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COVID-19 and Infertility: Frequently Asked Questions

05/20/2022

COVID-19 and Infertility: Frequently Asked Questions

Dear Valued Patient,

Shady Grove Fertility continues to follow recommendations from the Centers for Disease Control and Prevention (CDC), American Society for Reproductive Medicine (ASRM), and American College of Obstetricians and Gynecologists (ACOG) in response to COVID-19. Our Practice leaders examine the implications of all recommendations with a careful focus on our duty to our patients and to public health. We continue to monitor the situation closely and change our response as indicated, while practicing only evidence-based medicine as our standard.

Please refer to the Frequently Asked Questions below or visit the CDC website for more information about COVID-19.

Medical contribution by Eric A. Widra, M.D.

Eric A. Widra, M.D., is the Executive Senior Medical Officer for Shady Grove Fertility and the associate director of the Combined Federal Fellowship in Reproductive Endocrinology and Infertility—a post-graduate training program for future leaders in this subspecialty, operated through the National Institutes of Health, Walter Reed National Military Medical Center, and Shady Grove Fertility.

COVID-19 FAQ

Effective May 20, 2022, SGF is offering in-person New Patient consults and Follow Ups. Patients can bring one support person to New Patient consults and Follow Up appointments. Vaccination status is not required. 

Blood work, ultrasound, and procedure appointments are also being conducted in-person with safety precautions in place. Patients can bring a support person to the following appointment types: IUIs, obstetrical ultrasounds, embryo transfers, egg retrievals, and ASC surgical procedures. Patients cannot bring a support person to basic monitoring appointments such as blood work and ultrasound at this time.

We thank you for your cooperation in following the requirements below to protect the health of the SGF community:

  • Vaccination status is no longer required for in-person appointments. 
  • If you are experiencing cold or flu-like symptoms, have a fever, or have recently been exposed to someone who has tested positive for COVID-19, we kindly ask that you do not enter an SGF facility. Please contact your clinical team with questions.
  • All patients, visitors, and staff are required to wear a mask that covers both the nose and mouth while inside an SGF facility. Masks should be worn before entering the building, a lobby, or boarding an elevator.
  • Valve masks and neck gaiter masks are NOT permitted in our offices. One-way valve masks or masks with vents, are ineffective; Only protecting the person wearing it and not others.
  • Patients dropping off semen specimens are required to wear a face mask to enter an SGF office.

For more information, please visit the CDC’s website: Effective Masks

SGF does not test patients for coronavirus. Please contact your primary healthcare provider to discuss testing or if you are experiencing any cold or flu-like symptoms

SGF providers and staff are prepared to safely manage care while taking necessary precautions against the spread and transmission of COVID-19. At this time, SGF has taken measures to limit transmission by promoting hand hygiene and disinfecting protocols, inputting screening measures, modifying appointments and schedules, performing consults electronically when indicated, and adjusting treatment cycles if deemed necessary.

Given the recent rise in COVID-19 cases, it is important for you to consider the following information prior to starting your treatment cycle.  We will always work to maximize the chances for completing successful treatment, however, the rapid evolution of the pandemic may create new and unexpected challenges.

  • If you elect to proceed with treatment, at any point during your cycle, your treatment cycle may be stopped (cancelled) and rescheduled for a later date. There may come a point where SGF may not be able to support treatment cycles (e.g., illness of doctors or laboratory staff which would prevent SGF from rendering services, or SGF being required to shut down pursuant to a government order). In addition, if you have been exposed to COVID-19, diagnosed with COVID-19, or become symptomatic with any febrile illness which could possibly be COVID-19, SGF may elect to not proceed with your treatment cycle and reschedule for a later time.
  • If you proceed with an IVF treatment cycle, at any point during your cycle, SGF may determine that all viable embryos must be vitrified (frozen) and a transfer cancelled.  If you elect to proceed with your treatment cycle, you will be financially responsible for any charges incurred for services rendered not covered by your insurance (e.g., medications, ultrasound, bloodwork, and embryo vitrification).  Alternatively, you can elect to delay your treatment.

Following the recommendations of the CDC, ACOG and ASRM, SGF has no reason to believe that COVID-19 or the COVID vaccines can adversely affect fertility, treatment outcomes, or pregnancy.

