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COVID and Fertility Plans

These certainly are unprecedented times.  Our country has been shut down by an invisible virus.  We are learning more daily about this virus but the unknown sometimes is the scariest thing of all.

 

We are often asked by our patients "Should I wait to try to get pregnant"?

Here are my thoughts with this caveat: this is based on information known on May 6, 2020...

 

The "good" news is that pregnancy does not seem to make one more at risk for this virus.  There also is no good evidence of what we call vertical transmission, the passing directly from mother to baby.  There also is no evidence of fetal damage from the virus like we see with certain other viruses...remember Zika?

 

We have to consider that we only have data from essentially Dec 2019 to now.  However this does fit what we know about other coronavirus.  We have not seen fetal effects as a whole from that family of virus, which includes many that cause the common cold.

 

So why aren't pregnant women high risk for this virus like they are for the flu?  The damage is from the immune system's haywire response to the virus which damages the various organ systems.  Pregnant women are somewhat immunosuppressed... this may be protective.

 

Now what about early miscarriage?  Anecdotally some doctors are reporting more miscarriage in their practices.  However, there is no strong data supporting this and we are collecting that now.  Many hospitals around the country and testing all patients in the hospital for their COVID status and this will help us understand how common asymptomatic infection is.  We have a registry in place to try to get the best data:

https://priority.ucsf.edu/

 

Each woman has to make the best decision for themselves.  However, if you are older, please factor in the decreased fertility rate and increased miscarriage rate with advancing age.  My bottom line advice: Don't let the fear of COVID cause you to put off pregnancy if you are at risk for fertility problems.  

Author
John Thoppil, MD Dr. Thoppil is the founder of River Place Ob/Gyn. He has been named an Austin Monthly Top Doc the last 3 years and was the cover model of the January 2018 issue. He is the President Elect of the Texas Association of Obstetricians and Gynecologists and an Assistant Clinical Professor at Texas A&M Medical School

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