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Covid Protocol

Coronavirus and Treatment of Infertility

The coronavirus (COVID-19) pandemic in the U.S. and the rest of the world has caused fertility centers and their national societies to question the risks to patients, staff, and the developing fetus by this new virus. The virus is commonly spread by individuals who do not have symptoms, making avoidance very difficult. Patients with symptoms such as fever or dry cough should not go in for care, which risks other patients and health care workers, but rather should contact their health provider by phone. Their provider may recommend self-isolation at home with or without testing. In regions with a large number of cases, the focus of testing should be patients potentially needing hospital care, whereas in regions with fewer infections, widespread testing can allow for following up and testing contacts, thereby allowing more vigorous efforts to prevent spread.

Covid Procreate Fertility Protocol

At Procreate Fertility Center of Virginia, we follow the recommendations of the American Society for Reproductive Medicine (ASRM) and the Centers for Disease Control (CDC) to protect the health and well-being of our patients, employees, and visitors.

Research shows that vaccination before pregnancy or early in pregnancy reduces risks for mother and baby. While the ingredients of the COVID vaccine are too large to pass from mother to baby through the placenta, the vaccinated mother’s antibodies do protect the baby.

For more information, please read the complete guidelines from ASRM included below and discuss any questions or concerns with your healthcare provider.

American Society for Reproductive Medicine (ASRM) Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic

UPDATE No. 16 – July 23, 2021

Reproductive Facts Regarding COVID-19 Vaccination

As of July 16, 2021, the 7-day moving average of daily new cases of COVID-19 in the United States (U.S.) increased by nearly 70% compared with the previous 7-day moving average.(1)
The current status of the COVID-19 pandemic in the U.S. has been called “a pandemic of the unvaccinated”(2). The incidence of COVID-19 hospitalizations and deaths fell precipitously as COVID-19 vaccinations became widely available. Unfortunately, hospitalization rates are rising again, due to the highly contagious delta variant, especially in states with low vaccination rates. Nearly all (97%) recently hospitalized patients are unvaccinated.(2-5)
Current CDC data suggest only 16.3% of pregnant women included in CDC’s Vaccine Safety Data link have received >1 dose of a COVID-19 vaccine during pregnancy.(6) This low rate of vaccination is particularly concerning given the known increased risk of adverse outcomes for women infected with COVID-19 during pregnancy. (7,8)
Reproductive endocrinologists should discuss COVID-19 vaccination with all patients and encourage vaccination for all patients during evaluation and treatment for infertility. Vaccination either pre-conception or early during pregnancy is the best way to reduce maternal/fetal complications. Physician counseling has been shown to have significant positive impact on patient willingness to consider vaccination.(9)
None of the currently available COVID-19 vaccines reach or cross the placenta. The intramuscularly administered vaccine mRNA remains in the deltoid muscle cell cytoplasm for just a few days before it is destroyed.(10,11) However, protective antibodies to COVID19 have been shown to cross the placenta and confer protection to the baby after delivery.(12,13)
COVID19 vaccination does not induce antibodies against the placenta.(14)
Existing data suggest COVID19 vaccination during pregnancy does not increase risk of miscarriage.(15)
COVID19 vaccination does not impact male or female fertility or fertility treatment outcomes.(16-18)

REFERENCES

  1. Centers for Disease Control and Prevention. COVID Data Tracker Weekly Review. Available at https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html, last accessed July 2021.

  2. Rochelle Walensky. July 16,2021 Press Briefing by White House COVID-19 Response Team and Public Health Officials. Accessible at https://www.whitehouse.gov/briefing-room/press-briefings/2021/07/16/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-45/, last accessed July 2021.

  3. Allison Aubrey. 97% Of People Entering Hospitals For COVID-19 Are Unvaccinated. National Public Radio July 16, 2021. Available at https://www.npr.org/2021/07/16/1017012853/97-of-people-entering-hospitals-for-covid-19-are-unvaccinated, last accessed July 2021.

