186 Chapter 8 indicating that the high levels of fear of endometriosis-related problems as previously reported by patients are an overestimation of the actual numbers. The results of the patient-centeredness scores reported by women with endometriosis during the first lockdown were similar to those of the reference population outside the COVID-19 pandemic. This indicates that even during a COVID-19 pandemic, the same care aspects remain important to patients. At the time of writing, the Netherlands is recovering from the second lockdown of the pandemic. In contrast to the first lockdown, fertility treatments and endometriosis care have continued, with some restrictions on the number of physical consultations a day and a diminished capacity for surgical and ART care. With the results of the current study in mind, the importance of continuity of care can be underlined. Even though fertility care can be classified as ‘non-essential’ or ‘not life threatening’ during the COVID-19 pandemic, this study shows that restriction of care is associated with an increase in stress and a lowered quality of life among infertile women. It is necessary to stress the importance of the use of virtual care in combination with regular physical care to continue treatment for infertility patients as much as is possible. This study shows that women with endometriosis do not experience the same level of stress as a result of the temporary halting of their treatment as women with infertility do, and the ECQ results are comparable to the reference population. It can, however, be advised that healthcare providers should be accessible for endometriosis patients, and that they should make sure that their patients know how to reach them with questions related to an increase of endometriosis complaints. CONCLUSIONS Virtual care seems to be a good alternative for infertility and endometriosis patients in circumstances where physical consultations are not possible. Self-reported stress is especially high in infertility patients during the COVID-19-pandemic and they do not feel that they can cope well with the changes to their care. Healthcare providers should aim to increase their patients’ ability to cope with the healthcare changes. Future research should focus more on the role of video consultations as this approach has only recently been implemented in current care.
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