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A Guide To Trying To Conceive & The COVID-19 Vaccine

Fertility is complicated enough without worrying about COVID-19, so here's what you need to know.

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The decision to have a baby is one that can come with an incredible amount of uncertainty. Trying to conceive during a global pandemic probably means you have even more questions about health and safety than ever before. Wondering if the COVID-19 vaccine is safe if you're trying to conceive is likely a top concern for many who hope to become pregnant.

"The COVID-19 vaccine used by Pfizer and Moderna uses a new technology, and unfortunately pregnant women were not included in the research trials," Lauren Bishop, MD, a fertility specialist at Columbia University Fertility Center tells Romper.

But despite reports of concerns being raised on social media about how the novel coronavirus vaccine could negatively affect fertility, The New York Times reported that these claims could not be substantiated. "There’s no evidence that it does [negatively impact fertility], and there’s good reason to think that it does not," reported the Times. The vaccine is thought to work by creating antibodies that attack the virus' "spike" protein, but to date, there is no evidence to support theories that these antibodies could attack similar proteins found in the placenta. Bishop reiterates, "There have been no studies to support a negative impact on female fertility with use of the COVID-19 vaccine."

Reassuringly for those TTC, the Centers for Disease Control and Prevention (CDC) recently updated their vaccine recommendations to conclude that, “There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems.”

The COVID-19 Vaccine Technology Is More Compatible In Pregnancy Than Other Vaccines

Although COVID-19 vaccines have not been tested in pregnant people or those trying to conceive to date, Dr. Michael Cackovic, a maternal fetal medicine physician at The Ohio State University Wexner Medical Center, tells Romper that the technology used to create the vaccines is a different type than the ones typically not recommended for use during pregnancy. "The COVID-19 mRNA vaccine does not contain a live virus, and these types of vaccines are considered more compatible in pregnancy as they work by inducing an immune response by the host," Cackovic says.

"Since the vaccine is not a live virus, there is no reason to delay pregnancy attempts because you have received the vaccine or if you plan get the vaccine later," writes Lorene Temming, MD, and Katie Passaretti, MD, in a Q&A on pregnancy and the COVID-19 vaccine for Atrium Health.

One study published in the American Journal of Obstetrics and Gynecology looked at 131 women who received either the Pfizer or Moderna vaccine to examine the safety, efficacy, and outcomes of the vaccine. The study’s sample size, although small, included 84 pregnant participants, 31 who were lactating, and 16 who were not pregnant. As Romper previously reported, the “researchers found no evidence for increased risk of side effects for pregnant or lactating women” during this particular study.

Despite the lack of data on pregnancy and fertility impacts in large-scale human clinical trials, the CDC reported that in animal studies of the vaccine, vaccine manufacturers “found no safety concerns” in animals who received the vaccines during or before pregnancy. The CDC also reports that vaccine manufacturers are monitoring clinical trial participants who became pregnant. Additionally, both the CDC and Food and Drug Administration (FDA) have monitoring systems in place to collect updates on people who become pregnant after receiving the vaccine.

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Talk To Your Doctor About Receiving The COVID-19 Vaccine While Trying To Conceive

If you are trying to conceive, both the CDC and American College of Obstetrics and Gynecology (ACOG) recommend talking to your doctor about the potential risks involved with receiving a vaccination that has not yet been tested during pregnancy, as well as the risks involved if you do become pregnant and contract COVID-19. "The decision to take the vaccine while pregnant or attempting pregnancy is unique for every woman and is based on many factors. Women should inquire about the rate of positive testing for COVID-19 in their community to help determine their risk of infection," Bishop explains. "They should also discuss any underlying medical conditions they may have, and if these conditions could become more severe if they were to contract COVID-19 while pregnant."

You Should Still Get The COVID-19 Vaccine If You Become Pregnant

If you do become pregnant, it is possible to still receive the vaccine. ACOG has recommended that the vaccine not be withheld from pregnant women who are considered high risk and otherwise eligible for the vaccine, Bishop notes. "The decision to take or abstain from the vaccination should be made after a detailed discussion with your OB-GYN to weigh the risks versus benefits, and women should be supported in whichever decision they make," Bishop adds.

Currently, the CDC recommends that people who are pregnant receive the flu shot, as well as any other vaccine recommended by their physician. They also warn that "pregnant people are at an increased risk for severe illness from COVID-19 compared to non-pregnant people," so if you do become pregnant, continue to wash your hands, wear a mask, and maintain social distance when in public in order to mitigate potential risks.

Now that everyone aged 16 and older are eligible to receive the COVID-19 vaccine in the U.S., the CDC also recommends that those who do receive the vaccine and are or become pregnant consider participating in the v-safe pregnancy registry. This voluntary registry uses a smartphone-based survey tool to “gather information on the health of pregnant people who have received a COVID-19 vaccine.”

Experts are confident that this vaccine will end up being less of a worry for those trying to become pregnant and more of a reassurance in due time, and that data produced by new studies and registry participation will help bolster this assertion. "Hopefully in the upcoming months, more vaccine trials will include pregnant and breastfeeding patients so physicians will be able to provide women with more information," Bishop tells Romper.

Study Referenced:

Gray, K. Bordt, E., Atyeo, C., Elovitz, M., Alter, G., Edlow, E.(2021) COVID-19 vaccine response in pregnant and lactating women: a cohort study, American Journal Of Obstetrics and Gynecology. https://www.ajog.org/article/S0002-9378(21)00187-3/fulltext

Experts:

Lauren Bishop, MD, Fertility Specialist at Columbia University Fertility Center

Dr. Michael Cackovic, maternal fetal medicine physician at The Ohio State University Wexner Medical Center

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