DESCRIPTIVE DIFFERENCES IN FERTILITY TREATMENT USAGE AFTER THE START OF THE COVID-19 PANDEMIC: A PILOT STUDY - FEELINGS ABOUT INFERTILITY IN RESPONSE TO THE COVID-19 EPIDEMIC (FIRE)

Objective: Prior research has demonstrated that economic health has an influence on the utilization of assisted reproductive technology (ART) It is indisputable that the United States (US) economy has been negatively impacted by the novel coronavirus (COVID-19) pandemic However, there is limited data on how the pandemic has affected patient interest in fertility treatment and limited data on how concern about infectious disease and physical health may affect family building decisions We hypothesized that there would be a decrease in interest in fertility treatments due to the COVID-19 pandemic The aim of this pilot study was to assess if the experience of COVID-19 in the US has influenced intentions to pursue fertility treatment Design: Prospective internet-based survey Materials and Methods: An internet based survey, administered through Redcap was used to assess demographics, concern about COVID-19, fertility treatment prior to and after statewide lockdowns which became widespread on March 15th 2020 The pilot survey was administered June 1st to July 31st 2020 to infertile participants between the ages of 18-43 years The CloudResearch platform was used to recruit participants and administer the survey COVID-19 related questions were derived from the validated COVID concern survey Summary statistics are presented Institutional Review Board approval was obtained Results: The pilot survey was completed by 55 participants (female =46, 83 6%;male=9, 16 4%) from 23 states The mean age was 29 6 years (+/- 7 6) The majority were White (78%), non-Hispanic (92 7%), with varying education levels, 45 5% (25/55) with some college education, 20% with a bachelor’s degree (11/55) and 14 5% with graduated education (8/55) The majority of participants were “somewhat concerned” that they would lose their current job in the next 12 months (41 4%) While the majority believed that COVID-19 had spread widely in the US (32 7%) and had “inflicted serious damage in the area that” they lived (38 2%), most individuals felt that they could protect themselves from the virus (48 2%) Prior to the pandemic, 29 1% (n=16) participants sought ovulation induction medications, 16 4% (n=9) sought intrauterine insemination and 9 1% sought (n=5) in vitro fertilization (IVF) The remainder of patients were contemplating treatment After the pandemic, 13 patients were no longer interested in fertility treatment The majority of patients, 53% (n=7) stated “I am worried about the coronavirus/COVID-19” as the primary reason they discontinued treatment, compared to several other reasons including spontaneous conception, financial concerns, and lack of partner support Conclusions: COVID-19 is an important consideration for people who discontinue treatment;however, it may not deter the majority of patients who seek care Data is part of an ongoing larger prospective study References: 1 Kiatpongsan, S , Huckman, R S , Hornstein, M D The Great Recession, insurance mandates, and the use of in vitro fertilization services in the United States Fertil Steril 103, 448-454 (2015) 2 Conway, L G , III, Woodard, S R , & Zubrod, A (2020, April 7) Social Psychological Measurements of COVID-19: Coronavirus Perceived Threat, Government Response, Impacts, and Experiences Questionnaires 3 McFadden, S M , Malik, A A , Aguolu, O G , Willebrand, K S , & Omer, S B (2020) Perceptions of the Adult US Population regarding the Novel Coronavirus Outbreak Questionnaire