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Zika Virus and Fertility Planning

If you have been ignoring the news about Zika virus, maybe this will gain your attention. According to the U.S. Centers for Disease Control and Prevention, five of nine pregnancies among U.S. women who were infected with the Zika virus have resulted in tragic outcomes.

If you are traveling to an area where the Zika virus has been reported, precautions must be taken. Insect repellents containing DEET won’t harm a pregnant woman or her fetus when used as instructed to prevent infection with the Zika virus, a new research analysis suggests.

The American College of Obstetricians and Gynecologists (ACOG) supports the guidelines and is urging pregnant women and those planning a pregnancy to follow them.

Listen as Alan Martinez, MD discusses the Zika virus and the risks of travel for women that are pregnant or planning a pregnancy.
Zika Virus and Fertility Planning
Featured Speaker:
Alan Martinez, MD
Dr. Alan Martinez is a specialist in reproductive endocrinology and infertility. He was drawn to this specialty because it is an ever-evolving field of medicine that allows him to partner with patients and provide personalized treatment plans. He also appreciates that the field is filled with the latest laboratory technology, which continues to advance success rates.

After graduating with distinction with a B.S in biology and B.A. in psychology from San Diego State University, Dr. Martinez received his medical degree from the David Geffen School of Medicine at the University of California, Los Angeles. He completed his obstetrics and gynecology residency training at Saint Barnabas Medical Center, an affiliate teaching institution with Rutgers New Jersey Medical School. He completed his fellowship training at the University of Cincinnati Medical Center.

Learn more about Dr. Alan Martinez
Transcription:
Zika Virus and Fertility Planning

Melanie Cole (Host): If you're trying to become pregnant, should you be concerned about the Zika virus? According to the US Centers for Disease Control and Prevention, five of nine pregnancies among US women who are infected with the Zika virus have resulted in tragic outcomes. My guest today is Dr. Alan Martinez. He's a specialist in reproductive endocrinology and infertility at the Reproductive Science Center of New Jersey. Welcome to the show, Dr. Martinez. What is known about the effects of Zika virus on pregnant women? Let's start there.

Dr. Alan Martinez (Guest): Well, thank you for having me on the show today. I very much appreciate it. So, the Zika virus, as everyone knows very well by now, is affiliated with birth defects in the developing child should you get infected when you are pregnant. So, this includes changes in brain development as well as small development of the head, something known as microcephaly and it's also associated with miscarriage and stillbirth.

Melanie: So, what about the women and what's known about the effects of Zika on fertility? So, if a woman is thinking about getting pregnant, or she's of childbearing age, why should she be concerned about Zika?

Dr. Martinez: Well, that's a very good question. Zika, according to ACOG and the Center for Disease Control, there are strict precautions for both men and women as far as their sexual activity, as far as their birth planning, should they come in contact with people that have Zika virus, should they be infected, or even if they travel to areas that are known for having Zika virus outbreaks. So, it becomes very important for their reproductive planning in order to determine if it's a good time for them to get pregnant or not.

Melanie: So, if they are thinking about reproductive planning, what should they know about Zika and its transmission? Because you said if they've been around somebody with Zika or if one of the partners has been somewhere--how is it transmitted?

Dr. Martinez: So, it is transmitted sexually as well as being exposed to people that have an acute virus. So, it's a flu-like virus that is kind of affiliated with feverish chills, muscle aches, red eyes, irritated eyes, and those are some of the symptoms. So, anybody that has those kind of symptoms that may have traveled to some of these Zika infested areas, and that includes many places in the Caribbean, certain places in Asia, as well as Mexico and Central America, as well as South America, in those cases where you travel or you're exposed to people from those areas with those symptoms, then it's recommended that you consult with your physician to determine whether you may be at risk for having the Zika virus.

Melanie: How would you counsel, Dr. Martinez, a couple that comes in if maybe just the spouse, the man, has been to one of these countries for Zika, that has Zika virus, and they come to you for fertility treatments, what do you tell them?

