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
To stay informed on the latest in infectious disease news and developments, please sign upfor our weekly newsletter.
Contagion® is a fully integrated news resource covering all areas of infectious disease. Through our website, quarterly journal, email newsletters, social media outlets, and Outbreak Monitor we provide practitioners and specialists with disease-specific information designed to improve patient outcomes and assist with the identification, diagnosis, treatment, and prevention of infectious diseases. Our mission is to assure that the healthcare community and public have the knowledge to make more informed choices and have a positive impact on patient outcomes.
2 Clarke Drive
Cranbury, NJ 08512