By Barry Witt, M.D., Medical Director of WINFertility.
We are living in unprecedented times and current health concerns have many hesitant to continue with their plans to conceive. When attempting to conceive naturally or with the assistance of fertility treatment there are specific precautions to take during the coronavirus outbreak.
Women who have symptoms of the novel coronavirus (COVID-19) infection (fever, shortness of breath, cough) and have either been exposed to a confirmed case or have tested positive themselves, should avoid getting pregnant until they are completely recovered. This includes those who are planning on any fertility treatments in order to conceive.
Healthy women who are trying to conceive should follow the Centers for Disease Control (CDC) recommendations for preventing spread of coronavirus infection. These include 1) frequent hand washing with soap and water for at least 20 seconds or, if soap and water are not available, use of a hand sanitizer that contains at least 60% alcohol, 2) avoidance of touching your eyes, nose, and mouth, 3) Maintaining a distance between yourself and other people, 4) staying home if you’re sick, 5) covering coughs and sneezes by using a tissue or the inside of your elbow, 6) cleaning and disinfecting frequently touched surfaces daily using a household disinfectant.
For those who are planning to conceive, there is not much data yet to know whether there will be any significant detrimental effects on a pregnancy, but the very preliminary information suggests that this virus (unlike the unrelated Zika virus) does not likely have a major impact on pregnancy or fetal development. There is no information available regarding the susceptibility of pregnant women to COVID-19 infection. Pregnant women experience immunologic and physiologic changes, which might make them more susceptible to viral respiratory infections, including COVID-19. Pregnant women may also be at higher risk for severe illness and complications compared to the general population as has been observed in cases of other viral respiratory infections.
Although there is very limited data available regarding coronavirus effects on pregnancy, other respiratory viral infections have been associated with low birth weight and preterm birth. Also, high fever early in pregnancy may increase the risk of certain birth defects.
Given the unknowns, some may find it prudent to delay attempts at pregnancy until the coronavirus outbreak subsides.
The Effect on long-term fertility
There is no reason to suspect that the coronavirus infection will have long term effects on fertility as it mostly involves the respiratory tract and not the reproductive organs. It is reassuring that other viral respiratory infections are unrelated to long term fertility issues.
There is very little information about the impact of COVID-19 on reproduction and pregnancy. There are a few Chinese case reports of patients who tested positive delivering babies free of disease. But these are very small numbers, and although reassuring, the data should be interpreted with caution. It is important to note that coronaviruses are not related to Zika viruses which do have a clear impact on pregnancy and fetal development.
There is no data yet on any relationship of the coronavirus infection to infertility and it seems unlikely that one will be found since the virus mostly affects the respiratory tract. Women should be reassured that their fertility is not likely to be affected but should consider the risks of getting pregnant during this outbreak and should follow CDC recommendations to reduce the risk of contracting the infection while attempting conception and during pregnancy.
*As of March 17th, the American Society for Reproductive Medicine (ASRM) issued new guidance on fertility care during the COVID-19 pandemic calling for the suspension of most assisted reproductive treatments.
For more information, please visit www.winfertility.com
About Barry Witt: Dr.Witt is Medical Director of WINFertility and Greenwich Fertility. He is a board-certified reproductive endocrinologist and OBGYN who has been offering reproductive care for more than 25 years.