During the Coronavirus Pandemic and After Its Occurrence, We Need to Think of Infertile Couples More Than Ever

authors:

avatar Zahra Kiani 1 , 2 , * , avatar Mojdeh Banaei 3 , avatar Vida Ghasemi 1

Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Health Reproductive Research Center, Sari Branch, Islamic Azad University, Sari, Iran
Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Iranian Journal of Psychiatry and Behavioral Sciences: Vol.14, issue 3; e107608
published online: August 26, 2020
article type: Letter
received: July 25, 2020
revised: July 28, 2020
accepted: August 11, 2020
DOI: https://doi.org/10.5812/ijpbs.107608

how to cite: Kiani Z, Banaei M, Ghasemi V. During the Coronavirus Pandemic and After Its Occurrence, We Need to Think of Infertile Couples More Than Ever. Iran J Psychiatry Behav Sci. 2020;14(3):e107608. https://doi.org/10.5812/ijpbs.107608.

Dear Editor,

Infertility is a global problem, defined as a failure to achieve pregnancy after one year of sexual intercourse with-out contraception (1). It is estimated that the global prevalence of infertility ranges from 8% to 12%, meanwhile, some infertile couples never seek treatment or remain unidentified (2). In many cultures, infertility is considering a deficiency and therefore is a kind of stigma (3). However, infertility is not a disease, and its treatment can affect all aspects of life, which may have various psychological problems or consequences, including depression, anxiety, hopelessness, guilt, and feelings of worthlessness. It is estimated that about 25% to 60% of infertile couples experience psychological problems (4). Having sexual intercourse only to have a child reduces sexual pleasure. Besides, worries about the costs of infertility treatment may cause marital disputes. Eventually, all these issues can present couples’ difficulties in cultivating interpersonal relationships (5). Similar to other health issues, infertility is characterized by different dimensions, including biological, psychological, and social. Matters related to the inability to bear children are also mentioned in the law, including testing reports, insurance coverage, government funding for infertility services, and health science research. These problems can lead to psychological imbalance, separation of couples, and, ultimately, divorce (6).

Meanwhile, the COVID-19 pandemic health-related problems that began in China in December 2019 have now spread around the world. No drug or vaccine is introduced for its treatment for this disease has been found, compelling people to suspend various aspects of their lives (7). Many people have delayed their birthday celebrations and weddings; even infertile individuals have been forced to postpone efforts to strengthen their life expectancy through childbearing. In this respect, the coronavirus outbreak resembles a catastrophe that negatively affects a country’s economic situation (8). The cost of infertility treatment is the most important barrier to receive curative services, especially in developing countries, albeit it is also a problem in high-income nations, but in both regions, the costs incurred by people may reach catastrophic proportions, with individuals in low-income areas potentially may experience severe impoverishing effects. After the coronavirus pandemic, the economies of all countries are expected to change (9). This raises certain questions regarding infertility: What would be the costs of infertility treatment in this new normal, and how would children be born to people grappling with economic challenges?

In the United States, in vitro fertilization (IVF), on average, costs about $11,000 to $12,000. Other infertility treatments, such as ovarian stimulation and intrauterine insemination, are less expensive than IVF but are typified by a lower chance of success (10). The fundamental question is whether these costs will remain the same after the pandemic-an issue that infertile couples are pondering over during this period. Perhaps most of all, they are worried about whether they will one day be able to embrace a child and hear the words “father” and “mother” uttered by him/her. Also, special attention should be paid to the time limits for conceiving in some couples. Therefore the recent pandemic may lead to irreversible delays in treatment.

We need to consider the circumstances of infertile couples more seriously at this time and revisit, if necessary, the principles of human rights, the Cairo Conference on Population and Development, and the World Health Organization’s guidelines. Let us each do our part for them, regardless of color, race, religion, or ethnicity.

Human beings are members of a whole, In creation of one essence and soul. If one member is afflicted with pain, Other members uneasy will remain. If you have no sympathy for human pain, The name of human you cannot retain (11)!

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