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World Population Day 2021: The Impact Of The COVID-19 Pandemic On Fertility

World Population Day is observed on 11 July every year. Established in 1989 by the Governing Council of the United Nations Development Program, it is intended to increase awareness on population issues.

In comparison to the global population of 5.25 billion in 1989, the number has increased to 7.9 billion as of 2019 and it is expected to reach 8.5 billion by 2030. And by the end of the century, we are looking at a doubling of the population in comparison to that of 1989.

India has the world's second-largest populace after China, and with the advent of the COVID-19 pandemic, we are witnessing the hardships of the government in controlling and managing the pandemic outbreak in such a populated country.

The theme for World Population Day 2021 is "Rights and Choices are the Answer: Whether baby boom or bust, the solution to shifting fertility rates lies in prioritising all people's reproductive health and rights" or "'the impact of COVID-19 pandemic on fertility" which shines a light on the deadly virus' impact on sexual and reproductive health [1].

Impact Of The COVID-19 Pandemic On Fertility

The advent of the COVID-19 global pandemic has shaken the world balance, and it continues to impact the lives of people all around the globe. Experts have been and continue to study the possible impacts this pandemic could have on pregnancy, childbirth and fertility [2].

The COVID-19 pandemic has posed unique concerns and potential risks to women now pregnant or considering childbearing. Although there are no official statements from health bodies that women should avoid conception at this time, several organizations recommended a moratorium on infertility services (including both medically assisted reproduction and assisted reproductive technology) [3].

Preliminary studies on the impact of COVID-19 on fertility shows that there have been changes in couples' fertility plans and work division within the household, or predict fertility declines in high-income countries, in the meantime, the pandemic's impact on fertility, partnering, and family dynamics are rapidly evolving.

Here are our findings from different reports and studies that have explored the impact of the COVID-19 pandemic on fertility:

  • The possibility of risks specific for pregnant women and their foetuses have become a major concern in the medical field.
  • In contrast to the 2015 Zika virus epidemic, when unique birth defects were identified early in the course of the spread, no novel foetal or maternal risks have yet been confirmed [4].
  • The limited information available regarding the maternal and foetal effects of COVID-19 infection especially for the first trimester have raised concerns globally.
  • In terms of fertility, the pandemic posed an immediate dilemma for centres actively treating infertile couples with medically assisted reproduction (MAR) and assisted reproductive technology (ART), including in vitro fertilization [5].
  • Couples who are undergoing fertility treatment should continue the same; however, should discuss with the doctor whether they should conceive or not.
  • The European Society of Human Reproduction and Embryology (ESHRE) asserted that all fertility patients considering or planning treatment, even if they do not meet the diagnostic criteria for COVID-19 infection, should avoid becoming pregnant at this time [6].
  • The COVID-19 pandemic has a potential effect on future birth rates and a direct effect on either male or female fertility.

In a conversation with Boldsky on the impact of the COVID-19 pandemic on pregnancy and fertility, Dr Ritu Sethi (Gynecologist) said, "One of the most common questions couples have during this uncertain time is whether they should consider conceiving at an uncertain time like this or should they wait it out. In my opinion, it is a completely personal decision."

She continued, "however, it is important that everyone should understand that the COVID-19 pandemic is not 'going to go away,' so, if a couple is planning to conceive now or later on is completely their decision, and we experts are here to guide them in the process." Dr Ritu also highlighted the importance of vaccination.

COVID-19 Pandemic Factors That Can Affect Fertility

A case study by the United Nations Population Fund (UNFPA) identified five key dimensions of the COVID-19 pandemic that have the potential to impact fertility trends, patterns and choices and they are as follows [7]:

  • High mortality rate
  • Restricted access to family planning services
  • Reduced work-life balance
  • Economic recession and uncertainty
  • Disruptions to assisted reproduction services (fertility clinics, IVF etc.)

The impacts of the pandemic on fertility are unlikely to be uniform, between and within different countries. It also depends on the prevailing institutional, cultural and policy environments -that is, in any country where women have limited control over their fertility and related issues [8].

The study further added that restricted access to family planning services, economic uncertainty and recession, and reduced work-life balance, as well as restricted access to assisted reproduction services also restrict fertility choices at the individual level.

On A Final Note...

The impact of COVID-19 on fertility is not a limited area but extends to pregnancy and childbirth and essentially, population. The response to the COVID-19 crisis by health organizations around the world offers an opportunity to recognize and address the key and longstanding barriers to fertility choices so the authorities can strive towards a safe solution for the issues arising amidst the pandemic. While initial reductions in birth rates are likely, it is overall expected to rebound.