How Long Should Women Wait to Do IVF After Zika Exposure?
JUL 15, 2016 | CONTAGION EDITORIAL STAFF
Abdulla Al-Khan, MD, director of the Division of Maternal-Fetal Medicine and Surgery at Hackensack University Medical Center, discusses how long after exposure to Zika that a woman should wait before undergoing IVF therapy.
Interview Transcript (slightly modified for readability)
“[For] mothers who desire to undergo [In Vitro Fertilization (IVF)] therapy, [who know] of this ‘Zika crisis,’ it is important for to be a little cautious.
I would like to quote Dick Cheney’s [statement regarding] the ‘knowns and unknowns’. There [are] a lot of [things] we don’t know about Zika in terms of its infectivity, at what point in the pregnancy, whether it’s during the period of organogenesis, or later on, does this [virus] have serious fetal implications. Having said that, I think individuals have to look at this simplistically. Meaning: ‘Ma’am would you like to take the risk of having a baby affected by the Zika virus? [A baby who will have] significant neurologic insult?’ I’m sure the answer [will] be ‘No, I want to go through IVF [but] I want to have a healthy child’.
Until we [better] understand the [implications of a] Zika [infection] in mothers who are pregnant, I would [recommend avoiding] flying to areas where there is a [Zika] epidemic.
Until [we better understand Zika], use the universal precautions that we [as healthcare providers, have recommended, in order to avoid infection]. If you really have to go through [a Zika-endemic] area because, [for example], there’s a family emergency, then use [these] universal precautions.
The good news is [that] not all mothers who get bit by the mosquito are going to [have] a Zika-infected fetus. The [reported number of those fetuses who become infected with Zika] has been rather broad. [Researchers have reported that this number is] less than 0.05%, some [have reported that] it’s about 0.1% or 1%, and of course the latest* data [has reported that the numbers] could be as high as 13%, which I really doubt. I think [these low numbers are] a blessing. But those are all statistical numbers, meaning, someone is going to be that 0.1% or 0.05%.
[Using good] judgement [to make the] call [on traveling to a Zika-endemic area] is crucial, especially [for women] who are in the reproductive age-group or want to undergo IVF therapy or who are pregnant. If you can avoid a region which has a high prevalence of Zika, then I think you should.
[In regards to the woman who wanted to undergo IVF therapy after returning from a trip to a Zika-endemic area], until we know [more about Zika], if her physician told her [to wait] two months [after her return], as per her fertility specialist, I think that’s a reasonable period of time. It’s either two months or [the patient is] stuck with the long-term implication of a [baby] with severe neurologic insult. It may sound crude, but I think two months is nothing, and I think waiting two months is not going to make much of a difference in terms of your IVF process. It’s not that we’re going to physiologically change within two months. I think waiting for two months before [proceeding with IVF therapy is a reasonable thing to do]."
*at the time of the interview
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