David, a 35 years man who married a 33 years beautiful women, named Stephanie. His wife has been tried to conceive since the community was locked down in April of this year. Her medical report was good except the right fallopian tube was sluggish and some ovulation issue. She had been treated in our clinic since July and has great improvements. But she still not conceived. In the 5^th of August, His seaman analysts was showed his sperm morphology was only 1%. He felt very stress amid Covid-19 pandemic. He was afraid he would lose his job. As her acupuncturist recommended, he came for acupuncture and herbal treatment. After one month of stress treatment, he felt much better and his wife had a positive pregnancy test on 09/25/2020. She is continuing the acupuncture treatment for miscarriage prevention and the baby is growing normal so far.

This couple is not alone. We have seen more infertility cases in the past six months. Covid-19 pandemic has been causing infertility increasingly this year.

Despite the progress of modern medicine, the COVID-19 epidemic has caused more than 1 million deaths world wide in less than a year to date. In addition to the death toll, the epidemic has also caused widespread and serious emotional and health problems. The effects of traumatic stress associated with COVID-19 are reported in recent literature, as well as the effects of less severe stress exposure types. Coronavirus has led to various mental health problems, including anxiety, depression, PTSD and other traumatic and stress-related diseases, such as coronary heart disease, infertility, etc.

During the pandemic, different groups of people meet the trauma exposure standards of DSM-5 post-traumatic stress disorder: individuals who have witnessed the suffering and death of others, such as family members and medical staff; understand that the virus has caused the death or potential of family members or friends Individuals who died; and practitioners who were extremely exposed to details alike, such as journalists, emergency personnel, hospital staff, etc. In addition, social isolation, presidential elections, unemployment and economic losses, working at home and caring for children and other family members, exposure to non-traumatic stress, greatly increase personal emotional burden.

In August, CDC published a large-scale online survey of over 5,000 adults in the United States: 40.9% of them indicated at least one mental or behavioral health disadvantage associated with the epidemic. Traumatic and stress-related diseases were reported to be 26.3% anxiety or depression symptoms were 30.9%, and 13.3% of drug abuse to respond to 13.3%, and 10.7% of the cases of suicide seriously considered.

The online survey from nearly 3,500 people in Spain showed PTSD (15.8%), depression (18.7%) and anxiety symptoms (21.6%). Loneliness is the most symptomatic forecast, and other factors related to these problems are female, previous mental health problems, having physical symptoms similar to the virus, or having a close relative infected.

For fertility issues caused by mental stress, I recommend a gentle approach for stress to effective treatment, which is one of the more effective forms of acupuncture therapy, as we have amply demonstrated in the clinical practice of  nearly six months.

The current pandemic will challenge us and will also give us the opportunity to continue learning and share it with other reproductive medicine peers, hopefully linking us cooperatively.

Reference:

1. Forte G, Favieri F, Tambelli R, Casagrande M. COVID-19 Pandemic in the Italian Population: Validation of a Post-Traumatic Stress Disorder Questionnaire and Prevalence of PTSD Symptomatology. Int J Environ Res Public Health.2020;17(11):4151.
2. González-Sanguino C, Ausín B, Castellanos MÁ, et al. Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun. 2020;87:172-176.
3. Restauri N, Sheridan AD. Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions. J Am Coll Radiol.2020;17(7):921-926.