Expert / 9 March, 2021 / César Díaz-García

Covid-19 And The Implications For Fertility Treatment

Covid-19 and fertility. What are the implications? Lockdown tensions, economic anxiety and diminished dating opportunities may be contributing to a baby bust this year, as experts predict fertility rates are about to drop below pre-WWII levels. However, vaccination and the virus shouldn’t be a reason to delay the pitter-patter of tiny feet for most people.

Leading expert, César Díaz-García breaks down COVID-19 fact from fiction when it comes to all things fertility, as he answers your biggest questions:

My partner and I were planning to try for a baby this year, but I recently caught the COVID-19 virus. I feel back to full health now, but is it safe to start trying to conceive?

You don’t mention how long ago you caught the virus, but it’s recommended to wait at least 10 days after symptoms ended, to make sure that you’re fully recovered before trying to conceive. If that’s the case and you’re feeling healthy, then there’s no reason to wait! If you find you have been trying to conceive for more than a year (or six months if you are over 35 years old), then it’s recommended to see a fertility specialist.

My partner was very sick with the COVID-19 and ended up being treated in hospital. They feel fine now but could there be any lasting effects on fertility?

Rest assured that it’s very unlikely that your partner’s fertility will have been permanently affected, whether they are male or female. For men, being ill from any virus can cause a temporary drop in sperm count, so this is normal. There are some studies that suggest COVID-19 can affect sperm quality, but this data is still very limited. There is no evidence that the COVID-19 affects fertility in women. It’s recommended to wait at least 10 days after symptoms have disappeared before trying to conceive.

I have some underlying medical conditions which put me at higher risk of the COVID-19 virus so naturally, I am keen to be vaccinated as soon as possible; however, I’ve just found out I’m pregnant! Does this mean I can’t take the vaccine?

It’s recommended that those who are pregnant should not come forward to be vaccinated at this time. This is because there is limited research about the effects of the vaccine on pregnant women. That being said, vaccination is recommended in certain exceptional cases. This includes pregnant women who are exposed to a particularly high risk of infection on a frequent basis, for example those working on an ICU ward, or where underlying health conditions puts the pregnant women at risk of serious complications from COVID-19, such as asthma or type 1 or 2 diabetes. In your case, it’s best to speak with your obstetrician to evaluate the risks and benefits so you can make an informed decision based on your personal circumstances.

I want the COVID-19 vaccination but I’m also undergoing fertility treatment. Should I stop or interrupt my treatment?

It is safe to receive the vaccine and continue with your treatment cycle as planned, but you should check with your consultant before getting vaccinated, as everyone’s circumstances are different.

For example, at IVI, we recommend waiting at least two weeks after getting the jab before starting any treatment involving an insemination or embryo transfer. This allows any minor side effects to disappear and avoid causing unnecessary worry or stress during your fertility treatment.  You should not feel like you need to delay your plans and, rest assured, there is no reason to postpone pregnancy or fertility treatment because of the COVID-19 vaccine.

I’m 36 and desperate to start a family as soon as possible, but I’m worried about catching COVID-19 when I’m attending appointments at my fertility clinic. Is it safe to attend?

There is currently no evidence of any COVID-19 transmission through assisted reproduction, such as IVF treatment. Most clinics, such as IVI, have strict protocols to keep patients, staff and visitors safe. This includes routine cleaning and temperature checks, video consultations and test and trace policies so that we can continue offering fertility treatment in a responsible way.

I’m hoping to try for a baby next year, but I’m worried about taking the vaccine and how this could affect our chances – if it doesn’t affect fertility, then why are pregnant women advised against getting it?

There is no evidence that the vaccine affects fertility in men or women, and you should go ahead with the vaccine as directed by your doctor or other healthcare professional.

It is only a precaution to advise pregnant women not to take the vaccine and this is simply because it hasn’t been tested on pregnant women. Pregnant women are historically excluded from clinical trials, and they were also excluded from most COVID vaccination trials. That being said, so far there is no evidence to suggest that the vaccine could cause a negative effect in pregnancy. None of the authorised vaccines contain any live virus, which means they cannot multiple inside the body. Without containing organisms that can multiply, there is no risk that the vaccine can have a negative effect on an unborn baby.

My partner has been vaccinated and is taking more risks going out, but I’m pregnant and haven’t been vaccinated. Although I’m not in a vulnerable group, I’m worried that if I catch COVID my baby could be at risk. What should I do?

Pregnant women are considered at moderate risk (clinically vulnerable) of COVID-19. This is a precautionary measure, as there’s no evidence that pregnant women are more likely to get seriously ill from coronavirus. Pregnant women are more likely to be admitted to ICU, although this could reflect a lower threshold for admission rather than a more severe disease.

It may be possible for you to pass on coronavirus to your baby before they are born (known as vertical transmission), but this has only happened in a handful of cases. When it has happened, the babies have fully recovered very quickly.

Nevertheless, it’s recommended that you stay indoors as much as possible, observe social distancing and frequently wash your hands. Your partner, although vaccinated, should also be following these guidelines and any additional restrictions in place by the UK Government in the area where you live. Everyone for the time being should be staying at home unless necessary!

Can I still breastfeed if I’ve had the COVID vaccination?

Yes. COVID vaccines are not thought to be a risk to a breastfed baby, and the benefits of breastfeeding are numerous. Many organisations, including the World Health Organisation (WHO) have recommended that the vaccine can be received while breastfeeding.

We’re ready to start a family, however, is it more responsible for us to wait to be vaccinated first since I’ve heard you can’t have the vaccine if you’re pregnant?

There is no reason why you should postpone pregnancy or fertility treatment because of the COVID-19 vaccine. That being said, if you are able to plan your pregnancy, you might like to have both doses of the vaccine then try to conceive three months after the first dose. The only reason to do this is you would prefer to have built immunity status against the virus – not for any reason related to fertility. For some, the idea of waiting may not be attractive, and it may be more responsible to start trying to get pregnant sooner rather than later. After all, it’s quite normal to take up to a year to conceive if you are aged 35 years or over and healthy. Therefore, it depends on your individual circumstances and fertility.

Once you are pregnant, it is advised that you do not get vaccinated as there is little research about the side effects in pregnant women. There are some exceptions though, and if you feel strongly, it’s recommended that you speak with your obstetrician to evaluate the risks, benefits and your personal circumstances.

Article by Dr César Díaz-García, MD PhD Assoc Prof, www.IVI.uk.