti C, Cimadomo D, Borini A, Alviggi C, Ajossa S, et al. COVID-19 and ART: the view of the Italian Society of Fertility and Sterility and Reproductive Medicine. Reprod Biomed Online 2020; 40: 755-9.
18. Szalma I, Bitó T. Knowledge and attitudes about assisted reproductive technology: Findings from a Hungarian online survey. Reprod Biomed Soc Online 2021; 13: 75-84.
19. Rizwan M, Ahmad T, Qi X, Murad MA, Baig M, Sagga AK, et al. Social Media Use, Psychological Distress and Knowledge, Attitude, and Practices Regarding the COVID-19 Among a Sample of the Population of Pakistan. Front Med (Lausanne) 2021; 8: 754121.
20. Scotland GS, McNamee P, Peddie VL, Bhattacharya S. Safety versus success in elective single embryo transfer: women’s preferences for outcomes of in vitro fertilisation. BJOG 2007; 114: 977-83.
21. Lenton EA. Stimulated intrauterine insemination: efficient, cost-effective, safe? Hum Fertil(Camb) 2004; 7: 253-65.
22. Sarafino EP, Smith TW. Health psychology: Biopsychosocial interactions. 9th ed. New Jersey: John Wiley & Sons, 2016.
23. Schwarzer R, Knoll N. Functional roles of social support within the stress and coping process: A theoretical and empirical overview. International Journal Psychology 2007; 42: 243-52.
24. Gemmell LC, Williams Z, Forman EJ. Considerations on the restriction of Assisted Reproductive Technology (ART) due to COVID-19. Semin Perinatol. 2020; 44: 151288.
25. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues Clin Neurosci 2018; 20: 41-7.
26. Widge A. Seeking conception: Experiences of urban Indian women with in vitro fertilisation. Patient Educ Couns 2005; 59: 226-33.
27. Brucker PS, McKenry PC. Support from health care providers and the psychological adjustment of individuals experiencing infertility. J Obstet Gynecol Neonatal Nurs 2004 ; 33: 597-603.
28. Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020; 395: 1973-87.
29. Song C, Wang Y, Li W, Hu B, Chen G, Xia P, et al. Absence of 2019 novel coronavirus in semen and testes of COVID-19 patients. Biol Reprod 2020; 103: 4-6.
30. Patrì A, Gallo L, Guarino M, Fabbrocini G. Sexual transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): A new possible route of infection? J Am Acad Dermatol 2020; 82: e227-e.
31. Lenton EA. Stimulated intrauterine insemination: efficient, cost-effective, safe? Hum Fertil(camb) 2004; 7: 523-65.
32. Volgsten H, Svanberg AS, Olsson P. Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment. Acta Obstet Gynecol Scand 2010; 89: 1290-7.
33. Ying LY, Wu LH, Loke AY. The experience of Chinese couples undergoing in vitro fertilization treatment: perception of the treatment process and partner support. PLoS One 2015; 10: e0139691.
34. Dickson DA, Mankee-Sookram S, Jess N, Minto-Bain CL, Ramsewak S. Knowledge, attitudes and practices of patients of a fertility clinic in a ZIKA-endemic Caribbean country. Fertil Steril 2017; 108: e327-e8.
IssueVol 16, No 2 (June 2022) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v16i2.9480
COVID-19 Assisted Reproductive Technology Attitude Infertility

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Peivandi S, Razavi A, Shafiei S, Zamaniyan M, Orafaie A, Jafarpour H. Attitudes and Knowledge of Infertile Iranian Couples Among Treatment With Assisted Reproductive Technologies During COVID-19 Pandemics. J Family Reprod Health. 2022;16(2):116-123.