COVID-19, Fertility/Infertility and Pregnancy Info
We know that the current times are unexpected and tricky for all given COVID-19. We know how important family is — now and in the future — no matter the circumstances. While Jubel’s offering is almost ready for prime time, our team is committed to do everything we can to bring you reassurance and relevant information NOW. Our Medical Advisory Panel from leading U.S. academic and clinical institutions are committed to helping you cut through the noise. We’ve broken down government and scientific/medical advice into easier to digest sound bites for you.
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We will get you an answer quickly! We are here for you and thinking of you all.
– The Jubel Team
Q: What’s the current situation regarding fertility treatments?
A: The American Society for Reproductive Medicine (ASRM) recommends that new fertility treatments be suspended for the time being, with a few exceptions.
Q: I’m currently “in cycle.” What will happen to my treatment?
A: In general, doctors will continue to care for patients who are “in cycle” or who require urgent egg retrieval and preservation.
Q: I need an embryo transfer. Is this still possible?
A: Experts are now recommending to wait until more is known about the coronavirus.
Q: Will I still be able to reach my physician and nurses?
A: Many offices will use telehealth solutions and will try to minimize in-person interactions, for their safety and yours.
Q: Should I suspend my fertility treatments if there’s chance I’ve been exposed to COVID-19?
A: Yes, it’s best to wait until you are disease-free before trying to get pregnant. Even patients using egg donors, sperm donors or gestational carriers should try to avoid pregnancy. If you are undergoing fertility treatment, consider freezing eggs, or embryos, and do not have an embryo transfer until you are completely well.
This advice also applies to anyone with fever, cough, shortness of breath that may be caused by flu or another virus.
Having a high fever in the first trimester can cause birth defects, so it’s best to wait until the virus passes to begin a cycle of treatment.
Q: What proactive steps can I take if I am working with a gestational carrier?
A: In light of travel restrictions, babies born to gestational carriers may not be united with their new parents right away. It’s important to devise a contingency plan in the event that babies need to be cared for until they can join their new parents.
Q: I am in the middle of an embryo transfer. Will I be able to complete it? What happens next?
A: Some clinics may still complete embryo transfers that are in process, but put a hold on any future transfers for the time being. Some are continuing to freeze eggs and embryos contingent on availability of medical supplies. In general, many clinics are limiting volume of patients.
In geographic areas with “Stay Home” orders like LA or NY, some practices are now only finishing embryo transfers that are within the week. In some instances, patients are being given the option to postpone treatment given the uncertainty of public health hazards and pregnancy outcomes.
Q: What if I currently have an appointment scheduled?
A: Experts recommend minimizing in-person visits. Instead, we say do the consultation by phone or video chat.
Q: What should I do if I am planning to start a cycle?
A: We know it’s beyond disappointing, but it’s best to postpone. Whether the procedure is an IUI, an IVF retrieval or frozen embryo transfer, with a few exceptions, it’s best to wait until we know more about the virus.
Q: I am a cancer patient and was hoping to freeze my eggs before chemotherapy begins. Will I still be able to do it?
A: Yes. For emergency cases such as fertility preservation for cancer patients, fertility clinics will do everything possible to complete your care.
Q: What nutrition should I consider to stay in optimal health?
A: Right now, aim for a variety of whole, minimally processed foods including fruits, vegetables, beans/legumes, nuts/seeds, and lean meat. Don’t just stock up for the future. While the grocery shelves may be emptying, the produce sections are still packed! Check out some additional recommendations provided by one of our Nutrition Fertility Coach partners – Original Body by Joey.
Q: Is it safe to take Ibuprofen?
A: For women who are trying to get pregnant, experts have not yet weighed in on ibuprofen vs. acetaminophen. At this point, the World Health Organization is not recommending against taking ibuprofen for COVID-19-like symptoms. More study is needed. Until then, stick to acetaminophen.
Q: My pregnancy is a result of IVF. Is it safe for me to have fewer face-to-face appointments?
