PATIENT REACTIONS ON SOCIAL MEDIA TO THE ASRM COVID TREATMENTS SUSPENSIONS

Objective: On March 17, 2020, the American Society for Reproductive Medicine (ASRM) issued its initial recommendations regarding patient management and infertility treatment during the ongoing COVID-19 outbreak Included were recommendations to suspend initiation of new treatment cycles, including those of patients of advanced age or diminished ovarian reserve The purpose of this study was to survey patient opinions and reactions, as expressed on social media, to these recommendations and the three subsequent updates Design: Cross sectional study Materials and Methods: We surveyed “r/Infertility,” a group with 17,800 members on the social medial site Reddit, for reactions following each of the initial four ASRM recommendations Comments were made in individual “COVID/Coronavirus Mega Threads” on the days surrounding the March 17th, March 30th, April 13th, and April 24thannouncements We categorized posts based on their content, and quantified the number of posts per category Categories included emotional reaction, resulting concerns, shared empathy, exchanges of advice and information Results: 344 posts made by 148 users were categorized The largest number of posts (n=90, 26 2%) expressed empathy to difficult news that was shared by another user 82 posts (23 8%) discussed the future uncertainty, and 13 posts (3 8%) expressed an uncertainty in their clinics present policy The most common emotional reaction was of disappointment (n=38, 11 1%), but others also expressed anger, anxiety, and frustration (5 2%, 6 4%, and 7 3% respectively) A total of 23 posts (6 7%) expressed frustration specifically at treatment being cancelled mid-cycle A small number of comments questioned aspects of the guidelines, and expressed frustration with ASRM (7, 2 0%), but more users expressed concerns regarding the risk of becoming pregnant ((17, 4 9%), and none questioned the validity of the guidelines A significant portion of users questioned whether patients with diminished ovarian reserve should be restricted as well, or whether they should be given priority when treatments resume (21, 6 1%) Several users questioned why the general population was not being cautioned about becoming pregnant (9, 2 6%), and also expressed annoyance regarding comments made in the general population of an upcoming COVID “baby boom” as a result of the self-quarantining taking place (13, 3 8%) 38 posts exchanged advice (11 1%) and 83 posts offered information (24 1%) Conclusions: We surveyed a popular social media site for patient responses to the recent ASRM COVID guidelines, and demonstrate that while users overwhelmingly endorsed the treatment suspension, they struggled with the disappointment, frustration and anxiety that came with the delay in their care, the backlog that will result when treatments resume, and the uncertainty surrounding present and future ASRM/clinic policies In particular, patients with diminished ovarian reserve, and those whose treatment was canceled mid-cycle, were distraught by the lack of differentiation in the COVID guidelines