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.

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.

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. 

Side effects are more common after the 2^nd dose than the 1^st.  The most common side effect after the 1^st 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.

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.

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.

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.

• CDC ACIP COVID-19 Vaccines Work Group
• Safety and Efficacy of the BNT162b2 mRNA COVID Vaccine (NEJM)
• FDA Fact Sheet for Vaccination Providers
• FDA Fact Sheet for Recipients and Caregivers
• COVID-19 Vaccines in Pregnancy (AJOG)

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.

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.

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.

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 are also 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 are also being postponed due to the COVID-19 pandemic. 

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.

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.

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. 

Yes! People facing an urgent need for fertility preservation can proceed with treatment during the pandemic.

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.

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.

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.

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:

• Get accurate and current information to reduce anxiety. Utilize reliable sources such as the CDC, WHO and ASRM.
  
  
• Limit your use of social media and other sources of news. Set a certain time of day for gathering news. Choose a time when you are not likely to be triggered. Stop using tech devices an hour or more before bedtime…turn them off.
  
  
• Utilize relaxation or mindfulness apps to reduce anxiety and tension and improve sleep.  Focus on the present moment. Some examples are Ferticalm (for women), FertiStrong (for men), Buddhify, Headspace, MindshiftCBT, and Personal Zen.
  
  
• Engage in pleasurable activities and hobbies.  What do you do for fun?  Taking even ½ hour per day to focus on things other than the pandemic and your fertility journey will help.
  
  
• Pay attention to the messages you give yourself. Positive self-talk can be powerful. Saying things like “This isn’t the situation I expected but it doesn’t mean it won’t work out eventually” can be helpful.
  
  
• Stay in touch with others in your support network, either socially distanced or virtually.  Staying connected with others reduces the sense of isolation.  If you are experiencing Zoom fatigue, consider connecting on the weekend or after you have given yourself a break.
  
  
• Join RESOLVE: The National Infertility Association (www.resolve.org).  RESOLVE has an online support community, local support groups (now meeting virtually), webinars and other content to help you connect, get support, and stay informed.