A: Yes. As long as you have no medical complications. You may, however, need more ultrasounds because yours is an IVF pregnancy. For example, our experts say that after you hear your baby’s heartbeat for the first time, you make an appointment for a nine to 10-week scan for non-invasive prenatal testing. (Source, Dr. La Follette)
Q: If I’m pregnant, am I more susceptible to the COVID-19 virus?
A: There is no evidence now indicating that pregnant women are more susceptible to COVID-19. In general, pregnant women are more likely to come down with viruses that affect your breathing. While the information is still incomplete, cases from China suggest that COVID-19 does not behave like influenza. Pregnant women with flu fare worse than non-pregnant women of similar health status.
Q: Can COVID-19 affect the baby?
A: We currently do not have enough information about CoVID-19 in pregnancy to answer that question conclusively. Data suggest that the virus cannot cross the placenta and enter the pregnancy. It does, however, appear that pregnant women exposed to coronavirus can end up more ill than the regular healthy adult. There is no reason to be panicked right now, but we do recommend taking precautions to try to prevent catching the virus.
Q: What should I do to avoid getting sick?
- Wash your hands frequently, for at least 20 seconds each time. If you don’t have access to soap and water, use hand sanitizer that is 60 percent alcohol.
- Avoid touching your face.
- Cough into a tissue, then wash your hands.
- Wipe down surfaces where the virus might lurk, like a shared computer keyboard or telephone.
- Avoid contact with people who are sick, especially if those people have traveled to areas where coronavirus infections have been reported.
- Maintain “social distancing,” six feet away from another person.
- Avoid non-essential travel, especially by airplanes.
- Avoid gatherings of more than 10 people. We’re sorry to say that you should avoid groups and limit your personal contact to as few people as possible.
Q: What do I do if I have symptoms?
A: Mild respiratory symptoms (such as cough, fever, etc.) are not a reason to be overly concerned.
If you develop these symptoms and have been in contact with people who have been diagnosed with coronavirus infection or traveled to areas where coronavirus outbreaks have occurred, please contact your health provider for further guidance.
Testing for the virus is now available through both the Department of Public Health and commercial labs, but should be reserved for those who meet the criteria set out by your local public health officials. Here is a listing of local departments of public health:
Q: If I need to get tested, what will the test involve?
A: The test is performed using a long Q-tip-like swab that is inserted into both nostrils. Your provider will wear a mask, face mask, gown and gloves when s/he performs the collection. The swab is then placed into a container with fluid, and snapped off into a container, which is kept cold and then sent to the laboratory. The turn-around-time for the swabs varies by the lab and your region, but may take several days.
Q: I never got a flu shot this year. Should I get one now?
A: Yes, flu season lasts until May. A simultaneous infection with both influenza and COVID-19 can be much worse than just one infection. The vaccine has been shown to be safe in multiple large studies. People you are in close contact with should all also receive the flu vaccine.
Q: Should I start working from home now to avoid the COVID-19 virus?
A: Social distancing means remaining out of crowded public spaces, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.
Q: If work at home is not an option, should I take a leave from work?
A: That’s a personal decision, and depends on the extent of community spread in your region. You can see how heavily your area is affected here:
Q: Is it safe to go out?
A: Yes, if you maintain social distancing while out taking a walk for fresh air and exercise and limit your trips to places that are necessary like the grocery store and pharmacy. Practicing social distancing will reduce your risk of exposure.
Q: Is it safe to get takeout from a restaurant, or should I prepare all my own meals?
A: We recommend making your own meals. But if the prevalence of disease is low in your community, takeout is probably OK.
Q: Can I visit elderly grandparents?
A: For the time being, it’s probably safer to FaceTime your loved ones.
Q: What can I do to help?
A: Our healthcare workforce will become strained as the number of hospitalized and critically ill patients rises. Please show them some kindness by letting them know that they are appreciated. Please also consider joining the #DonateYourMask campaign, as the depletion of mask resources means that hospitals and clinics cannot acquire more.
Q: Is it safe to take Ibuprofen?
A: As a general rule, pregnant women should avoid ibuprofen and take acetaminophen for fevers, headaches and symptoms of flu and COVID-19.
