Fertility, Pregnancy and the COVID-19 Vaccine

There are so many myths and rumors that have circulated regarding the COVID-19 vaccine, fertility and pregnancy.

But here is the TRUTH: there is NO evidence to suggest that the COVID-19 vaccine causes infertility or is unsafe when pregnant or trying to get pregnant. While long term data does not exist, there is data that has demonstrated no changes on female fertility and no negative effects in pregnant women.

The initial COVID-19 vaccine trials did not include pregnant women or women who were trying to conceive. This is pretty standard for vaccine and drug trials. This exclusion of pregnant women stirred a lot of rumors that the vaccine was not safe during pregnancy, but this is far from the truth.

Pregnancy and the COVID-19 vaccine:

The CDC issued a statement about the safety of the COVID-19 vaccine and pregnancy. 35,000 pregnant women were followed and preliminary data was collected. This data showed no adverse effects on pregnant women or their babies after receiving the COVID-19 vaccine.

This included no increase in the rate of miscarriage or stillbirth or other pregnancy complications. In contrast, there is data that infection with COVID-19 can increase the risk of pregnancy complications. These include complications, such as preterm delivery, stillbirth, ICU admission, and cesarean deliveries. COVID-19 infection has serious complications and vaccination helps protect moms and babies.

Vaccination in pregnant women is supported by the American Society of Reproductive Medicine (ASRM), American College of Obstetric and Gynecology (ACOG) and the Society of Maternal Fetal Medicine (SMFM).

Menstrual cycle changes and COVID-19

COVID-19 infection can cause an alteration in a female’s menstrual cycles. In fact, one study demonstrated 25% of women who had COVID-19 reported a change in their cycles. This could be heavier or lighter menstrual cycles, or a change in the day their cycles were supposed to start. These menstrual changes lasted for about 1-2 cycles.

There are two explanations for these changes.

The first is likely due to stress. Infection is a form of stress on the body, which can alter the release of the hormones necessary for ovulation. Changes in ovulation can cause changes in a female’s menstrual cycle.

The second explanation for the change in menstrual cycles is due to the immune response. This immune response occurs after a COVID-19 infection as well as after the COVID-19 vaccine. The endometrium (lining inside the uterus) is an immune responsive organ. As a result, the endometrium is sensitive to changes after a COVID-19 infection or vaccination. This can cause changes in bleeding volume or irregular menstrual cycles. These changes are temporary. Therefore, if changes in your menstrual cycle persist for more than 2 months, you should see your doctor to evaluate for other causes.

Fertility and the COVID-19 vaccine:

The COVID-19 vaccine does NOT cause a change in ovarian reserve or production of ovarian hormones. Additionally, there are no differences in IVF outcomes.

Studies have assessed Anti-mullerian hormone (AMH) levels and noted no differences in AMH values after the COVID-19 vaccination. AMH is a marker for ovarian reserve or egg quantity, and it is reassuring to see no changes in a female’s ovarian reserve.

Additionally, there are two recent research studies that have assessed the COVID-19 vaccination and female fertility.

The first study analyzed ovarian follicular function, and concluded no negative effects on oocyte or follicular function after recent COVID-19 infection or mRNA COVID-19 vaccination.

The second study followed women undergoing in-vitro fertilization (IVF) treatment. There were NO differences in IVF outcomes amongst women before and after receiving the Pfizer vaccine COVID-19. There were also no differences in IVF outcomes in women with antibodies against COVID-19 due to a prior COVID-19 infection.

Based on these studies, vaccination is supported by the ASRM for women who are trying to conceive or undergoing fertility treatments, such as intrauterine insemination (IUI) or IVF.

Bottom line is that there is no biological reason that the COVID-19 vaccine would cause infertility, or have negative effects on women who are trying to conceive or who are pregnant.

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