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19 pandemic can cause stress and anxiety . - 312 ): 4 ( tion of the existing conditions theand giving right of choice to couples, especially for infertile cou- ples who are being treated with assist techniquestive (ARTs) in Covid anxiety anxiety can alter the balance of hormones needed for pregnancy. It can also affect the success of a couple's of literatures shows that currently couples are get- ting help by using a variety of methods, such as online counseling through social Skype networks to receive virtual like counseling, support, and assistance. Coupl and, if necessary, receive their treatment protocol online at the patient's portal. If Covid people about their treatment, talking to a fertility counselor, fertility coach and provider can help couple during this confusing period. Telemedicine psychological and support have established tool for a ART specialists. good Most fertility organiza- tions recommended the use of such tools during pandemic the anxiety and failing to cope with this kind of crisis cause a lot of psychological damage to couples, infertile which is irreparable. Therefore, for dis- tress health management, care providers can use a of variety safe methods such as o online supports, social networks, peer thereby supports, continuing treatment with a full explana- other the hand, some On treatments. theircontinue associations in American, British and European societies all emphasize that due to the unknown effects of coronavirus on the fetus and pregnancy and considering emergency health service providers, no fertility treatment cy- cle should be started at present. This means that no ovulation, IUI, fresh IVF transfer or cycles frozen should be embryo performed. decrease in number of visits and counse infertile couples in clinics, the mental health sues is- and the strategies for reducing distresses of infertile couples are of Since infertile couples are also vulnerablemore to paramount importance. disease, it is important to pay health attention to t Covid and it’s completely understandable. Stress and 21

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19) spread rapidly with human - - 10.18502/jri.v21i4.433 ber will require treatment with as- , Issue no. 4 no. , Issue 1 2 Due Due to the lack of information about the new . ects of this crisis, the damage and the resulting ) The respiratory 8 Volume http://dx.doi.org/ Journal & Infertility Reproduction of started taking their re are used by infertility health treatment centers centers. recommend that Some patients who are undergoing a new IVF cycle or recently have care such as workers the staff and medical ( coronavirus and its behaviors, various methods by using therapeutic using by hope, dialogues, inducing lis and face support social support,and tening counseling which should be offered by the health stress during the of outbreak during such diseasesstress such as influenza and SARS, there are ways such to anxiety manag such as psychological intervention various various methods of mental disorders management in pregnant women such as and CBT, food , supplements ductive ductive techniques (ARTs) are a common treat-ment of choice for many infertile couples due to male or female or idiopathi ences that threaten family, marriage and society, which will be more threatening in crisis situations 9% of couples all around the world will ence infertility experi-during their lifetime is one of the most stressful and sensitive experi- experience a delay in pregnancy, and that an in- creasing num sisted reproductive techniques. Statistically pregnancy pregnancy after twelve months or more of having a regular unprotected sex one in six couplesthat willestimates Organization pact on the mental health and individual’s all life aspects of an genital tract that is characterized by a lack of eff costs are increasing infertile couples, and it may have a negative im- world are affected by the crisis caused by the out- break of Covid in many countries to reduce the risk and negative global global concerns, and it caused the World to (WHO) considerOrganization it as a pandemic. Currently, the lives of many people around the ince, China in December 2019. The coronavirus disease (Covid human transmission around the world and raised virus was first observed in Wuhan, Hubei Prov- Infertility Infertility Distress Management in Couples Treated withAssisted Techniques (ART) in COVID Downloaded from http://www.jri.ir

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[email protected] 19: infertility in times of pandemic. What now? - Vaiarelli A, Bulletti C, Cimadomo D, Alviggi C, Borini Ajossa S, A, et al. COVID the view of the Italian society of fertility and steril and ity reproduc line. 2020;40(6):755 Rodriguez commendation for restrictive provision of fertility treatments during the COVID Obstet Gynecol Scand. 2020;99(5):569 World guideline on self ual and reproductive health World andOrganization; Health 2019. 180 p. rights. Geneva:

rome rome (SARS): lessons learnt from ings. empirical Clin Psychol Psychother. 2005;12(1):80 find de Souza MCB, Nakagawa H, Taitson EB, PF, Antunes Cordts RA. Management of ART and COV ID JBRA Assist Reprod. 2020;24(3):231 M.Sc., Research Center, Health and Reproductive Sexual mail:

Corresponding Author Corresponding - - - 1 NasibehofSchool Committee, ofDepartment Midwifery, of Medical MazandaranNursing University and Midwifery, Sciences, Sari, Iran 2 partmentReproductof of Medical MazandaranNursing University and Midwifery, Sciences, Sari, Iran * Zeinab Hamzehgardeshi, Health andCenter,Reproductive Department of Research Mazandaran School Nursing Midwifery, of and Midwifery, Medical Sari, Sciences, of Iran University E 9. 10. 11. 12. Fatemeh Hamidi Hamzehgardeshi

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9. 3. - - References Conflict of Interest Conflict interim interim guidance.

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treat mental disorders during pregnancy: A systema tic review and PLoS One. 2017;12(3):e0173397. multiple treatment meta Cheng SK, Wong CW. Psychological intervention with sufferers from severe acute respiratory synd Alviggi Alviggi C, Ajossa S, et al. COVID view of the Italian society of fertility and and reproductive sterility medicine. Reprode line. 2020;40(6):755 Biomed On van Ravesteyn LM, Lambregtse Hoogendijk WJ, Kampe deh M, Peyvandi S, Gelehkolaee KS, et a;. The ef ficacy infertile women undergoing treatment: in an RCT. vitro Int J Reprod fertilization Biomed. 2019;17 (1):57 Vaiarelli A, Bulletti C, Cimadom pandemic. pandemic. Reprod Biomed Online. 2020;41(2):151 3. Allot L, Payne D, Dann L. Midwifery and assisted reproductive technologies. N wives J. Zealand 2013;47:10 Coll Mid Hamzehgardeshi Z, Yazdani F, Elyasi deh M, Peyvandi S, Samadaee Galekolaee K, et al. Investigating the mental health women. status Int J of Reprod infertile Biomed (Yazd). 2019;17(4):293 Trinchant RM, Cruz M, Marqueta Infertility J, and Requena A. after COVID World Health Organization COVID O Hamzehgardeshi Z, Yazdani F, Elyasi F, Moosaza

Authors declare no conflict of interest 8. 7. 6. 5. 4. 3.

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