FAQs Related to COVID-19
Presented by ASRM and SARTThis communication from SART and ASRM is a frequently asked questions (FAQ) on the ASRM COVID-19 Taskforce Recommendations for current and future patients who need fertility medical treatments.
Posted Jan 27, 2021
A: We understand it can be confusing when respected physicians or their organizations come to different conclusions. However, the virus and what we know about treatments and vaccines are all rapidly changing. As we learn more about COVID-19 care and management, recommendations will evolve. In reality, currently, there is little data on which to evaluate the impact of the vaccine or the disease on pregnant individuals. Also, given the challenges of enrolling pregnant individuals in clinical trials, it is unlikely we will have full data for many years. Meanwhile, patients must make decisions about their health now. Our conclusion is that the vaccines are safe for pregnant individuals or those contemplating pregnancy. However, it is important that each patient discuss vaccination with their physician and decide what the best course of action is for them and their family.
Please review the ASRM COVID-19 Task Force Update 11 and Update 12 for information on which the Task Force bases its recommendations.
Posted Jan 22, 2021
A: While the COVID vaccine is new and there is a lot we do not know about it, the risks of developing severe illness from COVID are higher for pregnant woman. In severe cases, pregnant women with COVID are more likely to need ICU care and/or a ventilator than women with COVID who are not pregnant. The COVID-19 vaccine is made without live virus. In previous vaccines that used a similar design (i.e., those that also did not contain live virus), getting vaccinated was not associated with developing severe illness in either the pregnant mother or her unborn baby. Both the American College of Obstetrics and Gynecology (ACOG) and Society for Maternal and Fetal Medicine (SMFM) have released statements supporting use of the COVID-19 vaccine in pregnant and breastfeeding women (see links below), and although we do not know all the risks associated with taking the vaccine, when considering whether to take any medication prior to or during pregnancy, we always must consider the benefits relative to the theoretical or known risks. In this case, given how dangerous COVID can be during pregnancy, and the lack of evidence of harm to pregnant women associated with receiving the vaccine, we recommend that eligible women get the vaccine.
Posted Jan 22, 2021
A: No, it is impossible to get COVID from the vaccine. The vaccine does not contain live SARS COV2 virus. It is an mRNA vaccine. Please reference the CDC website for more information: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html.
There are several different types of vaccines in development. All of them teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building protection against the virus that causes COVID-19.
It typically takes a few weeks for the body to build immunity (protection against the virus that causes COVID-19) after vaccination. That means it is possible a person could be infected with the virus that causes COVID-19 just before or just after vaccination and still get sick. This is because the vaccine has not had enough time to provide protection.
Posted Jan 22, 2021
A: No, the vaccine will not impact your current medical conditions. In fact, if you have underlying medical conditions, you may be at higher risk of having severe complications from COVID-19. As a result, getting the vaccine which, after both doses offer approximately 95% protection from COVID 19, will lower your overall risk of illness.
Posted Jan 22, 2021
A: Side effects are more common after the 2nd dose than the 1st. The most common side effect after the 1st dose is arm soreness. Additional side effects include tiredness, headache, muscle pain, chills, joint pain, and fever. These typically last about 24 hours and can be improved with Tylenol or Advil.
Posted Jan 22, 2021
A: In theory, yes. Scientists are still unsure whether vaccination is protective against asymptomatic viral shedding. Preliminary data is promising in that vaccinated individuals may be less likely to be asymptomatic carriers than non-vaccinated individuals. However, it is still recommended that those who receive the vaccine continue to practice social distancing, masking, hand washing, etc.
Posted Jan 22, 2021
A: Because COVID-19 mRNA vaccines are not composed of live virus, they are not thought to cause an increased risk of infertility, first or second trimester loss, stillbirth, or congenital anomalies. It should be noted that pregnant and breastfeeding women were excluded from the initial phase III trials of these two vaccines, so specific safety data in these populations are not yet available and further studies are planned.
Because of this lack of data, we understand there are some organizations have chosen to recommend not to get vaccinated when trying to get pregnant and currently pregnant, we believe the risk-benefit ratio favors vaccination given the severity of COVID19 and its ability to be transmitted easily.
Posted Jan 22, 2021
A: No. Physicians should promote vaccination to patients, their communities, and to the public but because access to the vaccination is based on staggered eligibility criteria, your fertility specialist should not REQUIRE it prior to providing therapy.
Posted Jan 22, 2021
Posted Jan 22, 2021
A: No. We do not recommend avoiding pregnancy during this pandemic. At the same time, we are also not suggesting that a pandemic pregnancy is risk-free. The risk of acquiring the coronavirus in the first trimester is not known and will not be known for some time. We do know that severe illness can lead to pregnancy complications. If you are already pregnant, it is important to take all precautions possible to reduce your risk of exposure to the coronavirus by following CDC current recommendations, such as handwashing with soap, not touching your face, and practicing social (physical) distancing, whether you receive the vaccine or not.
Posted Jan 22, 2021
A: No. ASRM and SART does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are breastfeeding.
