COVID 19: Questions Your Patients May Have

Q: If I’m trying to get pregnant, should I stop trying to conceive due to the Coronavirus?

A: If you don’t have COVID-19, there is no medical reason to change your plans regarding trying to conceive. However, there may be logistical, psychological, and emotional reasons to modify your plans. For example, there may be less access to routine prenatal care. Out of an abundance of caution, you may consider postponing pregnancy. This is a very personal decision, and you should speak with your doctor for specific recommendations.

Q: We are ready to start fertility treatments. Is it okay to continue during the pandemic?

A: As of March 17, 2020, the COVID-19 Task Force of the American Society for Reproductive Medicine (ASRM) issued clinical recommendations. These recommendations were reviewed on March 31st by the ASRM COVID-19 Task Force which chose, at that time, to keep the recommendations substantially the same. The Task Force is committed to review of these recommendations at least every two weeks. The recommendations suggest that clinics:

  1. Don’t initiate new treatment cycles — including ovulation induction, intrauterine insemination (IUI), in-vitro fertilization (IVF) (both egg retrievals and frozen embryo transfers), and non-urgent egg or embryo freezing.
  2. Strongly consider canceling all embryo transfers (fresh or frozen).
  3. Continue caring for patients who are “in-cycle,” or have urgent needs for stimulation or cryo-preservation (egg or embryo freezing), such as in cases of eminent surgery or start of medications that would affect fertility.
  4. Postpone elective surgeries and any non-urgent diagnostic procedures.
  5. Prioritize telemedicine over in-person contact.

Q. Will contracting COVID-19 now impact fertility later?

A: Research is still ongoing in this area. There are no studies indicating that the virus has any impact on fertility. While Coronavirus fears have caused some people to seek out egg freezing, there is no known medical indication to seek out egg freezing as a preventive measure.

Q. What if I test positive for COVID-19?

A. If you already have COVID-19, the Society for Assisted Reproductive Technology (SART) recommends avoiding getting pregnant for now and waiting until you fully recover before attempting conception (either naturally or via assisted reproductive technology).

Q. What if I’m pregnant and test positive?

A. According to the World Health Organization (WHO), pregnant women don’t appear to be at a greater risk for illness related to COVID-19 — and only 1% of pregnant women infected has experienced severe illness that required medical attention. However, the American College of Obstetricians and Gynecologists (ACOG) notes that very little is known about the effect of COVID-19 on pregnant women and infants. It is unclear if COVID-19 can cross the placenta. Because pregnant women are at greater risk of severe complications from similar respiratory infections, they are considered an at-risk population for COVID-19.

Q. If I test positive, can the virus be passed to my baby?

A: A study was conducted on nine pregnant women infected with COVID-19 in Wuhan, China. All women recovered from their illness and all nine had live births without any evidence of transmitting the virus to the baby. The virus was not detected in samples of cord blood, amniotic fluid, or throat swabs from the newborns, or breast milk. However, the COVID-19 infection was recently found in a newborn, so “vertical transmission” (meaning passage of the virus from mother to baby during the period immediately before and after birth) cannot be excluded at this point.

Q: How can I get through this? Not knowing when this will end is making my anxiety so much worse.

A: Experiencing fertility issues is difficult enough, and is often accompanied by increased levels of anxiety and depression. Adding COVID-19 to the mix exacerbates an already stressed emotional equilibrium. Please see the advice from the ASRM Mental Health Professional Group in the document, A Message from the MHPG and ASRM on Coping During the COVID-19 Pandemic, for additional support.

Contributed by Janet Jaffe, Ph.D., Kristen Chambliss, Ph.D., Alison Fagan, Ph.D., Jennifer Riley, M.S.W., L.S.W., and Deb Levy, M.A., L.P.C.