210 Appendix distracts the user from their surroundings and takes them into a virtual world, the brain is focussed on the virtual reality instead of bodily sensations such as pain. Our study did not show a significant difference in overall pain, peak pain or satisfaction between the Virtual Reality group and the control group. It is possible that the VR intervention was not as effective because of a relatively low level of ‘immersion’, the feeling of being present in the VR environment. This low level of immersion in our study can be explained by the lack of sound in addition to the glasses and the fact that the movies were a lot shorter than the procedure, meaning that the participant repeatedly had to choose a new movie. HSG was introduced as a diagnostic test. The safety and comfort issues mentioned, but also radiation exposure, the use of iodine containing contrast and the need for a radiologic department were all reasons for the development of other types of visual tubal patency tests. These tests are based on different modalities such as ultrasound (Hysterosalpingo-foam-sonography or HyFoSy, Hysterosalpingo-contrast-sonography or HyCoSy, both either in 2D, 3D or 4D), MRI (MR-HSG) and transvaginal hydrolaparoscopy (THL). These alternative tests have all been studied with regards to efficacy, safety and diagnostic quality, but a review comparing the different tests with laparoscopy, the current gold standard, is missing. This is the reason for our Cochrane Review for which the protocol is presented in Chapter 7. During the course of this PhD-tract, Coronavirus Disease 2019 became a pandemic in the spring of 2020. All non-essential healthcare, including fertility care, was paused to prevent further spreading of the disease and to use all healthcare personnel and resources for the diseased. For patients with infertility this was a very uncertain time. Scheduled appointments were converted to telephone or video appointments and new treatment cycles could not be started. In Chapter 8 we described the results of our national survey, showing a low fertility-related quality of life in women with infertility during the COVID-19 pandemic and lockdown. Patients gave a good rating to the telephone and video appointments as a replacement of regular consultations during the lockdown, and thought that regular telephone appointments were a good addition to regular care in the future.
RkJQdWJsaXNoZXIy MTk4NDMw