Q: If I have COVID-19, will I need to be delivered by cesarean section?
A: Assuming that both you and the baby are still safe and have no other reasons for needing a C-section, such as breech presentation or prior fibroid surgery, the goal is still a vaginal delivery. Although cases reported from China indicate universal cesarean delivery, the policies and attitude toward cesarean delivery are very different than the recommendations in the U.S. So, just as doctors have been encouraging for the last few years, cesarean deliveries should be performed only when necessary. (Source, Han)
Q: Should I ask for an induction if I am 39 weeks pregnant? What about 36 weeks?
A: No. Labor and delivery floors are staffed to provide care 24 hours a day. They operate independently from the rest of the hospital, so there is no need to worry about the safety of the space or the availability beds on the labor floor.
Right now, the American College of Obstetrics and Gynecology and the Society (ACOG) and the Society for Maternal Fetal Medicine (SMFM) recommend against elective induction solely because of COVID-19 around us. In fact, inductions often result in longer hospitalizations prior to birth than spontaneous labor. And that might increase your risk of being exposed to COVID-19 in the hospital.
For 36 weeks, ACOG recommends against elective pre-term birth in general, and that does not change with the current COVID-19 pandemic. (source, Copel)
Q: Should I consider a home birth?
A: ACOG says that home births are less safe than births in medical facilities. The minimal degree of risk posed by potential COVID-19 exposure in the hospital does not change that recommendation. (source Copel)
Q: I just found out I’m pregnant! How will my prenatal care change now that we have “Stay Home” orders?
It’s likely that during the COVID-19 pandemic, prenatal care will change to include some number of video or telephone visits instead of face-to-face appointments to keep patients as socially distanced and safe as possible. The exact number of tele-med visits will vary – check with your doctor.
Some patients may be asked to buy a blood pressure cuff to monitor themselves at home. Your doctor will probably ask you to bring the cuff to your appointment so it can be calibrated.
Here’s a link to a blood pressure cuff that Bay Area OB/GYN Dr. Lizellen La Follette recommends.
Source, Dr. La Follette
Q: Besides taking my blood pressure, is there anything else I can do to self-monitor?
A: Yes! Try counting your baby’s kicks, which is a sign of wellbeing. Here’s a link to a kick-counter.
(Source, Dr. La Follette)
Q: What is the University of California at San Francisco model for prenatal care?
A: Right now, San Francisco is under an extreme “Stay Home” order, so it’s a good test case for prenatal care in the time of COVID-19.
Four visits will be in-person, the others will be via phone or videoconferencing.
The idea is to provide great care, while observing social distancing to prevent COVID-19. (Source, Dr. La Follette)
Q: Does a fewer number of in-person visits apply to all patients?
A: It covers a lot of patients. If you are 40 or under and have no medical complications and have a BMI of less than 40, you’ll be fine doing some tele-med. Women who use tobacco or marijuana, patients with hypothyroidism, well-controlled anxiety or depression and other conditions will also be fine with fewer visits.
Check with your doctor to be sure.
Jubel’s mission is to empower you through your quest to form and build a family. We provide you with 24/7 personalized, medically-vetted education and resources via a digital coaching experience.
Medical Advisory Panel
Christina Han, M.D., MFM, @ChrisHanMFM (Greater Los Angeles)
Joshua A. Copel, M.D., MFM, Yale Medicine, @jacopel (NY Metro)
Larry Platt, M.D., MFM, Center for Fetal Medicine, UCLA Professor (Greater Los Angeles)
Andy Huang, M.D., REI, @drandyhuang (Greater Los Angeles)
Bradley Trivax, M.D., REI, @drtrivaxivf (NY Metro)
David Finke, M.D., OB-GYN, @drfinke (Greater Los Angeles)
Lizellen La Follette, M.D., OB-GYN, @LizellenObGyn (San Francisco Bay Area)
Center for Disease Control and Prevention:
American Society for Reproductive Medicine:
American College of Obstetrics and Gynecology:
Last Updated: 3/25/2020