Posted Jan 22, 2021
A: It is extremely difficult to consider postponing your treatment. Most people have gone through tremendous loss and grief by the time they get to the place where they are doing an IVF cycle. In addition, navigating the cost and insurance coverage aspects is daunting. Now that you are at this point in your family building, you are dealt a huge unknown with the COVID-19 pandemic, and how you should proceed, or start, this medical treatment. It should be some helpful to hear that there is no evidence that delaying treatment until vaccinated will affect your ability to have a child, even if you have concerns about advanced age and / or diminished ovarian reserve (low egg supply).
A recent 2020 paper in the peer reviewed article in Human Reproduction concluded, “A delay in IVF treatment up to 180 days does not affect the live birth rate for women with diminished ovarian reserve when compared to women who initiate IVF treatment within 90 days of presentation” to the clinic.
Posted Jan 22, 2021
A: No one providing your care believes that any fertility treatment is elective. Infertility is a disease, and treatment of infertility is medically necessary. There is a distinction between a treatment that cannot be postponed even for a few days (such as surgery for a ruptured appendix), and treatment that is time sensitive and extremely important (such as IVF) but not a medical emergency. Unfortunately, there is not a universal definition, and we have seen many misleading terms used, even by state public health agencies.
We know that other important non-emergency treatments also are being postponed during this pandemic. Fertility treatment is not being singled out. Orthopedic surgery, eye surgery, kidney stone procedures, dental procedures, and many other treatments also are being postponed due to the COVID-19 pandemic.
Posted Jan 22, 2021
A: ASRM/SART has developed guidelines to minimize risk of viral transmission while pursuing fertility care. The most recent guidance can be found here and is updated periodically.
As anyone who has been through fertility treatment or has prepared to begin fertility treatment knows, multiple clinic visits and procedures are required. Unfortunately, even if a clinic screens patients and staff to lower the risk of COVID-19 exposure in the fertility clinic, there is no way to guarantee prevention of exposure. COVID-19 is spreading rapidly throughout the United States. People who have the COVID-19 are contagious days before they develop any symptoms. The virus can be in the air that they breathe out and the air you breathe in. This risk is reduced by wearing masks and by increasing physical distance between people.
However, these precautions are not foolproof and do not guarantee your safety. We wish we could screen in a way that could eliminate risk, but we honestly cannot.
Posted Jan 22, 2021
A: States and local governments have different local requirements. A clinic that begins a treatment cycle could be forced to cancel it by their city or state regulations. Furthermore, health care workers who are exposed to the coronavirus may not be able to come to work that could affect your care. It is possible that even if you begin to invest time and money into fertility treatment now, it could be cancelled due to governmental restrictions or lack of available staff.
Posted Jan 22, 2021
A: Yes. While we are still learning about the virus and where it resides or if it is present or active in reproductive tissues/cells, there is no evidence of cross contamination of COVID-19 between samples in storage in the IVF Lab.
Posted Jan 22, 2021
A: Yes! People facing an urgent need for fertility preservation can proceed with treatment during the pandemic.
Posted Jan 22, 2021
A: COVID-19 infection can last for weeks. Since pregnant women are known to be at increased risk of severe complications, you can start trying 10 days after symptoms started or after a positive COVID-19 test.
Posted Jan 22, 2021
A: Based on currently available information, pregnant women who become infected with COVID-19 do not appear to be at increased risk of miscarriage or other complications of pregnancy. However, pregnant women are known to be at greater risk of severe complications from other respiratory viral infections such as influenza and SARS. For that reason, pregnant women are considered an at-risk population for COVID-19.
Notably, in many reports cesarean delivery has been used for women who presented in labor and delivery. Though evidence is limited, there are anecdotal cases where pregnant women infected with COVID-19 have encountered an exacerbation of breathing difficulties after delivery.
A recent report from the CDC suggests that pregnant women with COVID-19 appeared to be at increased risk of mechanical ventilation and admission to the intensive care unit (ICU) compared to nonpregnant women, though the total number of women with severe complications overall is low. Pregnant women were not found to be at increased risk of death associated with COVID-19 compared with non-pregnant women.
Posted Jan 22, 2021
A: Infection with COVID-19 can be particularly concerning for those who are pregnant, as they may be at higher risk for severe complications. Although the effects of COVID-19 infection during pregnancy have not yet been fully defined, including effects of infection in the first trimester of pregnancy, infection may precipitate premature labor and/or delivery. However, full term newborns delivered from mothers with active COVID-19 infections have done well.
Posted Jan 22, 2021
A: We know that the infertility treatment is often stressful. The upheaval in many life domains created by the COVID-19 pandemic adds to that strain., There are several strategies you can use to cope. First, remember that your fertility nurse is likely experienced in providing emotional support for patients coping with infertility and pregnancy loss. Start by sharing what you are feeling with her/him. Your nurse also can connect you with your clinic’s specialized fertility counselor. This counselor can consult with you on how to manage the stress and emotions surrounding this extremely difficult set of circumstances. You also locate a fertility counselor through the Mental Health Professional Group of ASRM. Click here for a directory of mental health providers. Most of these fertility counselors offer telehealth services that may be covered by your insurance carrier. Here are some additional ideas for coping: