INFORMATION ON COVID VACCINATION ON FERTILITY TREATMENT, PREGNANCY AND BREAST FEEDING
VACCINE ADMINISTRATION AND DAY OF MENSTRUAL PERIODS
There is no physiological, endocrine or immunological basis for such a consideration. Women should receive the vaccine on any day of the menstrual cycle, even during menstruation.
VACCINE ADMINISTRATION IN THE PRECONCEPTION PERIOD (BEFORE CONCIEVING) OR FOR
WOMEN UNDERGOING FERTILITY TREATMENT INCLUDING ASSISTED REPRODUCTION (IVF / ICSI / IUI/ OI / FET)
Women should take the vaccine at any point of time before a pregnancy is confirmed as and when they have an opportunity to do so. There is no basis for deferring pregnancy or treatments for taking the vaccine. There is no evidence that vaccine administration affects fertility or miscarriage rates.
PREGNANCY TESTING BEFORE ADMINISTERING THE VACCINE
This is not necessary and creates a hurdle to vaccine acceptance. It is not
recommended to test for pregnancy before vaccination.
VACCINE ADMINISTERED INADVERTENTLY TO A PREGNANT WOMAN IN EARLY PREGNANCY
The vaccine does not have any known teratogenic effects as per available evidences. Women who are vaccinated in this manner should not be advised to terminate the pregnancy.
They should be counseled that the risk of congenital anomalies does not
rise above the baseline risk. However, at the present time, it would be prudent to defer vaccination in the first trimester as there is no substantial available data to establish absence of teratogenicity.
VACCINES FOR A PREGNANT WOMAN ALREADY INFECTED IN THE PAST
A pregnant woman faces greater risks in pregnancy if she is infected with COVID-19 as compared to a pregnant woman who is not infected or a non-pregnant woman who is infected. Therefore, vaccination is advisable even if there has been a past infection. As for the general population, vaccination should be deferred for 12 weeks from the infection or 4 to 8 weeks from recovery.
VACCINE FOR A PREGNANT WOMAN WITH CO-MORBIDITIES (pre-existing or developed in pregnancy)
These co-morbidities do not represent contraindications to the COVID vaccine and in fact, these women will be served maximally from the protective effect. Women with such conditions should consult with their obstetrician or care provider and seek their advice on this.
VACCINE FOR A BREASTFEEDING WOMAN
There is no evidence of harm from any harm if a vaccine is administered to a
breastfeeding woman. In fact, there is possible benefit from the passage of antibodies to the neonate. Breastfeeding women should be vaccinated as per the usual method and schedule of the general population.
WHEN NOT TO TAKE COVID VACCINATION (CONTRAINDICATIONS TO VACCINATION):
As for the general population, pregnant and lactating women should avoid
vaccination in the following conditions:
- Anaphylactic or allergic reaction to a previous dose of COVID-19 vaccine
- Immediate or delayed-onset anaphylaxis or allergic reaction to vaccines or injectable therapies, pharmaceutical products, food-items etc.
Temporarily contraindications in the following conditions:
- Diagnosed COVID-19 infection – defer for 12 weeks from infection or 4 to 8 weeks from recovery.
- Active symptoms of COVID-19 infection.
- COVID-19 infection treated with anti-COVID-19 monoclonal antibodies or convalescent plasma.
- Acutely unwell and hospitalized (with or without intensive care) patients due to any illness.
CAN ANY OF THE COVID-19 VACCINES AFFECT FERTILITY?
No.There is absolutely no evidence, and no theoretical reason, that any of the vaccines can affect thefertility of women or men.
SHOULD PEOPLE OF REPRODUCTIVE AGE RECEIVE A COVID-19 VACCINE?
People of reproductive age are advised to have the vaccine when they receive their invitation forvaccination. This includes those who are trying to have a baby as well as those who are thinking abouthaving a baby, whether that is in the near future or in a few years’ time.
CAN I HAVE A COVID-19 VACCINE DURING MY FERTILITY TREATMENT (IVF, FROZEN EMBRYO TRANSFER, EGG FREEZING, OVULATION INDUCTION, INTRA-UTERINE INSEMINATION, USING DONATED GAMETES OR NOT)?
