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OBJECTIVE: To assess the willingness of patients with infertility to continue with their in vitro fertilization (IVF) treatment during the COVID-19 pandemic. METHODS: This cross-sectional survey was conducted in the reproductive, endocrine, and infertility medicine department (REIMD) at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia. Patients that were planned to undergo IVF treatment at REIMD were contacted and asked about whether they would like to start IVF treatment during the COVID-19 pandemic from August 2020 to August 2021. Data was analyzed using the SPSS version 24. Statistics obtained as means and standard deviations from continuous variables correlated with the Chi-square test and results were considered significant at p≤0.05. RESULTS: Of the 400 participants, 245 (61.25%) were between the ages of 30-39 years. About 42.75% (n=171) of the patients had 6-10 years of infertility, and 18% (n=72) had at least one pregnancy but no living children. While 64.7% (n=259) of the participants responded on the first call, 83% (n=332) agreed to continue their treatment. Of those, 13% (n=43) preferred to book appointments as soon as possible; 29.8% (n=99) preferred booking within three months; while 57.2% (n=190) chose to book after three months. From our sample, 86.8% (n=59) were afraid to contract the virus and the choice to delay the IVF treatment correlated with the patient's age (p<0.001) and duration of infertility (p=0.007). CONCLUSIONS: The COVID-19 pandemic affected IVF treatment courses, and many patients were afraid to be infected during this pandemic.

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A endometriose consiste no alojamento de tecidos endometriais em certas regiões que ficam fora do útero. O número de casos dessa patologia é cada vez maior e é capaz de influenciar a fertilidade feminina. Os sinais e sintomas da patologia foram considerados no estudo, além de fatores biopsicossociais que envolvem as mulheres. Esse trabalho foi baseado em uma revisão bibliográfica a partir de uma seleção de artigos que relatam sobre endometriose e sobre a relação dessa enfermidade com infertilidade na população feminina. A partir da revisão de literatura, essa patologia pode causar modificação quimiotática e anatômica no aparelho de reprodução das mulheres, causando assim a infertilidade, dependendo do nível em que se encontra essa doença. Ademais, o tratamento dessa enfermidade, hormonal ou cirúrgico, é capaz de influenciar no processo saúde-doença da mulher, e ainda, possibilitar uma futura gravidez.

Endometriosis consists in endometrial tissues growth or adaptation outside of the uterus. The number of cases of this specific pathology has become more frequent and it may be capable influencing female fertility. Biopsychosocial factors as well as signs and symptoms that involve women are considered in this study. This work was based on a bibliographical review of selected articlesthat referred to endometriosis and its relationship with infertility in the female sex. According to this review, this pathology causes chemotactic and anatomic modification in the uterus, and consequently, infertility which depends on how advanced the disease is. Furthermore, the treatment of the disease, hormonal therapy or surgery, can influence the health-disease process as well as enable a future pregnancy.

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BACKGROUND: Pregnancies achieved through medical treatments following a period of infertility may demand extra emotional and practical investment from women. AIM: This paper aims at understanding the experience of pregnancy after Assisted Reproductive Technology, and exploring whether this experience is affected by previous failed infertility treatments. METHODS: This paper uses a qualitative approach. Participants were nineteen expectant first-time mothers from Brazil who conceived through Assisted Reproductive Technology treatment. During the third trimester of gestation, a semi-structured interview was administered to assess perceptions of and feelings about treatment and pregnancy. Interview transcripts were analysed using thematic analysis, and the sample was divided into two groups according to whether it was the participant's first treatment or not. FINDINGS: Themes identified include: tolerance of the demands of treatment and pregnancy, consideration of the mechanics of treatment and pregnancy, and emotionally painful aspects of treatment and pregnancy. Pregnancy itself was regarded as a reward or compensation for the difficulties undergone. Perspectives differed according to whether pregnancy followed the first Assisted Reproductive Technology treatment; those who had undergone previously unsuccessful treatments focused less on the mechanical aspects of the process but were more concerned about possible physical problems. CONCLUSION: The similarities and differences found according to number of treatments attempted should be taken into consideration when providing psychological support for expectant Assisted Reproductive Technology mothers.

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La Inseminación Intrauterina (IIU) es un procedimiento utilizado para el tratamiento de la infertilidad. En la actualidad las dos principales indicaciones para la IIU son el factor masculino leve y la infertilidad de causa desconocida. Los resultados obtenidos de la medicina basa en evidencias recomiendan que la IIU se realice en ciclos estimulados, en los cuales se gatille la ovulación con Gonadotropina Coriónica humana (hCG) y se suplemente la fase lútea con progesterona. Igualmente, se recomienda una monitorización ecográfica del crecimiento folicular y la realización de dos inseminaciones por cada ciclo de tratamiento. Para realizar la IIU se requiere de la indemnidad anatómica de los genitales internos de la mujer y de una separación espermática > 1,0 - 1,5 millones de espermatozoides conmotilidad progresiva. Las evidencias muestran que las mejores probabilidades de embarazo se producen cuando la mujer es menor de 35 años y la infertilidad es menor a cinco años. Nuestra tasa global de embarazo por ciclo con IIU en parejas infértiles es de 14,1 por ciento. Por otro lado, la tasa cumulativa de embarazo con IIU no recomienda realizar más de 4 a 6 ciclos de tratamiento, ya que las posibilidades de éxito después de ese tiempo son mínimas.

Intrauterine insemination (IUI) is procedure used for the treatment of infertility. At present, there are two principal indications for IUI: mild male factor and unexplained infertility. Results obtained through evidence based medicine, recommend IUI to be performed in stimulated cycles, triggering ovulation with human Chorionic Gonadotrophin (hCG) and giving a luteal phase supplementation with Progesterone. Ultrasound monitoring of the follicular growth and two inseminations per treatment cycle, are also recommended. In order to perform an IUI, a normal woman internal genital tract and a sperm count > 1,0 - 1,5 million with progressive motility after sperm preparation, are required. Evidence suggests that pregnancy is more likely in women less than 35 years and with infertility of 5 years, at the most. Our overall pregnancy rate per cycle with IUI in infertile couples is 14.1 percent. On the other hand, the cumulative pregnancy rate with IUI does not recommend performing more than 4 to 6 treatment cycles, since the probability of success after that is minimal.

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