ZIKA VIRUS: Trying to conceive

If you are trying to get pregnant.

If you are trying to conceive, you may have heard some of the recent press coverage concerning the Zika virus which has been possibly linked to a certain neurological birth defect in babies known as microcephaly (an abnormally small head and brain).

Couples who are trying to get pregnant need to exercise caution in order to minimize the risk of infection.

Most importantly, Do Not Travel to Areas Where Zika is Present

This applies to both males and females as there has been evidence that Zika is sexually transmissible from men to women. According to the latest information provided by the CDC, the Zika virus can be active in semen for up to two weeks after infection, although it is possible that it persist past that time period.   It is unknown if the Zika virus can be sexually transmitted from a woman to a man.

The virus remains in the blood of the infected person for only about a week to ten days.  You should abstain from sexual activity during the transmissible period, or at the very least, use condoms during any form of sexual activity.  Researchers believe that if a baby is conceived after the virus is cleared from the blood, the baby is not at risk for birth defects.

There are no concrete recommendations for couples who are attempting to conceive.  However, it is safe to assume that if a man is infected that the virus will be present in the semen for at least two weeks if not longer.  We also have no data to suggest that performing intrauterine inseminations (IUI) can prevent the spread of Zika.  Therefore, the safest course of action is to stop attempting to conceive for a couple of months after symptoms appear, by either abstaining from sexual contact or using a condom.

There are tests to detect Zika virus, but they are not commercially available.  The tests can be used to establish the diagnosis of infection in the blood.  Although they can also be used to detect the Zika virus in the semen, we have a limited understanding of how to interpret the results of the tests, so testing of semen is not recommended. Testing of the Zika virus is solely used to establish infection, not to determine the risk of sexual transmission. The American College of Obstetrics and Gynecology (ACOG) recommends that if a pregnant patient becomes clinically ill within 2 weeks of travelling to affected country then testing should be performed, but testing is not recommended if symptoms do not occur within 2 weeks of travel.

If you are concerned you have symptoms of the Zika virus you should speak to a healthcare provider, especially if you are pregnant.  Our knowledge of Zika is constantly evolving.  If you want the most up to date information about the Zika virus or to find out where the Zika virus is prevalent please check out the CDC website http://www.cdc.gov/zika/index.html.

New UPDATE 4/12/2016

American Society for Reproductive Medicine Issues Guidance Document on Zika Virus

Washington DC – The American Society for Reproductive Medicine (ASRM) today issued a new document “Guidance for Providers Caring for Women and Men of Reproductive Age with Possible Zika Virus Exposure.”  The report is intended to help physicians and other health care providers who are treating and counseling patients concerned about Zika’s impact on reproduction.

Among the key points of the report:

• Women who have Zika disease symptoms should wait at least 8 weeks after symptoms appear, and men should wait 6 months, before attempting reproduction.
• Men and women with possible exposure to, but not showing symptoms of, Zika should also wait 8 weeks. (this includes travel to countries where Zika is prevalent)
  
• These same timelines should be used for sexually intimate couples using their own gametes in fertility treatments.
• For donated reproductive tissue, FDA guidance should be followed. Currently, FDA rules a potential donor ineligible for 6 months following being diagnosed with, or having had a high probability of exposure to, the virus.
• Testing for Zika virus is complicated, not universally available and routine serologic testing is not currently recommended.
• In areas of active Zika virus transmission, the use of contraceptive methods to prevent unintended pregnancy is essential.
• Physicians should counsel and educate their patients on Zika and update their informed consent procedures to reflect that counseling.

Bottom Line:  You need to talk with your physician if you have traveled to a ZIKA country or have plans to travel to a ZIKA country.