SGF does not recommend a delay in treatment in most cases and recommends a risk-benefit analysis discussion between patients and their provider. With caution and safety measures in place, we feel it is appropriate to move forward with fertility treatment, if that is what your physician advises. 

Given the recent rise in COVID-19 cases, it is important for you to consider the following information prior to starting your treatment cycle.  We will always work to maximize the chances for completing successful treatment, however, the rapid evolution of the pandemic may create new and unexpected challenges.

  • If you elect to proceed with treatment, at any point during your cycle, your treatment cycle may be stopped (cancelled) and rescheduled for a later date. There may come a point where SGF may not be able to support treatment cycles (e.g., illness of doctors or laboratory staff which would prevent SGF from rendering services, or SGF being required to shut down pursuant to a government order). In addition, if you have been exposed to COVID-19, diagnosed with COVID-19, or become symptomatic with any febrile illness which could possibly be COVID-19, SGF may elect to not proceed with your treatment cycle and reschedule for a later time.
  • If you proceed with an IVF treatment cycle, at any point during your cycle, SGF may determine that all viable embryos must be vitrified (frozen) and a transfer cancelled.  If you elect to proceed with your treatment cycle, you will be financially responsible for any charges incurred for services rendered not covered by your insurance (e.g., medications, ultrasound, bloodwork, and embryo vitrification).  Alternatively, you can elect to delay your treatment.

You can protect yourself and help stop the spread of COVID-19 by taking the following precautions:

  • Get vaccinated per CDC recommendations. 
  • Wear a mask that fully covers your nose and mouth when in public. 
  • Practice social distancing. Stay at least six feet away from others.
  • Avoid people who are sick and crowds
  • Wash your hands frequently with soap and water for 20 seconds or use hand sanitizer with at least 60% alcohol
  • Follow CDC travel guidance
  • Follow quarantine guidance after exposure to COVID-19
  • Follow any applicable workplace guidance

SGF supports guidance from the CDC, FDA, and ACOG regarding COVID vaccinations while trying to conceive. Updated guidance from the CDC states:

COVID-19 vaccination is recommended for all people aged 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. Getting a COVID-19 vaccine can protect you from severe illness from COVID-19.

Guidance from ACOG also supports COVID-19 vaccination,

Vaccination is strongly recommended for non-pregnant individuals. Based on the benefit-risk assessment, COVID-19 vaccination continues to be recommended for all persons aged ≥ 12 years under the FDA’s EUA. Further, ACOG recommends vaccination for individuals who are actively trying to become pregnant or are contemplating pregnancy. Additionally, it is not necessary to delay pregnancy after completing both doses of the COVID-19 vaccine. 

Claims linking COVID-19 vaccines to infertility are unfounded and have no scientific evidence supporting them. Given the mechanism of action and the safety profile of the mRNA vaccines in non-pregnant individuals, COVID-19 mRNA vaccines are not a cause of infertility. Adenovirus vector vaccines such as the Janssen COVID-19 vaccine cannot replicate following administration, and available data demonstrate that it is cleared from tissues following injection. Because it does not replicate in the cells, the vaccine cannot cause infection or alter the DNA of a vaccine recipient and is also not a cause of infertility (Evans, 2021, Morris 2021). Therefore, ACOG recommends vaccination for all eligible people who may consider future pregnancy. 

If an individual becomes pregnant after the first dose of a COVID-19 vaccine requiring two doses (Pfizer-BioNtech or Moderna), the second dose should be administered as indicated. 

Finally, routine pregnancy testing is not recommended and should not be required prior to receiving any EUA-approved COVID-19 vaccine.

During this unprecedented time, we continue to offer our patients the support they need and deserve. Our staff is available to ensure that patients can progress toward their family building goals.

To expedite the proper handling of your needs and to provide the best possible service, please direct all communication to the contact information below. 

  • All general scheduling questions should to be addressed to the SGF New Patient Center at: 1-888-761-1967. 
  • All clinical questions should be addressed to your clinical team and sent via the SGF Patient Portal. 
  • All financial questions should be addressed to your financial team and sent via the SGF Patient Portal. 
  • All SGF Patient Portal technical/troubleshooting questions, call the SGF New Patient Center at 1-888-761-1967. 

For more information about COVID-19, visit www.cdc.gov or your local health department. 

