Five quick facts about COVID-19 and fertility

1.    COVID-19 does not appear to cause birth defects but may increase pregnancy complications.

Unlike viruses such as rubella, chickenpox, or Zika virus, there is no evidence that COVID-19 causes birth defects. Because of the immunosuppression and increased respiratory demands of pregnancy, expectant mothers who become infected with COVID-19 must be closely monitored. COVID-19 in pregnancy can pose some increased risks to the baby, such as preterm birth and growth restriction. 

2.    Semen from infected men might contain COVID-19. 

In a study of 38 men in China with COVID-19, 15.8% had detectable virus in the semen. Sexual transmission of COVID-19 through semen has not been confirmed, but it recommended that men who are currently infected with, or recovering from, COVID-19 use a condom or abstain from sex.

3.    It is safe to conceive during the pandemic.

Doctors support women’s autonomy to conceive during the pandemic. Although women with medical conditions such as diabetes, high blood pressure, or obesity may be at higher risk of complications from COVID-19, the virus does not pose pregnancy-specific risks that warrant delaying conception.

4.    In utero transmission of COVID-19 is very rare.

Early evidence suggested that COVID-19 did not pass from mother to child prior to birth. A recent case in the United States, however, did find evidence of in utero transmission but the risk of neonatal infection remains very low, at less than 2%.

5.    Women who are planning to conceive, pregnant, or breastfeeding should consider getting the COVID-19 vaccine.

None of the COVID-19 vaccines contain live virus. Vaccines that do use live virus (e.g., the chickenpox vaccine) are contraindicated in pregnancy. The vaccines undergoing development and approval for COVID-19 include three types: mRNA, protein subunit, and vector vaccines. Both Pfizer-BioNTech and Moderna’s vaccines use mRNA technology. There is presently no evidence for safety, or harm, of the COVID-19 vaccine in pregnant or breastfeeding women because these groups were excluded from the initial studies. The American Society for Reproductive Medicine has stated that the COVID-19 vaccine “should not be withheld” from women who are pregnant, breastfeeding, or planning to conceive. The Society of Obstetricians and Gynaecologists of Canada just released a similar statement that supports offering the vaccine to pregnant and breastfeeding women, particularly those in higher risk groups such as health care and front-line workers, Indigenous communities, or those in outbreak settings.
—Caitlin Dunne, MD 
—Julie Van Schalkwyk, MD

Dr Dunne is a clinical assistant professor at the University of British Columbia in the Division of Gynaecologic Reproductive Endocrinology and Infertility. She is also a co-director at the Pacific Centre for Reproductive Medicine and a member of the BCMJ Editorial Board. Dr Van Schalkwyk is a clinical associate professor at the University of British Columbia in the Division of Gynaecologic Specialties – Gynaecologic Infectious Diseases. She is also the site head of Obstetrics and Gynaecology at BC Women’s Hospital & Health Centre.

This post has been peer reviewed by the BCMJ Editorial Board.

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