Dr César Díaz García is the medical director of IVI Clinic London. Here, he answers questions about pregnancy, childbirth, fertility treatment and breastfeeding amid the coronavirus (COVID-19) pandemic.
UPDATE: This article was first published on 13 March – and on 16 March, the government updated its advice for pregnant women. You can read more about it here.
I’m 12 weeks pregnant – should pregnant women be particularly worried about coronavirus?
At the moment, it has not been scientifically proven that pregnant women are more susceptible to infection from coronavirus, so it is recommended to follow the same steps to prevent infection as those defined for the rest of the population. Although the number of cases of pregnancies and coronavirus infections reported so far is still very limited, there is currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19. When it comes to the mother, most of the cases will experience only mild or moderate cold/flu like symptoms. More severe symptoms can also occur, but the frequency is the same as in the non-pregnant population.
I have recently undergone a failed round of IVF but was planning to have a frozen embryo transfer in April or May – should I postpone that? I don’t want to have to cancel halfway through the cycle when the country is on lockdown.
It is very difficult to predict if there is going to be a complete lockdown or when it is going to happen. Having said that, and given how stressful a fertility treatment can be, starting a process that could be potentially cancelled at any point is probably not a good idea. Postponing the embryo transfer have no detrimental effect on the embryo and will help you to bypass these difficult moments.
I am trying to conceive and having regular sex with my boyfriend – should we stop? Would it be a bad idea to get pregnant in the next two or three months?
Carrying a pregnancy could add some stress to a situation like the one we are already living, in which the uncertainty about many daily live aspects is patent. Postponing the pregnancy is a very personal decision and there is no black or white, but from a strictly medical point of view, most of the infected women will experience only mild or moderate symptoms. In fact, there will even be asymptomatic pregnant women. The probability of having more serious complications are the same as in the rest of the population. There is no data available to suggest any effect on the foetus either.
I’m about to give birth – do I need to change to my birth plan?
In women with no symptoms and no suspicion of being infected with coronavirus, there is no need to change the birth plan. For those with symptoms, confirmed or not, the Royal College of Obstetricians and Gynaecologists (RCOG) has developed a guideline in which recommendations will be given based on the different scenarios. The most reasonable thing to do is to discuss with your health professional the potentially increased risk of foetal compromise if the infection is present, and individualise the approach based on the clinical situation. Depending on these factors, you’ll be advised to attend a midwifery-led or obstetric unit for birth.
Is it safe to breastfeed my new-born? What if I develop symptoms?
For the time being, the evidence available suggests that the coronavirus is not present in human milk, although there are risks of transmitting the disease mother to infant due to the close contact. There are some precautions that could minimise the risk of transmission, such as hand washing before touching the baby, wearing a face-mask for feeding at the breast or if using a pump, properly clean it. In any case, it is important that you discuss with your midwife/obstetricians the risks and benefits of breastfeeding in more detail, but in general, according to the available evidence, we could say that the benefits of breastfeeding prevail over the risks.
I’ve been trying to conceive for 12 months and was just about to seek professional help and start the process of getting tests for me and my partner. Is now a bad time to pursue non-urgent medical treatment?
Given the actual situation, doing the initial consultations and investigations will not entrain any danger for your health. By doing this, you’ll buy sometime, being ready to start after the coronavirus peak has passed. This could alleviate part of the stress. Another reassuring fact it is that, to date, there is no evidence of the transmission of this type of viral infection through assisted reproduction treatments.
I am planning on becoming a single mother using fertility treatment in the next six months. Would you advise me to freeze my eggs and wait until after the coronavirus peak to try and get pregnant?
The fertility pathway for a single mum consists of different steps including choosing a fertility clinic, doing the initial investigations (some of the results could take up to three weeks to come back), choosing a sperm donor, getting the sperm to the fertility clinic, visiting the fertility counsellor and then doing the egg collection and fertilisation (or alternatively the intrauterine insemination). The initial consultation (you can even do it online, without being physically present in the clinic) and investigations and organising the next steps is something that could be done as soon as you wish. Nevertheless, you have to keep in mind that some of the pre-treatment tests have a limited validity in time (mainly the infectious disease tests, that are required to be done in the three months prior to the treatment). My advice would be to start the process as soon as you want and only start the ovarian stimulation after the peak. Freezing the eggs will only save you some months, which will not make any difference from a clinical point of view.
This advice was up-to-date as it was published on 13 March, 2020 at 1pm.
READ MORE: Coronavirus: When Is The Virus Likely To Peak? And Should Pregnant Women Be Especially Concerned?