REFERENCES

  1. Advisory Committee on Immunization Practices. ACIP recommendations. Available at: https://www.cdc.gov/vaccines/acip/recommendations.html. Retrieved December 11, 2020. 
  2. Centers for Disease Control and Prevention. COVID-19 (coronavirus disease): people with certain medical conditions. Available at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Retrieved December 11, 2020. 
  3. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): people with certain medical conditions. Available at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Retrieved December 7, 2020. 
  4. Centers for Disease Control and Prevention. Local reactions, systemic reactions, adverse events, and serious adverse events: Pfizer-BioNTech COVID-19 Vaccine. Available at: https://www.cdc.gov/vaccines/covid-19/info-by-manufacturer/pfizer/reactogenicity.html. Retrieved December 13, 2020 
  5. Centers for Disease Control and Prevention. Understanding mRNA COVID-19 Vaccines. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html. Retrieved December 13, 2020 
  6. Centers for Disease Control and Prevention. Health equity considerations and racial and ethnic minority groups. Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html. Retrieved December 13, 2020 
  7. Collin J, Byström E, Carnahan A, Ahrne M. Public Health Agency of Sweden’s Brief Report: pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand 2020;99:819-22. Available at: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13901. Retrieved December 11, 2020. 
  8. Delahoy MJ, Whitaker M, O’Halloran A, Chai SJ, Kirley PD, Alden N, et al. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19 – COVID-NET, 13 states, March 1-August 22, 2020. COVID-NET Surveillance Team. MMWR Morb Mortal Wkly Rep 2020;69:1347-54. Available at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6938e1.htm. Retrieved December 11, 2020. 
  9. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status – United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769-75. Available at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6925a1.htm. Retrieved December 11, 2020. 
  10. Ethical issues in pandemic influenza planning concerning pregnant women. Committee Opinion No. 563. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:1138-43. Available at: https://journals.lww.com/greenjournal/Fulltext/2013/05000/Committee_Opinion__No__563__Ethical_Issues_in.47.aspx. Retrieved December 11, 2020. 
  11. Hamel L, Lopes L, Muñana C, Artiga S, Brodie B. The undefeated survey on race and health. San Francisco, CA: Kaiser Family Foundation; 2020. Available at: https://www.kff.org/report-section/kff-the-undefeated-survey-on-race-and-health-main-findings/. Retrieved December 11, 2020. 
  12. Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group. BMJ 2020;369:m2107. Available at: https://www.bmj.com/content/369/bmj.m2107. Retrieved December 11, 2020. 
  13. Moore JT, Ricaldi JN, Rose CE, Fuld J, Parise M, Kang GJ, et al. Disparities in incidence of COVID-19 among underrepresented racial/ethnic groups in counties identified as hotspots during June 5-18, 2020 – 22 states, February-June 2020. COVID-19 State, Tribal, Local, and Territorial Response Team. MMWR Morb Mortal Wkly Rep 2020;69:1122-6. Available at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm. Retrieved December 11, 2020. 
  14. Panagiotakopoulos L, Myers TR, Gee J, Lipkind HS, Kharbanda EO, Ryan DS, et al. SARS-CoV-2 infection among hospitalized pregnant women: reasons for admission and pregnancy characteristics – eight U.S. health care centers, March 1-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1355-9. Available at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6938e2.htm. Retrieved December 11, 2020. 
  15. Pfizer-BioNTech COVID-19 vaccine (BNT162, PF-07302048). Vaccines and Related Biological Products Advisory Committee briefing document. Available at: https://www.fda.gov/media/144246/download. Retrieved December 11, 2020. 
  16. Schlake T, Thess A, Fotin-Mleczek M, Kallen KJ. Developing mRNA-vaccine technologies. RNA Biol. 2012;9(11):1319-1330. doi:10.4161/rna.22269. U.S. Food and Drug Administration. December 11, 2020 communication to Pfizer Inc. Available at: https://www.fda.gov/media/144412/download. Retrieved December 13, 2020 
  17. S. Food and Drug Administration. Fact sheet for healthcare providers administering vaccine (vaccination providers). Emergency Use Authorization (EUA) of the Pfizer-Biontech COVID-19 vaccine to prevent Coronavirus Disease 2019 (COVID-19). Available at: https://www.fda.gov/media/144413/download. Retrieved December 13, 2020 
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