Covid and Fertility treatment
Fertility treatment and vaccination
- COVID-19 vaccination is recommended for women who are contemplating pregnancy or who are pregnant to minimize risks to themselves and their pregnancy.
- Couples should get vaccinated as soon as possible with whichever vaccine is available to them in their area as almost all vaccines have equal efficacy.
- Should conception be postponed till vaccination is completed?
- Planning for a pregnancy before getting fully vaccinated or vice versa is a personal choice. However, it is advisable to plan a pregnancy for those with a limited reproductive horizon like advanced maternal age, poor ovarian reserve, severe endometriosis and poor responders.
- Although couples who choose not to be vaccinated or if vaccine is not available, should not be denied access to infertility treatments.
- When should a couple restart fertility treatment post vaccination?
- It is advisable to postpone the start of any treatment (sperm collection, ovarian stimulation, embryo transfer) for at least a week after the completion of vaccination (first or second dose) to allow time for the immune response to settle.
- IFS (Indian fertility society )recommends that vaccination may be considered during fertility treatment however, keeping in mind the minor side effects after vaccination which may be bothersome to some patients, it is recommended to separate the date of vaccination by 1 -3weeks from some treatment procedures (for example, egg collection in IVF treatment) preferably, so that any symptoms, such as fever, are not wrongly attributed to the treatment, and sero conversion is effective.
- However, Assisted reproduction treatments should preferably be delayed for a period extending from 2 weeks to 2 months in women who have had any significant side effects from COVID-19 vaccination like allergic reaction.
- Is there any effect on fertility?
No vaccine does not have any effect on the fertility of either the male of the female partner and there is no scientific proof to it that it affects fertility. Vaccination is absolutely safe for both males and females who want to conceive
- When should the vaccine be taken in pregnancy?
- According to CDC, the vaccine is a mechanism to protect your baby, and the sooner you get it, the better.
- As of now, there is limited data on the safety of use in pregnancy ,of COVID vaccines available in India. However, animal studies do not show any adverse fetal or neonatal effects of the vaccine. Every individual needs protection from the surging COVID-19 infections. There is a need to prevent severe covid infection and vaccine appears to be the answer.
- IFS recommends that this protection should be extended to pregnant women.
- Since safety data is presently unavailable and COVID is also a known cause of first trimester miscarriage, IFS recommends deferring the vaccination in the first trimester and taking it in the second or third trimester
COVID-19 is also more likely than the vaccine to cause a fever, which can be problematic in the first trimester of pregnancy
- Should the male partner take the vaccine if the couple is trying to conceive?
- All major fertility organisations recommend that covid 19 vaccine should be offered to men also, desiring fertility.
- Should the couple wish to start treatment it is recommended that the cycle may be planned in such a manner that potential effects of fever post vaccination does not affect the cycle
- Should donors and surrogates be vaccinated?
- Donors and surrogates should be encouraged to get complete vaccination. At least one week gap is recommended from most recent vaccination prior to gamete donation. If at all the donor feels unwell after vaccination, donation should be deferred for at least a week after all symptoms have abated.
- The patient, partner, donor or surrogate, all should undergo COVID RTPCR testing prior to starting treatment and before any ART procedure.
- Oocyte donors
- Clinics should consider incorporating additional counselling and documentation regarding screening for SARS-CoV-2 during ovarian stimulation for oocyte donation (OD)
- Oocyte donors should be screened with ART triage questionnaire and RTPCR test done before starting the treatment
- Clinics should consider cancellation if the donor has a positive RTPCR test for SARS-CoV-2 or develops COVID-19 during ovarian stimulation
Similar protocol must be followed for sperm donors. RTPCR should be done before donation and vaccination should be mandatory.
Data regarding presence of SARS-CoV-2 in semen is conflicting. Quarantine of all anonymous donor sperm specimens for 6 months must be carried out as per ICMR requirement.
- Is intercourse permitted after taking the vaccination?
Since this it is an integral part of fertility treatment, it can be practiced provided the couple/patient is not discomforted by the side effects (like body aches and fever) of the vaccine
- Should breast feeding be discontinued for a few days after the vaccine shot ?
There is no reason to halt or discontinue breastfeeding at all. It may be continued without any break.
- Is any vaccine approved for pregnant women by WHO?
- The various stages of trials of all COVID-19 vaccines available in the world haven’t been done on pregnant women. However, in circumstances where the risks outweigh the benefits, WHO permits use of vaccines eg for Health CareWorkers. The Pfizer and the Moderna Vaccines are presently recommended.
- Prominent organisations like the Federation of Obstetric and Gynaecological Societies of India (FOGSI) and The International Federation of Gynecology and Obstetrics (FIGO) recommend pregnant women and lactating mothers to go ahead with the vaccination in view of the rising number of severe cases in pregnancy during the second phase. This has been strongly recommended to the Indian Govt. and awaits approval.
IFS also strongly recommends the same.
- Can prophylactic pain killers be taken before vaccine?
It is recommended not to take painkillers before the vaccine shot as it may dampen body’s immune response. A mild antipyretic like acetaminophen maybe taken for fever.
11. Can I get COVID from the vaccine?
No, it is impossible to get COVID from the vaccine. The vaccine does not contain live SARS COV2 virus.
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.
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.