You may wish to consider the timing of having a Covid-19 vaccine during your fertility treatment,taking into account that some people may get bothersome side effects in the few days aftervaccination that they do not want to have during treatment. These include for example, tenderness atthe injection site, fever, headache, muscle ache or feeling tired.
It may be sensible to separate the dateof vaccination by a few days from some treatment procedures (for example, egg collection in IVF), sothat any symptoms, such as fever, might be attributed correctly to the vaccine or the treatmentprocedure. Your medical team will be able to advise you about the best time for your situation.
SHOULD I DELAY MY FERTILITY TREATMENT UNTIL AFTER I HAVE HAD THE COVID-19 VACCINE?
The only reason to consider delaying fertility treatment until after you have been vaccinatedwould be if you wanted to be protected against Covid-19 before you were pregnant.
The chanceof successful treatment is unlikely to be affected by a short delay, for example of up to 6months, particularly if you are 37 years of age or younger. However, delays of several monthsmay affect your chance of success once you are over 37 and especially if you are 40 years of ageor older.
HOW SOON AFTER HAVING A COVID-19 VACCINE CAN I START MY FERTILITY TREATMENT?
Immediately – you do not need to delay your fertility treatment, unless you wish to have yoursecond dose before pregnancy (see above).
I HAD A POSITIVE PREGNANCY TEST TODAY. CAN I STILL HAVE A COVID-19 VACCINE?
If you are in a risk category for Covid-19, either because of the potential for exposure at work ormedical issues, you can still have the vaccine in pregnancy. If you have no increased risks forCovid-19, the Joint Committee on Vaccination & Immunisation (JCVI) have advised that youdelay it until after pregnancy.
There is no reason to believe that any of the Covid-19 vaccineswould be harmful, but their effects in pregnancy have not yet been fully investigated. The
information that is known is reassuring. None of the vaccines contain live virus and so there isno risk that the pregnant woman or her baby could get Covid-19 from the vaccine.
I AM DONATING MY EGGS/SPERM FOR THE USE OF OTHERS. CAN I STILL HAVE A COVID-19 VACCINE?
Covid-19 vaccines do not contain any virus and so you cannot pass on Covid-19 by receiving thevaccine. The HFEA have stated that you must allow atleast 7 days from the most recent vaccination prior to donating eggs or sperm. If the donor feelsunwell after the vaccination, they must not donate for 7 days after their symptoms have gotbetter
I HAVE HAD RECURRENT MISCARRIAGES AND AM NOW TRYING TO GET PREGNANT AGAIN. SHOULD I POSTPONE HAVING A COVID-19 VACCINE?
There is no reason to postpone having your Covid-19 vaccine as it will not affect your risk ofhaving a miscarriage.
INTERNATIONAL RECOMMENDATIONS OF COVID VACCINATION IN PREGNANCY
International professional bodies have taken a uniformly positive stand on the COVIDvaccine in pregnancy and lactation. These statements are based on the ratio ofpotential benefits and risks of the vaccine versus the disease in a given geographicarea. At present, it is believed that the risk of getting COVID-19 in pregnancy and itsresulting morbidity is much more than the theoretical risks from the vaccine.
Though some countries have a risk based approach to immunization, Federation of International Gynaecologists &Obstetriciansbelievesthat such an approach might actually be of disadvantage to the pregnant woman.
The Royal College of Gynaecologists, London,taking the advisory from the Joint Committee on Vaccination andImmunization (JCVI) has stated that pregnant women should be offered the vaccinewith the same criteria as the general population.
The American College Of Gynaecologistsstates thatpregnancytesting should not be mandated before vaccine administration andneither should it be deferred for women who are in the preconceptional period.
These bodies have emphasized the lack of data of vaccine use in pregnancy. They
empower women to make an informed choice in this matter. They do notdistinguish between the types of vaccine in pregnancy but advise that the
vaccination be completed with the same type of vaccine taken first.
International bodies such as the FIGO, ACOG, RCOG and SOGC mention the need forfollow up of women who are vaccinated during pregnancy and lactation and to publishand disseminate such information.
NOTE: SOURCEOF INFORMATION IS FROM British Fertility Society, Federation Obstetric & Gynaecological Societies of India, Royal College of Obstetricians & Gynaecologists, London&American College of Obstetricians & Gynaecologists.