What’s the Deal With the COVID-19 Vaccine and Fertility?

So you’re thinking of lining up to get the COVID-19 vaccine but maybe you’re worried about your fertility. Leave it to the pandemic to open up a whole new world of questions!

Maybe you saw posts making the rounds on social media that make some pretty scary claims that the new COVID-19 vaccines will hurt your fertility, or maybe you’re simply uneasy after a year of health news that’s put everyone on edge. We get it. 2020 will go down in history as the year that made us all second guess, well…just about everything.

But we know you came here for answers, not more questions! So what do the doctors (and not your high school best friend who went to Google University Medical School) have to say about the coronavirus vaccine and your fertility?

Will getting the COVID-19 vaccine affect fertility?

According to Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale University, there are no definitive answers because the pharmaceutical companies didn’t purposely recruit pregnant women for their trials. And yet we know that health experts, including Dr. Anthony Fauci of the White House's coronavirus task force and World Health Organization Director-General Tedros Adhanom Ghebreyesus, all say COVID-19 vaccines are a must to end the pandemic.

So, what do you do next if you’re trying to take your fertility into account?

Well, for starters, Minkin says the lack of pregnant women in the clinical trials doesn’t necessarily mean that the vaccine poses a problem — for pregnant women or women who are trying to conceive. It simply means the researchers don’t have data on these particular folks. Right now, there is no known reason why a woman shouldn’t get the vaccine.

Currently, Minkin says most doctors are advocating women get the shot (or series of shots — depending on which vaccine you get), and some of the major medical organizations are pushing doctors to collaborate with patients to help them make the right decision.

Did you notice that we said *some*? The World Health Organization released a statement in late January advocating against the COVID-19 vaccine for most pregnant women unless the risks of getting the disease outweigh any potential vaccine side effects. That means they’re still advocating the vaccine for pregnant women who work in a healthcare setting or similar setting with high exposure risk, as well as for women with high risk pregnancies. 

The WHO is not advocating testing for pregnancy prior to vaccination, and its statement made special note that it does not recommend delaying pregnancy after getting the shot. 

So, what about the rest of the experts?

The CDC, American College of Obstetricians and Gynecologists (ACOG), and Society of Maternal Fetal Medicine are all advising doctors not to withhold the COVID-19 vaccine from patients who are planning to conceive, currently pregnant, or breastfeeding. Joining them is the American Society for Reproductive Medicine (ASRM), which came out with a statement on December 16, suggesting that both patients undergoing fertility treatment and pregnant patients should be encouraged to receive the vaccine — based on eligibility criteria.

The folks at ASRM say doctors and patients should work together to make that decision. You can expect your provider will consider these criteria in helping you choose:

• Local COVID-19 transmission and risk of picking up the virus in your area
• Personal risk of contracting COVID-19
• Risks of the vaccine and any side effects
• The lack of data out there about the vaccine during pregnancy

Honestly, like any medical decision, it comes down to individual women and their doctors to make the choices that are right for them.

Benefits of the COVID-19 vaccine

Doctors give multiple reasons for recommending the COVID-19 vaccine for both men and women on their fertility journey.

For women

If you’re fully vaccinated before conceiving, Minkin says “you'll have the benefit of immunity before conception.” That’s important. Data indicates pregnancy is associated with a higher risk of severe COVID-19 impact, and the American College of Obstetricians and Gynecologists is recommending pregnant women and lactating women have the vaccine made available to them to keep them safe.

The WHO, despite its cautions for pregnant women, is also advocating breastfeeding mothers get vaccinated — they say it’s both “biologically and clinically unlikely” to pose any risk to a breastfeeding child.  There’s currently no evidence (yes, we know we keep saying this) that contracting COVID-19 will affect your fertility, and experts like the WHO continue to say there’s no reason to put off pregnancy just because you’ve gotten a vaccine, but researchers are still monitoring this as more people contract the virus and more time passes. Vaccination is intended to prevent the virus as well as any potential side effects of getting sick.

For guys

Scientists are already seeing some cases where men who’ve experienced COVID-19 end up with impacted sperm production, which could impair their fertility. Preventing him from contracting the virus at all could prevent that from happening.

What if you’re already undergoing fertility treatment?

Many hopeful parents-to-be had to put fertility treatments on hold during the COVID-19 pandemic, but maybe that’s not you. You’ve been faithfully doing those injections, and your body is riding that gonadotropins rollercoaster.

Should you still get the vaccine? Minkin says this is another unknown simply because of a lack of data, but again this isn’t a sign that the vaccine is off the table.

The lack of data goes both ways, she says. There’s no evidence that being on hormones will affect how your body handles a vaccine AND there’s no known evidence that taking the vaccine can affect your treatments either.

Do we know anything about the COVID-19 vaccine?

We have thrown a lot of “we just don’t know” at you. So what the heck do we know?

Well, we know that the COVID-19 shot is an mRNA vaccine, rather than a live virus vaccine. That means:

• It doesn’t affect your genes. Any time scientists go poking around the human DNA strand, folks get nervous (and hey, we get it). But the one letter difference between RNA and DNA is a biggie — an mRNA or messenger ribonucleic acid vaccine never enters the nucleus of human cells. That means your basic DNA will not be changed if you choose to get the vaccine.
• The effect of mRNA vaccines on a fetus has been evaluated: And the folks at the Society for Maternal Fetal Medicine say there are no risks of an mRNA vaccine to fetal health.
• It’s similar to the make-up of vaccines for influenza, Zika, and rabies: According to the CDC, this is not the first time mRNA vaccines have been developed and used.
• It has undergone testing by the Food and Drug Administration: The FDA gave the Pfizer coronavirus vaccine a thumbs up for emergency use, but only after doing what they call a “benefit-risk assessment.” That means the experts at the FDA evaluated every bit of information from the company’s clinical trials. They’re expected to do the same for other pharma companies and their vaccine trials too.

When will we have some data?

Now that vaccines are being administered, researchers are already kicking off studies to get more information about the effects of the vaccine on the body, and that includes fertility concerns. Here’s what’s on tap:

• Experts at the American Society for Reproductive Medicine have called on doctors to encourage more patients to participate in vaccine trials and post marketing surveillance.
• Scientists are already looking to see if the vaccine affects a man’s semen and for how long.
• Although pregnant women weren’t sought out for vaccine trials, there have been some reported pregnancies in women involved, and the pharmaceutical companies are tracking them. The Moderna trial, for example, ended up including 13 women who have gotten pregnant along the way — six who had the vaccine and seven who were in the placebo group.

What about THAT article?

But wait a second, what about that article you saw all over everyone’s Facebook feed claiming a link between the vaccine and fertility? The one warning you that the vaccine is “female sterilization”?

The article showed up as a screenshot on Facebook in early December, seemingly pulled from a blog called “Health and Money News.” In it, you’ll see claims that the COVID-19 vaccine is “training the female body to attack syncytin-1,” a spike protein that’s part of the building of placenta, which would result in “female sterilization.”

That sounds frightening, we know. But it’s also fake news.

Minkin sums the viral article up in one pretty clear word: “bogus.” As for all the details the article goes into about spike proteins and syncytin-1, the Yale professor says it’s got no “significant scientific validity.” There you have it.

Bottom line

As of right now, there just isn’t a lot of clinical data or guidance to be found. You’re caught between a rock and a hard place, and we know it’s scary!

If you’re on your fertility journey and considering whether or not you should get vaccinated against COVID-19, we suggest you ignore the bogus myths and go directly to your doctor’s office. They’ll be able to help you plan out the best path forward.