  4. Johnson CK, Stobbe M. Nearly all COVID deaths in US are now among unvaccinated. Associated Press June 29, 2021. Available at https://apnews.com/article/coronavirus-pandemic-health-941fcf43d9731c76c16e7354f5d5e187, last accessed July 2021.

  5. Keating D, Shapiro L. For unvaccinated, coronavirus is soaring again. Washington Post July 21, 2021. Available at https://www.washingtonpost.com/health/interactive/2021/unvaccinated-case-rate-delta-surge/, last accessed July 2021.

  6. Razzaghi H, Meghani M, Pingali C, Crane B, Naleway A, Weintraub E, et al. COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021. MMWR Morb Mortal Wkly Rep 2021;70:895–9.

  7. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641–7

  8. Villar J, Ariff S, Gunier R, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection. The INTERCOVID Multinational Cohort Study. JAMA Pediatr. Published online April 22, 2021. Available at https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779182, last accessed July 2021.

  9. UCSF Aspire. Assessing the Safety of Pregnancy In the CoRonavirus PandEmic, Unpublished data. Available at https://aspire.ucsf.edu, last accessed July 2021.10. Centers for Disease Control and Prevention, Infectious Diseases Society of America. COVID-19 Realtime Learning Website. Vaccines FAQ, mRNA vaccines. Available at https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/vaccines-information–faq/, last accessed July 2021.

  10. Centers for Disease Control and Prevention, Infectious Diseases Society of America. COVID-19 Realtime Learning Website. Vaccines FAQ, mRNA vaccines. Available at https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/vaccines-information–faq/, last accessed July 2021.

  11. Pardi N, Tuyishimea S, Muramatsua H, Karikoa K, Muib BL, Tamb YK, et al. Expression kinetics of nucleoside-modified mRNA delivered in lipid nanoparticles to mice by various routes. J Controlled Release 2015;217:345-51. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624045/, last accessed July 2021.

  12. Gray KJ, Bordt EA, Atyeo C, Deriso E, Akinwunmi B, Young N et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol Gynecology. Published online March 2021, available at https://www.ajog.org/article/S0002-9378(21)00187-3/fulltext, last accessed July 2021.

  13. Beharier O, Mayo RP, Raz T, Sacks KN, Schreiber L, Suissa-Cohen Y, et al. Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine. J Clin Invest 2021;131:e150319. Available at https://doi.org/10.1172/JCI150319, last accessed July 2021.

  14. Shanes ED, Otero S, Mithal LB, Mupanomunda CA, Miller ES, Goldstein JA, et al. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination in Pregnancy. Obstet Gynecol. Published online July 08, 2021. Available at https://journals.lww.com/greenjournal/Fulltext/9900/

  15. Severe_Acute_Respiratory_Syndrome_Coronavirus_2.206.aspx, last accessed July 2021.

  16. Shimabukuro TT, Kim SY, Myers TR, Moro PL, Oduyebi T, Panagiotakopoulos L, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med 2021;384:2273-82.

  17. Gonzalez DC, Nassau DE, Khodamoradi K, Ibrahim E, Blachman-Braun R, Ory J, et al. Sperm parameters before and after COVID-19 mRNA vaccination. JAMA 2021;326:273-4.

  18. Morris RS. 2021 SARS-CoV-2 spike protein seropositivity from vaccination or infection does not cause sterility. Fertil Steril Reports. Available online June 2, 2021. Available at https://www.sciencedirect.com/science/article/pii/S2666334121000684, last accessed July 2021.

  19. Orvieto R, Segev-Zahav A, Aizer A. Does COVID-19 infection influence patients’ performance during IVF-ET cycle?: an observational study. Gynecol Endocrinol. Published online May 11, 2021. Available at https://pubmed.ncbi.nlm.nih.gov/33974475/, last accessed July 2021.

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