The Zika virus is very frightening for pregnant women who live in countries where the disease is already rampant. That's because the mosquito-borne virus is linked to serious birth defects like microcephaly, in which a baby's head doesn't develop fully. In the United States, however, most pregnant women are fortunate not to be burdened with these worries and concerns.
But the incidence of pregnant women with a known Zika infection in the U.S. is climbing. There are now over 200 pregnant women in America with a documented Zika infection. (The majority of these cases are a result of travel to an affected country, while others are through sexual transmission.) In May, the first case of microcephaly linked to a locally acquired Zika infection in the United States was confirmed.
As a fertility doctor, I have many patients concerned about how the Zika virus will affect their plans for pregnancy, especially if they're traveling. Here’s what I tell them:
What to know about Zika if you're trying to conceive
The CDC has very clear recommendations about how the threat of Zika should be handled in women who are in the process of trying to get pregnant. Women who might have been exposed to Zika by either traveling to a country where Zika is prevalent or through sexual contact with a man infected with Zika need to wait eight weeks before they try to get pregnant—whether or not they have symptoms of the infection.
For men, if they’ve had a possible Zika exposure because of recent travel, the amount of time they need to wait to attempt pregnancy depends on whether they develop symptoms. If they have no Zika symptoms, they only need to wait eight weeks after exposure. However if they have any Zika symptoms, they need to wait at least six months before they start trying for pregnancy. Unfortunately, the Zika virus stays present in semen longer than in blood.
It’s not an option to simply test for Zika upon return from travel to avoid a delay in trying to get pregnant, because the tests are not 100 percent reliable, and the results take so long to get back.
Testing for Zika
The current diagnostic tool for Zika is a blood test that's performed during the first week of symptoms. In addition, a urine sample should also be collected within two weeks of the onset of symptoms (it tests for the virus in a slightly different manner). But the tests are not perfect, in that they don't pick up the disease with 100 percent accuracy. Plus, other viruses can cause the test to be positive, even when Zika is not present.
These tests are not readily available in just any lab. In fact, samples have to be sent to state or local health departments. It takes at least three weeks to get the results back once the tests are performed. Thus, the tests are not appropriate for widespread use. They serve more to track the incidence of infection in the United States and detect Zika in pregnant mothers so that closer monitoring of the fetus can be performed.
What my fertility patients are facing
I’ve had several patients trying to get pregnant who have been affected by the threat of Zika. With summer upon us, trips to countries with warm beaches and plenty of sunshine are on the calendar for many couples considering starting a family. Unfortunately, many of those countries are rife with Zika outbreaks. Active Zika virus outbreaks have spread to most of South and Central America, as well as the Caribbean and even as far as Fiji.
Recently, I've had many conversations with patients weighing the pros and cons of traveling for a relaxing vacation to Mexico, and the unfortunate consequences of delaying attempts at pregnancy for at least two months upon their return.
The decision to travel and delay attempts at conception is even more complex for those suffering from infertility, whose dreams of starting a family are already taking longer than anticipated. The decisions are tougher, especially with women who may desperately need that vacation for their mind and body after numerous months of unsuccessful fertility treatments. Unfortunately, in many cases for older women, time is of the essence and every month counts. For those patients, a delay of just a few months can be costly.
Some couples have resorted to freezing sperm before they travel to a country with Zika. If only the male partner is traveling, you can avoid any delay in trying to conceive if you freeze sperm in advance, as the female partner can be inseminated while the partner is away and once he is back. This way, you can avoid the automatic two-month delay and the potential six-month delay if he gets infected.
When both partners are traveling, you'll have to wait two months. But if frozen sperm is banked ahead of time, you can at least know you don’t have to wait six months.
The bottom line: Plan ahead
What is the best way to handle Zika if you are trying to have a baby? Don’t travel to a country with Zika outbreaks. There are lots of other amazing places to unwind and center yourself. Explore and be inspired by a new destination in the United States or Europe.
If you or your partner must travel to a Zika country, prepare ahead of time by freezing sperm and taking measures while you're there to prevent mosquito bites. Seek help from a health care provider and fertility specialist if you've been trying to get pregnant or plan to get pregnant soon.