Zika Virus and Infertility Treatments
To continue or not to continue fertility treatments?
That was the question which was faced by Amanda and her husband. The Puerto Rico-based couple had been undergoing fertility treatments for over 1 year when Zika transmission was reported on their island. They knew, some international health officials and also including Puerto Rico’s secretary of health and had advised ladies to consider delaying pregnancy in an effort to avoid serious birth defects. But they also knew, pushing back treatment could reduce their chances of conceiving.
For those couples who are trying to conceive. The existence of a birth defect causing virus has been added a layer of fear and uncertainty. The safest option can well be to wait until more is known, or until a vaccine is available but that is not a realistic option for most of the people.
“Most of these couples have been struggling with infertility for many of years, and time ain’t on their side,” says Juan Correa Perez, Ph.D., an embryologist in Texas who works closely with infertility clinics in his birthplace of Puerto Rico. That is why infertility specialists are being inundated with questions from concerned patients.
“At this point in time, because we do not have all the answers. The best we may probably do is [focus on] prevention and making [patients] aware of the situation, what the symptoms are!. Where to look for more information,” Dr. Perez says. “I think if you make them aware, they can make an intelligent decision.”
Kaylen Silverberg, M.D., A medical director of the Texas Fertility Center and Ovation Fertility, says he gets Zika-related questions about “every day.” Questions he is fielded include, Is it safe to get pregnant? What if my husband travels to a country with Zika and I do not? Should he bank sperm before he travels? Should I freeze my eggs?
Here is what you need to know to make informed decisions:
Zika infection during pregnancy doesn’t guarantee that the kid will be born with birth defects. But it is wise to take precautions. None knows exactly how great the risk of serious birth defects is!. In fact, researchers are still learning a lot about virus infection and also the transmission. But that uncertainty, potential for extremely serious health problems which is exactly why couples struggling with infertility can want to be extra cautious.
“A lady who gets infected and she is pregnant will wind up being monitored for her entire pregnancy. If the kid looks affected, she’s then facing delivering a baby who may likely be extremely mentally handicapped and may face a very short life span, or she may be facing terminating a pregnancy fairly late in the course of gestation,” says Nanette Santoro, M.D., The professor of reproductive endocrinology at the University of Colorado. “For a lady who ain’t struggling with infertility, this is awful. For every woman who has conceived after struggling with infertility, it’d be unimaginable stress and pain.”
Think about delaying fertility treatments if you have traveled to (or are planning travel to) an area with Zika transmission. If you are planning on using your own sperm-cell and eggs for fertility treatments, you could want to stay put for a while. The American Society for Reproductive Medicine suggests waiting 8 weeks before trying conception after possible exposure but not showing symptoms of Zika infection. Ladies who have Zika symptoms, however, should wait at least 8 weeks after symptoms appear, and the men with symptoms would wait 6 months after symptoms appear, before TTC. And given that there is no easy way to determine whether or not you have been exposed an estimated 80% of people who’ve been infected do not show any symptoms, and virus-detecting blood tests are not suggested unless you already have symptoms it is safest to wait.
Consider banking sperm-cell. If the male partner must travel to a high-risk area, sperm-banking before departure would be wise. Because the virus can be spread through sexual contact, the CDC says that men who develop symptoms after travel should abstain from unprotected sex and, therefore, attempting to conceive naturally or with fertility treatments for at least 6 months after symptoms first develop. Men who travel to affected areas but do not develop symptoms are advised to abstain from sex or use condoms (i.e. no TTC) for at least 8 weeks.
Time is very precious to those couples who have already waited for years after years to get pregnant. Banking sperm ahead of time allows a couple to “go full speed ahead” with fertility treatments, Dr. Silverberg says.
Donor eggs and sperm-cell should be safe, provided certain precautions have taken. There’re no commercially available tests for Zika, so clinics cannot screen eggs or sperm-cell for the virus. But in early 2016, the FDA issued suggestions instructing clinics to screen potential donors. Donors who live in or have traveled to areas with the active transmission cannot donate until 6 months have passed plenty of time, it’s believed, to clear the virus.
If you are using a gestational carrier, talk about any travel plans. Babies seem to be at the greatest risk if the mother is ever infected when she is pregnant. So if you are using, or considering using a gestational carrier, it is a good idea to put a nix on travel to countries under a travel advisory for the duration of the pregnancy. (See the CDC’s list of travel advisories.)
“One of my couples had been planning to transfer their embryos inside the uterus of a gestational carrier. She was planning on traveling to the Caribbean and they became quite concerned. They met with her and told her that if she did not postpone her trip, they would get someone else,” says David Diaz, M.D., a reproductive endocrinologist at Orange Coast Memorial Medical Center in California. “The carrier agreed it was probably not in her best interest, or the interest of the parents to go, so she postponed her trip.”
Egg freezing ain’t the answer. Egg freezing can be a way for ladies to prolong their fertility, but if you are dealing with infertility right now, egg freezing won’t help you decrease your risk of birth defects, because the greatest risk seems to be infected during pregnancy, Dr. Silverberg says.
After much reflection and discussion, Amanda and her husband had decided to continue fertility treatments. “I put it in God’s hands,” says Amanda, who is also relying on bug spray and long-sleeved clothing to protect her from mosquito bites. “If He wants this to happen, then it’ll happen.”