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BACKGROUND: Instagram is a popular app and social media networking platform that is utilised by patients to obtain and share health information Objective: To assess whether infertility patients changed or altered their user engagement on Instagram in the time period around fertility clinic closure and reopening during the Covid-19 pandemic Design: Content Analysis Materials and Methods: The Instagram native insights analytics tool was used to analyse five social media accounts used by three independent Fertility Nurse Consultants in the United Kingdom (UK) Posts were examined between 1/03/20 - 02/07/20 for comments, likes, reach, profile visits, sharing and saving, growth and engagement, together with audience subdivision by gender, age and geography Results: 436 posts were identified, saved by users 388 times generating 1834 profile visits Average increases were noted in: followers 266%, comments 700%, likes 225%, reach 311% and user engagement 176% Users were 89 2 % female and 10 8% male, predominantly from the UK, United States and Portugal The age demographic was: Female 55 years 4 4% and Male 55 years 9 4% Posts with the highest user engagement contained factual information regarding fertility clinics closure and reopening, validating increased anxiety concerning the impact of delay on chances of conception and managing negative thinking and uncertainty Recurring themes in patients’ comments related to information provided by fertility clinics For example, ‘I called my clinic yesterday and all I got was we have absolutely no idea’, ‘we haven’t heard a peep from our clinic since lock down’, ‘I just want to hear from my clinic if they are opening or not’, ‘I am normally pretty resilient but this has floored me’ As a result of increased user engagement and direct messaging, all five social media accounts posted daily to keep up with demand They also participated in homogeneous podcasts, commenced support webinars and engaged with followers in real time weekly Instagram Live sessions One account commenced a support group which had a 95% weekly engagement rate Conclusions: The results of this study indicate that Infertility patients increasingly relied on Instagram to manage their expectations surrounding treatment suspension, which they perceived as providing information and a support network that they felt was missing from their health provider Moving forwards, as Covid-19 continues to cause uncertainty, it is clear that fertility clinics should offer an additional psychological aspect to care, providing regular, updated information that matches patient preferences to their needs The authors are aware of the limitations and reason for caution with this study Only five Instagram accounts were analysed Therefore, only a small amount of data was available, with a particular user segment, which may not be indicative of the whole population
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