The influence of neurovegetative and psychological characteristics of infertile patients with long-term COVID-19 on the effectiveness of assisted reproductive technologies

Authors

DOI:

https://doi.org/10.15574/HW.2024.170.12

Keywords:

long-covid-19, infertility, socioeconomic status, fear of covid-19, autonomic dysfunction, anxiety, depression, assisted reproductive technologies

Abstract

The connection of the long-COVID-19 symptom with violations of various systemic factors, in particular with the female reproductive system, is considered, but the number of such studies is not large.

The purpose of the study is the influence of neurovegetative and psychological characteristics of infertile patients with long-term COVID-19 on the effectiveness of assisted reproductive technologies (ART).

Materials and methods. The main group consisted of 80 women with infertility and "long-COVID", the comparison group - 40 patients without a history of COVID-19. In the main group, 2 subgroups were distinguished: 1 - 64 women with unsuccessful ART and 2 - 16 patients in whom ART was successful (a live birth was obtained). Socio-economic status and stress factors (questionnaire), fear of stress-19 (FCV-19S scale), autonomic dysfunction were assessed using the O.M. questionnaire. Wayne (1998), Anxiety and Depression Levels on the Hospital Anxiety and Depression Scale (HADS). The used methods of variational statistics using the Student's t-test and Fisher's angular transformation with a critical significance level of p<0.05 were used to calculate the odds ratio (OR) and its confidence interval (CI).

Results. Women with infertility and "long-COVID-19" are characterized by a relatively low level of socio-economic status: a lower level of income, a smaller share of entrepreneurs and housewives, not comfortable enough living conditions. These patients have a higher level of stressogenic load: comorbidity with chronic somatic pathology (58.8%), conflict situations in the family (31.3%), dissatisfaction with their sexual relationships (58.7%), a significantly higher level of fear of COVID -19 (29.73±1.31 points). Vegetative dysfunction is diagnosed in 82.5% of patients. Symptoms that are typical for "long-COVID-19" are most often noted: reduced work capacity/fatigue (82.5%), attack-like headaches (72.5%), difficulty breathing (47.5%), sleep disturbances (47 .5%). Unfavorable medico-social and psychological risk factors for the failure of ART programs in patients with "long-COVID-19" can be a point assessment of the autonomic dysfunction syndrome above 25 (OR=5.80, CI 1.22-27.64), anxiety (OR=5.80, CI 1.56-21.62), presence of depression (OR=4.20, CI 1.27-13.89), chronic somatic disease (OR=4.20, CI 1.30-13.62), conflict situations (OR=3.86, CI 1.24-12.04).

Conclusions. Women with infertility and "long-COVID-19" need additional examinations to assess the medical and social status, vegetative function and psychological state, correction of detected violations.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research.

No conflict of interests was declared by the authors.

References

Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. (2022). The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict. 20(3): 1537-1545. Epub 2020 Mar 27. https://doi.org/10.1007/s11469-020-00270-8; PMid:32226353 PMCid:PMC7100496

Bisenius S, Kersting A. (2022). Psychosomatische Aspekte von long-Covid. MMW Fortschritte Med. 164(1): 40-41. https://doi.org/10.1007/s15006-021-0540-1; PMid:35043333 PMCid:PMC8765825

Campen CLMCV, Rowe PC, Visser FC. (2021, Dec 24). Orthostatic Symptoms and Reductions in Cerebral Blood Flow in Long-Haul COVID-19 Patients: Similarities with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Medicina (Kaunas). 58(1): 28. https://doi.org/10.3390/medicina58010028; PMid:35056336 PMCid:PMC8778312

Choutka J, Jansari V, Hornig M, Iwasaki A. (2022). Unexplained post-acute infection syndromes. Nat Med. 28(5): 911-923. https://doi.org/10.1038/s41591-022-01810-6; PMid:35585196

Colleran H, Jasienska G, Nenko I, Galbarczyk A, Mace R. (2015, May 7). Fertility decline and the changing dynamics of wealth, status and inequality. Proc Biol Sci. 282(1806): 20150287. https://doi.org/10.1098/rspb.2015.0287; PMid:25833859 PMCid:PMC4426630

Dani M, Dirksen A, Taraborrelli P, Torocastro M, Panagopoulos D, Sutton R, Lim PB. (2021). Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clin Med (Lond). 21(1): e63-e67. https://doi.org/10.7861/clinmed.2020-0896; PMid:33243837 PMCid:PMC7850225

Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re'em Y et al. (2021). Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 38: 101019. https://doi.org/10.1016/j.eclinm.2021.101019; PMid:34308300 PMCid:PMC8280690

Ferrario SR, Panzeri A, Cerutti P, Sacco D. (2021). The psychological experience and intervention in post-acute COVID-19 inpatients. Neuropsychiatr Dis Treat. 17: 413-422. https://doi.org/10.2147/NDT.S283558; PMid:33603379 PMCid:PMC7884934

Fleischer M, Szepanowski F, Tovar M, Herchert K, Dinse H, Schweda A et al. (2022, Dec). Post-COVID-19 Syndrome is Rarely Associated with Damage of the Nervous System: Findings from a Prospective Observational Cohort Study in 171 Patients. Neurol Ther. 11(4): 1637-1657. https://doi.org/10.1007/s40120-022-00395-z; PMid:36028604 PMCid:PMC9417089

Imrie R, Ghosh S, Narvekar N, Vigneswaran K, Wang Y, Savvas M. (2023, Feb). Socioeconomic status and fertility treatment outcomes in high-income countries: a review of the current literature. Hum Fertil (Camb). 26(1): 27-37. https://doi.org/10.1080/14647273.2021.1957503; PMid:34315303

Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A et al. (2021). More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 11(1): 16144. https://doi.org/10.1038/s41598-021-95565-8; PMid:34373540 PMCid:PMC8352980

Nicholls-Dempsey L, Badeghiesh A, Baghlaf H, Dahan MH. (2023). How does high socioeconomic status affect maternal and neonatal pregnancy outcomes? A population-based study among American women. Eur J Obstet Gynecol Reprod Biol X. 20: 100248. https://doi.org/10.1016/j.eurox.2023.100248; PMid:37876770 PMCid:PMC10590715

Papadopoulou M, Bakola E, Papapostolou A, Stefanou MI, Gaga M, Zouvelou V et al. (2022, Sep). Autonomic dysfunction in long-COVID syndrome: a neurophysiological and neurosonology study. J Neurol. 269(9): 4611-4612. https://doi.org/10.1007/s00415-022-11172-1; PMid:35536408 PMCid:PMC9086662

Papadopoulou M, Bakola E, Papapostolou A et al. (2023). Autonomic dysfunction entwined with post-COVID but absent in non-post-COVID patients: a neurophysiological and neurosonology study. Ther Adv Neurol Disord. 16: 17562864231180711. Published 2023 Jun 15. https://doi.org/10.1177/17562864231180711; PMid:37337588 PMCid:PMC10273095

Penman-Aguilar A, Talih M, Huang D, Moonesinghe R, Bouye K, Beckles G. (2016). Measurement of Health Disparities, Health Inequities, and Social Determinants of Health to Support the Advancement of Health Equity. J Public Health Manag Pract. 22; Suppl 1: S33-42. https://doi.org/10.1097/PHH.0000000000000373; PMid:26599027 PMCid:PMC5845853

Pollack B, von Saltza E, McCorkell L, Santos L, Hultman A, Cohen AK, Soares L. (2023, Apr 28). Female reproductive health impacts of Long COVID and associated illnesses including ME/ CFS, POTS, and connective tissue disorders: a literature review. Front. Rehabil. Sci. 4: 1122673. https://doi.org/10.3389/fresc.2023.1122673; PMid:37234076 PMCid:PMC10208411

Reece S, Dickerson J, Kelly B, McEachan RRC, Pickett KE. (2023). The long-term impact of the Covid-19 pandemic on financial insecurity in vulnerable families: Findings from the Born in Bradford Covid-19 longitudinal study. PLoS One. 18(11): e0295064. https://doi.org/10.1371/journal.pone.0295064; PMid:38019781 PMCid:PMC10686492

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC et al. (2021). Attributes and predictors of long COVID. Nat Med. 27(4): 626-631. https://doi.org/10.1038/s41591-021-01292-y; PMid:33692530 PMCid:PMC7611399

Swift BE, Liu KE. (2014, Nov). The effect of age, ethnicity, and level of education on fertility awareness and duration of infertility. J Obstet Gynaecol Can. 36(11): 990-996. https://doi.org/10.1016/S1701-2163(15)30412-6; PMid:25574676

Wong TL, Weitzer DJ. (2021). Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) - a systemic review and comparison of clinical presentation and symptomatology. Medicina (Mex). 57(5): 418. https://doi.org/10.3390/medicina57050418; PMid:33925784 PMCid:PMC8145228

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Published

2024-02-28