COVID-19 大流行对生育护理可及性的影响：大学附属生育诊所的回顾性研究。
Impact of the COVID-19 Pandemic on Access to Fertility Care: A Retrospective Study at a University-Affiliated Fertility Practice.
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynaecology, Schulich School of Medicine and Dentistry, Western University, London, ON.
Department of Obstetrics & Gynaecology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON.
出版信息
J Obstet Gynaecol Can. 2022 Apr;44(4):378-382. doi: 10.1016/j.jogc.2021.10.017. Epub 2021 Nov 5.
OBJECTIVE
To elucidate the impact of the COVID-19 pandemic on access to fertility services.
METHODS
A retrospective quality improvement study was conducted at a university-affiliated fertility practice in southwestern Ontario. Annual procedural volumes for intrauterine and donor inseminations (IUI/DI), in vitro fertilization and intracytoplasmic sperm injections (IVF/ICSI), and frozen embryo transfers (FET) during the COVID-19-affected year were compared with mean annual volumes from the 2 preceding years. In addition, volumes for the same procedures were compared between the first quarter of 2021 and mean first quarter volumes from 2018 to 2019. Piecewise linear regressions were conducted to evaluate whether any changes in monthly procedural volume were attributable to the COVID-19 pandemic.
RESULTS
In 2020, our fertility practice attained the mean annual volumes of 89.7% for IUI/DI, 69.0% for IVF/ICSI, and 60.6% for FET. In contrast, in 2021, we performed mean first quarter volumes of 130.1% for IUI/DI, 164.3% for IVF/ICSI, and 126.8% for FET. The slopes of the pre- and post-COVID-19 segments of the piecewise linear regressions were significantly different for IUI/DI (P < 0.001) and IVF/ICSI (P = 0.001), but not for FET (P = 0.133).
CONCLUSION
The COVID-19 pandemic resulted in decreased annual volumes of medically assisted reproductive procedures at a university-affiliated fertility practice in southwestern Ontario. Impact on monthly procedural volume was confirmed for IUI/DI and IVF/ICSI by linear regression. Local adaptations helped compensate and exceed expected volumes in 2021. As a result, the COVID-19 pandemic resulted in a short-lived limitation in access to fertility care.
目的
阐明 COVID-19 大流行对获得生育服务的影响。
方法
在安大略省西南部的一家大学附属生育诊所进行了回顾性质量改进研究。将 COVID-19 流行年份的宫腔内和供体授精（IUI/DI）、体外受精和胞浆内精子注射（IVF/ICSI）以及冷冻胚胎移植（FET）的年度程序量与前 2 年的平均年度量进行了比较。此外，还比较了 2021 年第一季度与 2018 年至 2019 年同期的相同程序的数量。进行分段线性回归以评估每月程序量的任何变化是否归因于 COVID-19 大流行。
结果
2020 年，我们的生育实践达到了 IUI/DI 的年平均量的 89.7%、IVF/ICSI 的 69.0%和 FET 的 60.6%。相比之下，在 2021 年，我们进行了 IUI/DI 的平均第一季度量的 130.1%、IVF/ICSI 的 164.3%和 FET 的 126.8%。IUI/DI（P<0.001）和 IVF/ICSI（P=0.001）的分段线性回归的 COVID-19 前后段斜率差异显著，但 FET（P=0.133）差异不显著。
结论
COVID-19 大流行导致安大略省西南部一家大学附属生育诊所的医学辅助生殖程序的年度数量减少。线性回归证实 IUI/DI 和 IVF/ICSI 的月度程序量受到影响。当地的适应措施有助于在 2021 年弥补并超过预期数量。因此，COVID-19 大流行导致生育护理的短期限制。
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