Fertility Dilemma: The Lived Experience of Women Undergoing Failed in-Vitro Fertilization amid Covid-19

Background: Infertility is a stressful life event, and those who choose to conduct assisted reproductive treatment (ART) are likely to suffer physical and psychosocial burden. While many studies have explored the lived experience of infertile women, but few have focused on those women who have experienced failure of in-vitro fertilization (IVF). The outbreak of the Covid-19 not only affects their daily life, but also disrupts their fertility journey. This research aims to understand the lived experience of women with failed IVF cycle, to explore how the pandemic influences their life in individual, relational and medical level.

Methods: Online in-depth semi-structured interview was adopted with sixteen Chinese women from October 2020 to March 2021. The interview lasted 90 minutes. Convenience sampling was used to recruit female participants who have failed to achieve clinical pregnancy after at least one fresh or frozen IVF embryo transfers. Chinese-speaking women who has undertaken IVF treatment in the reproductive center of hospital in Shenzhen City, China were recruited by posted fliers and practitioners’ referral. Driven by grounded theory, data is analyzed by thematic analysis using software Nvivo 12.

Results: The study identifies three themes: race against biological clock, unpredictable financial hardship, and intrusive intergenerational burden. Firstly, participants reveal that the psychosocial pressure brought by treatment failure was intertwined with the fear for Covid-19. The lock-down policy and suspension of clinic service prevent them from entering the treatment cycle as scheduled, and thus raise their severe anxiety towards age-related infertility. Several participants describe it as a race against the outbreak of pandemic and the biological clock. Moreover, participants highlight the financial burden with the bill of treatment which is not covered by the health insurance in China currently. The perception of economic recession following pandemic and expensive medical expense might influence their decision making towards continuity of treatment. Lastly, the lockdown inevitably pushed Chinese couples live with their parents, making women confront intergeneration fertility pressure directly. Fulfilling the filial duty by having a biological baby is took for granted by Chinese family, and participants reveal that they feel tension between themselves and mothers-in law because of the failure to archived this goal.

Conclusions: The findings reveal that the intersection of infertility and Covid-19 further aggregates psychological, financial and intergenerational burden among infertile women in a post-pandemic world. The findings also demonstrate the need for specific psychosocial program targeting infertile women and couples to facilitate them cope with the new challenges amid pandemic.