17 August 2021

Expert Q&A: Pregnancy and COVID-19 vaccination

Doctor
Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London

 

Please note: this page is up-to-date as of 16 August 2021 and will be updated as information becomes available.

 

My partner and I were planning to try for a baby this year, but I recently caught COVID-19. I feel back to full health now, but is it safe to start trying to conceive?

It’s recommended to wait at least 10 days after your symptoms have subsided to make sure that you’re fully recovered before trying to conceive. If that’s the case and you’re feeling healthy, then there’s no reason to wait! If you find you have been trying to conceive for more than a year (or six months if you are over 35 years old), then it’s recommended to see a fertility specialist.

 

My partner was very sick with COVID-19 and ended up being treated in hospital. They feel fine now but could there be any lasting effects on fertility?

Rest assured that it’s very unlikely that your partner’s fertility will have been permanently affected, whether they are male or female. For men, being ill from any virus can cause a temporary drop in sperm count, so this is normal. There are some studies that suggest COVID-19 can affect sperm quality, but this data is still very limited. There is no evidence that the COVID-19 affects fertility in women. In fact, research from IVI found a previous COVID-19 infection had no negative impact on the ovarian reserve according a recent clinical study. As always, it’s recommended to wait at least 10 days after symptoms have disappeared before trying to conceive.

 

I have an underlying medical condition which puts me at higher risk of the COVID-19 virus so naturally I am keen to be vaccinated as soon as possible. However, I’ve just found out I’m pregnant! Does this mean I can’t have the vaccine?

If you have an underlying medical condition which makes you more vulnerable to severe illness from COVID-19, you are strongly encouraged by UK health leaders to get the coronavirus vaccine and take whichever vaccine you’re offered. The NHS has worked with numerous health charities to produce detailed information about the COVID-19 vaccine and how it relates to a number of health conditions, which you may also wish to review.

If you’re pregnant, it is safe to receive the vaccine. New NHS data shows that since the start of May 2021, 98% of pregnant women hospitalised with COVID-19 had not been vaccinated. In contrast, there were no pregnant women hospitalised who had received both vaccine doses and only three admitted to hospital who had received one vaccine dose.

 The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives both recommend that pregnant women receive the vaccine. Both medical bodies agree that vaccination is one of the best defenses for pregnant women against severe COVID-19 infection, while the Joint Committee on Vaccination and Immunisation have confirmed that the Pfizer and Moderna COVID-19 vaccines have been shown to be effective and safe for those who are pregnant and carrying a baby. If you are unsure, it’s best to speak with your obstetrician to evaluate the risks and benefits so you can make an informed decision based on your personal circumstances.

 

I want the COVID-19 vaccination but I’m also undergoing fertility treatment. Should I stop or interrupt my treatment?

It is safe to receive the vaccine and continue with your treatment cycle as planned, but you should check with your consultant before getting vaccinated, as everyone’s circumstances are different.

For example, at IVI, we recommend waiting at least two weeks after getting the jab before starting any treatment involving an insemination or embryo transfer. This allows any minor side effects to disappear and avoid causing unnecessary worry or stress during your fertility treatment. You should not feel like you need to delay your plans and, rest assured, there is no reason to postpone pregnancy or fertility treatment because of the COVID-19 vaccine.

 

I’m 36 and want to start a family as soon as possible, but I’m worried about catching COVID-19. Is it safe to attend a fertility clinic?

There is currently no evidence of any COVID-19 transmission through assisted reproduction, such as IVF treatment. Most clinics, such as IVI, have strict protocols to keep patients, staff and visitors safe. This includes routine cleaning and temperature checks, video consultations and test and trace policies so that we can continue offering fertility treatment in a responsible way.

 

I’m hoping to try for a baby next year, but I’m worried about taking the vaccine and how this could affect our chances – if it doesn’t affect fertility, then why were pregnant women initially advised against getting it?

