TTC and COVID-19? 

During these times of great uncertainty, the Canadian Fertility & Andrology Society (CFAS) has recommended that all fertility clinics greatly reduce in-person interactions to help prevent the spread of COVID-19 and to practice social distancing. This means:

  1. Conducting consultations by telemedicine or phone
  2. Completing current IVF cycles but utilizing freeze-all only 
  3. Suspending all diagnostic and elective procedures and surgeries 
  4. Postponing any new cycle starts (IUI, IVF, FET), aside from urgent cryopreservation for oncology

So what does that mean for you? At this time, it is not recommended to actively try to conceive during a pandemic. If you are currently undergoing treatment at a fertility clinic in Toronto, they have suspended all new cycles until further notice and closed their clinic doors. If you have frozen embryos, they are also not doing any transfer until further notice. This news is heartbreaking for anyone who was actively trying or whose cycles have been postponed or cancelled. 

Preconception Fertility Care

I am always one to try and look on the bright side of every situation. This delay in fertility treatment for many is a great opportunity to focus on your preconception care: eating an optimal fertility diet, improving egg and sperm-quality, engaging in healthy behaviours and preparing your body for pregnancy. As it takes approximately 90 days for both eggs and sperm to fully mature, we can use these next few months to focus on your best fertility health. If you are already under the care of a fertility clinic, I work closely with your fertility team to ensure our treatments work together in a safe and synergistic manner. 

As many of you will want to resume treatment as soon as possible, take this time to prepare your body, physically and mentally, for the next steps on your fertility journey. As I have also suspended all in-person appointments until further notice, virtual naturopathic consultations are available to all persons located in Ontario. 

What if you are already pregnant?

A small study in China examined the amniotic fluid, cord blood, baby’s throat swab, and breast milk of 9 pregnant women who had tested positive for COVID-19 in their third trimester. They found no evidence to suggest the virus was able to transmit to the baby through the uterus. It also did not appear to have an adverse effect on the newborns such as fever or respiratory distress. At this time, there does not appear to be the vertical transmission of COVID-19 from mother to baby, but it cannot be entirely ruled out. N.B. all mothers gave birth via a c-section in this study. Until we know more about COVID-19, transmission from mother to fetus/infant via the placenta, breastmilk, or during birth is still a possibility.

 

What we do know is that that pregnant women are not at a higher risk of infection than nonpregnant individuals. (Good news!) In the first trimester, the risk of developing fever due to COVID-19 carries the same risk as other infections. For example, a high fever during the first trimester of pregnancy, regardless of the origin, does carry a small risk of increased birth defects. In the third trimester, there is limited data to show that COVID-19 may cause preterm delivery between 30-33 weeks in some individuals. It is important to practice good hand hygiene, physical and social distancing and restrict unnecessary travel during this time. 

References

CFAS Communication on COVID-19 

Chen, Huijun, et al. “Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.” The Lancet 395.10226 (2020): 809-815.

Panahi, Latif, Marzieh Amiri, and Somaye Pouy. “Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review.” Archives of Academic Emergency Medicine 8.1 (2020).