Covid-19 vaccine, fertility and pregnancy
9 February 2021Several people, both online and offline, have expressed concerns about the possible impact of COVID-19 vaccine on fertility and pregnancy. In this article, we go back to evidence-based sources of information, to reassure you and empower you in your journey to baby.
Does the COVID-19 vaccine affect fertility?
The Royal College Obstetricians Gynaecologists (RCOG) and the Royal College of Midwives (RCM) have issued a response to these concerns. Dr Edward Morris, President at the RCOG, said: “We want to reassure women that there is no evidence to suggest that Covid-19 vaccines will affect fertility. Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data.”
At the moment, vaccination is being offered to the most vulnerable people in society. For women and men of reproductive age, they will be offered the vaccine if:
- they are health and social care workers at risk of catching COVID-19, or
- they have serious medical conditions who have a greater risk of severe illness from COVID-19. These include:
- organ transplant
- currently undergoing cancer treatment
- bone marrow or stem cell transplant in the last 6 months
- significant lung condition, e.g. cystic fibrosis or severe asthma
- conditions that significantly increase the risk of infection (like severe combined immunodeficiency or homozygous sickle cell disease)
- currently taking medication to suppress your immune system
- conditions affecting the spleen, like having it removed
- Down’s syndrome
- Significant kidney conditions and/or on dialysis
- Significant heart conditions
RCM Chief Executive Gill Walton said: “If you are eligible for and have been offered a Covid-19 vaccine, the decision whether to have the vaccination is your choice. You can either have the vaccine or wait for more information about the vaccine. Women who are eligible for the vaccination should consider discussing any concerns they have with their midwife or healthcare professional.”
There is a factsheet with this information available here: https://www.rcog.org.uk/globalassets/documents/guidelines/2021-01-12-covid-19-vaccine-info-sheet.pdf
If you have been trying to conceive, and are offered the vaccine, the NHS highlights that you do not need to avoid pregnancy after vaccination. The vaccine cannot give you or your baby COVID-19.
Does the COVID-19 vaccine affect fertility treatment?
If you are in the process of undergoing fertility treatment, ESHRE has issued a statement, saying that “it seems prudent to postpone the start of assisted reproduction treatments (sperm collection, ovarian stimulation, embryo transfer) for at least a few days after the completion of vaccination (i.e. after the second dose) to allow time for the immune response to settle. In the absence of information on the effect of the COVID-19 vaccine on oocytes and sperm, embryo implantation and early stages of pregnancy, and to allow time for antibody development, a more cautious approach could be considered (i.e. postpone the start of ART treatment for up to 2 months).”
Does the COVID-19 vaccine affect pregnancy?
Government guidance about the COVID-19 vaccine for women who are pregnant states that “the vaccines have not yet been tested in pregnancy, so until more information is available, those who are pregnant should not routinely have this vaccine. Non-clinical evidence is required before any clinical studies in pregnancy can start, and before that, it is usual to not recommend routine vaccination during pregnancy.”
Despite this recommendation, it is worth noting that information available so far about the Pfizer BioNTech vaccine, reviewed by the Medicines and Healthcare products Regulatory Agency (MHRA) by World Health Organisation and the regulatory bodies in the USA, Canada and Europe and has raised no concerns about safety in pregnancy. Non-clinical studies of the Astra-Zeneca COVID-19 vaccine have raised no concerns.
For these reasons, and because studies have shown that pregnant patients with COVID-19 are at a greater risk of more severe illness than their non-pregnant women, the Joint Committee on Vaccination and Immunisation (JCVI) has recognised the potential benefits of vaccination are particularly important for some pregnant women. So, you may be able to get the vaccine if you're pregnant and are at high risk of getting coronavirus because of where you work, or have a health condition that means you're at high risk of serious complications of coronavirus.
The bottom line is…
- COVID-19 vaccine does not affect fertility. If you are offered the vaccine, because you are at high risk of catching the virus or at high risk of developing severe disease, you should take it.
- If you are planning on having fertility treatment, and are offered the vaccine, delay fertility treatment for at least a few days after the completion of vaccination
- If you have already started fertility treatment, and are offered the vaccine, speak with your medical team
- If you are already pregnant you should not be vaccinated unless you are at high risk
- if you have had the first dose and then become pregnant you should delay the second dose until after the pregnancy is over (unless you are at high risk)
References
[2] https://www.rcog.org.uk/globalassets/documents/guidelines/2021-01-12-covid-19-vaccine-info-sheet.pdf
[4] https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/
[5] https://www.eshre.eu/Europe/Position-statements/COVID19/vaccination
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