Dr. Martinez: So, I have had that situation and we've become very adept at discussing this. So, men who travel, and this is a very common thing with professions and traveling around the world these days, and they went to a Zika infested area, even without symptoms, currently the CDC recommends that we advise patients to wait at least eight weeks after any possible exposure--that means during their time of travel--before trying to attempt to get pregnant with their partner.

Melanie: So, when they say to you then, "Eight weeks? We'd like to start right now," is there anything they can do prophylactically to help find out if they do have Zika, is there a test so that you would know? Or, is there anything they can do in the meantime?

Dr. Martinez: Yes, there is currently a test for the Zika virus and we do have some patients that request that and we've provided that to them. For your local areas, you consult with your healthcare provider and then we direct you to areas where you can get testing for that. So, it's a blood test, and it tells you whether you have exposure. Now, if a person, even if they test negative with it, you could be in the time period where with more recent exposure to infection where you may not have blood evidence of carrying the virus, so we still recommend that you know, couples, once they're counseled and they understand that, hey, we cannot remove all of the risks should you elect to proceed with fertility treatments. However, you know, the recommendation, technically, is to wait at least eight weeks before trying to conceive.

Melanie: And, while the risk of Zika for pregnant women and microcephaly for the baby, what about infertility? Do you have any information on whether or not it can affect your ability to get pregnant?

Dr. Martinez: No. At this time, there is no evidence that fertility, per se, is affected by the Zika virus. It is rather, as you alluded to, is more with the effects of getting pregnant in the early stages of having the Zika virus, when you're at risk for you know, damage to the developing baby. So, currently, as of now, there's no evidence that says, okay, infertility is more prevalent in these patients. However, the repercussions of getting pregnant with the knowledge that you may be infected, that becomes an ethical issue and that's why we have to counsel patients accordingly.

Melanie: If you're counseling a patient and you've helped them with fertility and they are pregnant and something happens, do you test for Zika now? I mean, if before the virus out, if somebody was pregnant and went to one of these countries before we knew as much as we do now, is there any connection there? Would you test now? Would they even know?

Dr. Martinez: Well, and that's a very good question. In the case of our patient may convey to you that they had some recent travel right before, you know a month or two before their infertility treatments and them getting pregnant, then we can definitely have the testing done on them to see if they are, indeed, carriers. And if they have shown that they have been affected, then it becomes an issue of watching the pregnancy very closely to make sure through ultrasounds that the baby is developing appropriately. But, you know, currently, anybody that has potential exposure, there's a series of questions that we use for them, and then we gauge if they're at risk for potentially being exposed, and then, if that's the case, then we recommend the testing for them.

Melanie: And if you do know that a couple has been to one of the infected areas, do you give them advice on how to protect themselves from Zika?

Dr. Martinez: Yes. Currently, either to abstain from sexual intercourse, either for the men or the women when the have potential exposure. Also, we encourage barrier protection if they are to have intercourse. They are to use barrier protection such as condoms to decrease the chances of passing the virus on. But, anybody, both the man and the woman, if you've traveled to any areas, or if you've been exposed to anybody with the Zika virus, or you've had intercourse, whether it be vaginal, anal, or oral sex with anyone who has traveled to an area, it's recommended that you use barrier protection and that you potentially get tested, even in light of being asymptomatic.

Melanie: So, in just the last few minutes, kind of wrap it up, your best advice about all the information that comes about Zika and fertility and pregnant women.

Dr. Martinez: Well, so the best thing to do is to be honest with your providers about areas of the world that you've traveled in, specifically the Zika-predominant areas, that is, and if you've had any sort of contact via sexually with any individual who may have traveled to those areas or potentially could be exposed, you need to, you know, provide that information to your provider so they can best counsel you. And, if we have patients that are honest with us, then we have appropriate means of testing and then we can make good recommendations based upon that.

Melanie: Thank you so much, Dr. Martinez. It's really important information. Thank you for being with us today. You're listening to Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. For more information, you can go to www.fertilitynj.com. That's www.fertilitynj.com. This is Melanie Cole. Thanks so much for listening.