Pregnant women and those trying to conceive or undergoing fertility treatment (such as IVF or egg freezing) will understandably have extra concerns about the recent coronavirus outbreak.
"We have seen a surge of questions, fears and concerns about coronavirus." - Dr Meera Shah, Nova IVF.
Upon writing this on March 6th, 2020, The American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technologies (SART) suggest that individuals who are pregnant or seeking to initiate a pregnancy soon, avoid non-essential travel to known areas of infection or contact with potentially infected individuals. This advice applies to both men and women.
Patients, including prospective oocyte and sperm donors, as well as gestational carriers, who meet the diagnostic criteria for COVID-19 infection should avoid becoming pregnant. If they are undergoing active infertility treatment, they suggest that these patients consider freezing all oocytes or embryos and avoiding an embryo transfer until they are disease-free.
So, if you have any symptoms and if you're donating eggs or going through fertility treatment they suggest you should freeze all eggs or embryos and avoid an embryo transfer until you are disease-free. It also suggests women with symptoms should avoid becoming pregnant. And THIS is the thing that makes some women want to freeze their eggs now...they don't know how long Coronavirus is going to be around for, and the biological clock is ticking...
Furthermore, ASRM and SART are concerned that there may be intended parents who are using a gestational carrier to build their families whose travel may be restricted due to the virus, and who may then be unable to join their newborn in a timely manner. Consequently, they strongly encourage all intended parents and the legal professionals, organizations, and programs that facilitate these arrangements to promptly take the necessary steps to identify families that may be affected and develop contingencies in the event that these babies need to be cared for following their birth.
We do urge you to take heed of these warnings. But here are the facts about coronavirus and pregnancy laid out as we know them.
So far, it seems there are no obvious signs that the risks are greater for pregnant women.
"As far as we know, the pathogenesis does not differ in pregnancy," says Dr Meera Shah, Reproductive Endocrinology and Infertility Specialist at Nova IVF in Mountain View, California. "We are not providing different recommendations to pregnant women. Some very preliminary studies have shown that there is no vertical transmission of the virus, or increased risk of pregnancy complications."
However, because COVID-19 (the respiratory illness caused by the virus) is such a new disease, it's important to bear in mind that there's a lack of research at this stage.
There's a particularly paucity of data around pre-conception impacts - such as the potential effects of the virus on egg and sperm development - or studies into the effects of early-stage pregnancy.
Here's more on what the experts are saying:
Babies born to women infected with coronavirus have so far appeared to be healthy at birth...
That's according to a study published last month in The Lancet. The babies tested free of the virus and it was not detected in samples of amniotic fluid or breastmilk.
However, it is too soon to understand any longer-term or developmental risks, and the study was small - it involved just 9 women and babies in China.
Additionally, a World Health Organisation (WHO) analysis of 147 pregnant women who were infected found that only 8% had serious impacts, and 1% were in a critical condition.
"As opposed to Influenza A(H1N1)pdm09, pregnant women do not appear to be at higher risk of severe disease." - World Health Organization
But respiratory viruses, in general, can be dangerous...
In a small study of 12 women in Hong Kong who tested positive for SARS (another respiratory illness and the closest relative of coronavirus) during the 2003 outbreak, four of the seven women who were in their first trimester had a spontaneous miscarriage, and three of the women died.
And The American College of Obstetricians and Gynecologists (ACOG) says that: "based on limited data...pregnant women may be at higher risk of severe illness, morbidity, or mortality compared with the general population."
Although there isn't much specific data on the effects of coronavirus on pregnancy, what is known is that one of its symptoms, fever, could be dangerous.
Fevers just before or during early pregnancy have been associated with birth defects and with some developmental conditions.
As such:
The CDC is urging pregnant women to be vigilant...
Pregnant women should make sure to take preventive actions, such as washing their hands and avoiding those who are ill, according to advice from the Centers for Disease Prevention and Control.
"Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19," it warns.
Something to be aware of...
Currently, health officials are emphasizing that seasonal influenza remains a larger concern for the U.S. population.
Flu rates continue to be high across the United States, and health care practitioners are encouraged to continue to offer the flu vaccine to their unvaccinated patients, particularly pregnant women.
For more information on seasonal influenza and recommendations for pregnant women see the CDC’s website and ACOG’s Clinical Guidance.
If you are pregnant, trying to conceive or undergoing fertility treatment and have flu-like symptoms or you have been exposed to coronavirus, inform your ObGyn or fertility clinic immediately.