182 Chapter 8 up consultations with known patients or discussing alterations in medication. The downside noted by infertility patients during the COVID-19 pandemic is that they missed personal contact with their doctor as fertility treatments are intensive treatments. For endometriosis patients, a reported downside was missing the choice to be able to have a physical consultation when they felt they needed one. Healthcare providers reported the lack of travel time, being able to provide a safe alternative for healthcare during the pandemic, and time efficiency (e.g. ‘patients don’t have to wait when the doctor is delayed’ and ‘more flexible planning of appointments’) as benefits of telephone consultations. The additional benefit that video consultations have over telephone consultations according to healthcare respondents is the ability to experience non-verbal communication as well as being able to have conversations with the patient and their partner at the same time. The most important downside of telephone consultations reported by healthcare providers was the lack of non-verbal communication. For video consultations, healthcare providers reported technical difficulties (including connection errors and patients not understanding the technology) to be the most important downside. Not being able to perform physical examinations and additional investigations (e.g. ultrasonography or blood sampling) and difficulties with providing emotional support were recorded as downsides for both telephone and video consultations. Fertility patients reported having an increase in stress, reasons being increasing age, which could damage the chance of pregnancy, fear of aggravating underlying illness and ambiguity in information from the hospitals on when treatments could restart. Infertility patients’ quality of life The fertility-related quality of life information of the infertility patients (n = 318) and the data from a Dutch reference population (n = 473) are shown in Table 5 (1), with the core FertiQoL subdomains shown separately. Although a statistical comparison between the infertility patients in this study and the reference population was not possible due to a lack of access to the data describing the reference population, the quality-of-life scores seem to be lower in the group in the current study compared with the reference population for all subdomains of the FertiQoL.
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