There is no evidence to suggest that the vaccine affects fertility in men or women, and you should go ahead with the vaccine as directed by your doctor or other healthcare professional.

Until the guidance was updated in April 2021, pregnant women were advised not to take the vaccine as a precautionary measure. This was simply because there was not yet enough evidence to support routine vaccination for pregnant women at that time. Pregnant women are historically excluded from clinical trials, and they were also excluded from most COVID vaccination trials. That being said, there is no evidence to suggest that the vaccine could cause a negative effect in pregnancy. None of the authorised vaccines contain any live virus, which means they cannot multiply inside the body. By not containing organisms that can multiply, there is no risk that the vaccine can have a negative effect on an unborn baby.

Currently, guidance from the JCVI advises pregnant women to be offered COVID-19 vaccines at the same time as people of the same age or risk group as there is now enough evidence to support their safety profiles. Evidence on COVID-19 vaccines is being continuously reviewed by the World Health Organization and the regulatory bodies in the UK, USA, Canada and Europe. Pfizer and Moderna vaccines are the preferred vaccines for pregnant women of any age who are coming for their first dose.

 

My partner has been vaccinated and is taking more risks nowadays, but I’m pregnant and haven’t yet been vaccinated. Although I’m not in a vulnerable group, I’m worried that if I catch COVID-19 my baby could be at risk. What should I do?

There is no evidence to suggest that pregnant women are more likely to get seriously ill from coronavirus. Compared to the general population, pregnant women are more likely to be admitted to ICU, although this could reflect a lower threshold for admission rather than a more severe case of the disease. If you catch COVID-19 while you are pregnant, it may be possible for you to pass on coronavirus to your baby in-utero (known as vertical transmission), but this has only happened in a small number of cases. When it has happened, the babies have fully recovered very quickly.

That being said, since April 2021, pregnant women have been encouraged by health leaders to take the vaccine when offered, with many agreeing that it is the best way to protect you and your baby against COVID-19. If you haven’t yet received your vaccine, you can book an appointment using the online vaccination booking service offered by the NHS.

 

Can I still breastfeed if I’ve had any of the COVID-19 vaccines?

The good news for mothers who have been vaccinated against COVID-19 is there is no need to be concerned when breastfeeding. It is perfectly safe for you and your baby. Likewise, breastfeeding women who are offered their vaccine have nothing to worry about and many leading medical bodies, including the World Health Organization (WHO), are now recommending that women who are nursing should receive the vaccine when offered.

There are also tangible benefits to breastfeeding following your vaccination too: it is possible for babies to gain passive immunity to COVID-19 through the immunoglobulins present in breast milk. Immunoglobulins are antibodies which can protect your baby not only from COVID-19, but all sorts of pathogens (eg anything which triggers the body’s infection-fighting cells). If the breastfeeding mother has received one or both doses of the COVID-19 vaccine, she will pass some of the IgG antibodies to her baby. Similarly, if she has had a previous COVID-19 infection, she will pass IgA antibodies to her baby. IgG and IgA are different classes of antibody, but both perform a similar job of eliminating pathogens which stops us from getting poorly.

 

We’re ready to start a family, however is it more responsible for us to wait to be vaccinated first?

There is no reason why you should postpone pregnancy or fertility treatment because of the COVID-19 vaccine. That being said, if you are able to plan your pregnancy, you might like to have both doses of the vaccine then try to conceive three months after the first dose. However, this is a completely personal choice and the only reason to do this is if you would prefer to have built immunity status against the virus – not for any reason related to fertility. For some, the idea of ​​waiting may not be attractive, and it may be more responsible to start trying to get pregnant sooner rather than later. After all, it’s quite normal to take up to a year to conceive if you’re under 35 and healthy, with no known fertility issues. Therefore, it depends on your individual circumstances and fertility.

If you have any questions or concerns about your fertility and wish to speak to one of our consultants, we are happy to help. Contact us today.

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