A Balanced Approach to Fertility Technologies

• Both the Pfizer and Moderna vaccines are mRNA (messenger RNA) vaccines that DO NOT CONTAIN LIVE VIRUS. Since the vaccines are not live, there is no reason to delay pregnancy attempts or defer fertility treatment until the second dose has been administered. The vaccines are not thought to cause an increased risk of infertility, first or second-trimester loss, stillbirth, or congenital anomalies. The vaccines have not yet been studied in the pregnant population, so large scale data is not available at this time.

• The mRNA instructs the body's own cells to replicate the coronavirus's spike protein. The body recognizes this protein as foreign and generates protective antibodies.

• Mask wearing, hygiene, and social distancing should remain firmly in place at this time, as it is not known whether a vaccinated individual can spread the virus if they become infected.

• ASRM, ACOG, and SFMFM do not recommend withholding the vaccine from patients who are TTC, pregnant, or lactating. Recent studies demonstrate that pregnancy is a risk factor for severe COVID-19 disease. Comorbidities such as obesity, hypertension, cancer, diabetes, age, etc may increase this risk further.

• Vaccine may cause fever (up to 16% of those vaccinated). Fever in pregnancy has been associated with the risk of neural tube defects, however, this risk is mitigated if the patient is taking >400 mcg folic acid daily. Also, COVID-19 infection itself causes fever in 83-99% of patients. Surgical procedures may be delayed or canceled if patients develop fever or other symptoms after the COVID-19 vaccine or infection. It would be best to avoid vaccination just prior to retrieval or transfer.

• Decision on whether or not to receive the vaccine should be made WITH the patient and on an individual basis, based on risk vs benefit. The risk for a front line healthcare worker with frequent exposure is different than the risk for someone who is working from home!