Covid Vaccine Pregnancy and Fertility

Dr. Alan Martinez discusses the correlation between the COVID 19 vaccine and pregnancy and fertility.
Covid Vaccine Pregnancy and Fertility
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.
Transcription:
Covid Vaccine Pregnancy and Fertility

The Reproductive Science Center of New Jersey is a leading provider of advanced reproductive technologies, sharing its knowledge with you. It's time for Fertility talk with RSCNJ. Here's Melanie Cole.

Melanie: Welcome to Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole. And today, we're discussing the coronavirus, vaccine, pregnancy, and fertility. Joining me is Dr. Alan Martinez. He's a specialist in reproductive endocrinology and infertility at the Reproductive Science Center of New Jersey.

Dr. Martinez, it's a pleasure as always. Let's jump in and tell us what we know about the COVID vaccine and pregnant women or parents to be.

Dr. Alan Martinez: Thank you for having me today, Melanie. I appreciate it. So yes, COVID vaccines have become available over the last couple months. The main ones being Pfizer and Moderna and there's another one that is in the works and coming through. They are both mRNA vaccines and, overall, they are currently being recommended by the major societies, Society for Maternal-Fetal Medicine, as well as American College of Obstetricians and Gynecologists, and our kind of overseeing body, American Society of Reproductive Medicine. As patients who are undergoing fertility treatments, male or female in getting or planning to get pregnant or who are pregnant, they are currently recommended by these major societies.

Melanie: Okay. So let's dig into that just a little bit. For women that are pregnant at this time, it's recommended that they do get the vaccine. What do you tell them if they ask you? They say, "I had a lot of trouble getting pregnant. I'm really scared about what this could possibly do or any interactions." What do you tell them?

Dr. Alan Martinez: So I educate them and tell them that, what I had mentioned before, which is the type of vaccine, that these are mRNA vaccines. And I let them know that the possibility of getting COVID-19 causes more harm in pregnant women. You know, they're more likely to end up in the intensive care unit. They're more likely to be ventilated than those patients who are not pregnant. And they're more likely to have a higher level of mortality compared to patients of the same age as far as the vaccine itself.

Although the major studies that were done and these vaccines were pushed through under the emergency use authorization, there were a large amount of patients who were tested for side effects and safety of the vaccine. But overall, these did not include pregnant women. And so, although the type of vaccine is thought to pose minimal risk to the female or pregnant patient, there is the lack of absolute evidence at this time. And so it becomes a shared decision-making process.

Melanie: And what a good way to put it, Dr. Martinez. So tell us a little bit about access to the vaccine. Are pregnant women considered higher priority or higher risk? As you mentioned for COVID, the complications can be disastrous. So where are they in the vaccine line if there's somebody that's eager to get this?

Dr. Alan Martinez: So for patients who desire to get the vaccine, many states have the online systems that are set up where you complete a series of questions and, based upon those answers, your workplace environment, whether you are pregnant or not, your age, any comorbid conditions, that's all taken into consideration.

And pregnancy is one of them that is on that list. So therefore, it is up to each individual state as to how they are actually contacting patients and giving preference, but it is on there as a consideration. And so patients should state that they're pregnant and they should give all the information to the best of their ability so that they can potentially have access to the vaccine sooner than later.

Melanie: And do we know about nursing mothers? I know once the baby is born, we're mainly talking pregnancy and fertility, but what about nursing mothers? What do we know about that?

Dr. Alan Martinez: So nursing mothers, it is thought that it should be safe to have the vaccine when you are nursing. The type of vaccine and the response that it makes the immune response, these things do not cross the placental barrier. And so they pose essentially no risk to the offspring. And so it's thought that, lactating mothers can also be candidates for the vaccination.

Melanie: So while we're talking about pregnancy and obviously fertility, along the coronavirus lines, can it be transmitted through IVF or to or from embryos?

Dr. Alan Martinez: So the patient who is exposed to COVID and demonstrates an active infection, they're showing antigen response. And any patients that are currently infected, it's recommended that are not to continue fertility treatments. Not because of risk to the offspring or the embryos, but primarily because of risk to those healthcare providers and everyone they come in contact with during their medical care.

So currently in the United States and throughout the world, if you convert to a positive status in the middle, or just as you're trying to become pregnant, the care is halted. And then it is resumed at a later time when you're not infectious.

However, they've shown that even mothers that deliver who are positive COVID patients at time of delivery, that they're offspring may show some initial levels of the virus in the system, but usually that's cleared, I believe, within about seven to 14 days. And so there's thought to be no long-term effects and the same should be held with the embryo quality and any health of that resultant pregnancy from that embryo.

Melanie: This has been really important information. Dr. Martinez, as we wrap up, please reiterate the safety and efficacy of the COVID vaccine for pregnant women or people going through fertility treatments. What would you really like the take-home message to be?

Dr. Alan Martinez: Yes. So COVID-19, as we all know poses increased likely risk to pregnancy patients. The vaccine is not a live virus. It does not contain any ingredients that are known to be harmful to pregnant patients or to the fetus itself. And many other vaccines are given safely in pregnancy, the flu vaccine, tetanus, diptheria. So this should fall into the same category.

Yes, it was rushed as an emergency use authorization medicine during the pandemic. But the vaccine and the potential risks, which are minimal, other than some small side effects of pain at the injection site, fatigues, headaches, and muscle pain, sometimes fevers, chills, joint pains, those are temporary. And your ability to get the vaccine to have an amount of immune response so that you're no longer infectious, that increases your overall chances of remaining healthy as well as those you come in contact with.

However, even with the vaccine, I always tell the patients that you still need to practice the appropriate mitigation strategies. Wear your mask, social distance greater than six feet and wash your hands and practice good overall hygiene.

And lastly, any concerns, questions, you need to talk to your healthcare provider whether it's a reproductive endocrinologist, your general medical doctors, and it's important to educate yourself and to ask the questions so that you can determine if you're at a higher risk of getting COVID, it probably makes sense to get the vaccine.

If you are concerned about the unknowns of the vaccine and you are a patient that poses very little risk, meaning you don't interact with others, you don't work outside of your home, you're being ultra-cautious, then potentially, you know, if you feel strongly, you may wait to receive the vaccine until a later time.

However, the major societies, American Society of Reproductive Medicine, ACOG, Maternal-Fetal Medicine, all of these societies say that it is safe to get the vaccine in pregnancy and the healthcare providers do promote that general recommendation.

Melanie: And that would certainly be the main message and you made it so well, Dr. Martinez. Thank you so much. And it's encouraging to hear that all these organizations and experts such as yourself are giving this the approval of safety for pregnant women. So thank you so much for joining us and really clearing that up for us today.

That concludes this episode of Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. For more information, please visit fertilitynj.com to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other Reproductive Science Center of New Jersey podcasts. I'm Melanie Cole.