Frequently asked questions about fertility and assisted reproduction (XVII)

Fertility and assisted reproduction remain important topics of discussion for many hopeful parents, especially in uncertain times. Once again, we’re bringing you a summary of our participation in the La Opinión de Málaga online chat — a virtual meeting that allows us to address the questions that expectant mothers and fathers have about fertility and assisted reproduction.

This chat is part of the newspaper’s “Ask a Specialist” section. To answer any questions, we have the medical director of URE Centro Gutenberg, Dr. Claudio Álvarez. In this case, and as was the case with the previous edition, many of the questions were about COVID-19. We’ll leave you with them!

Can severe COVID-19 be treated in pregnant women without risk to the fetus?

Severe COVID-19 is a risk for both the mother and the fetus. Treatment for a pregnant woman will depend on the type of complication (respiratory, coagulation, multiple organ failure, etc.). Any medical treatment can be a risk to the fetus, but the mother’s life is first at stake. Treatment will be to safeguard her life by trying to minimize problems for the fetus as much as possible.

Is it currently inadvisable to become pregnant?

No health or scientific authority has advised against pregnancy during the current pandemic. The recommendations are to take extreme preventive measures to reduce the risk of infection during pregnancy.

Is it possible to undergo fertility treatments during these times of COVID?

Yes, it is possible. Reproductive centers have strengthened preventive measures to provide treatments as safely as possible. Patients also have the responsibility to take all preventive measures. Wearing a mask, avoiding crowds, maintaining social distancing, washing hands frequently, etc.

After having two miscarriages in a year and a half, should I get tested or keep trying?

Two or more miscarriages in a row are defined as “recurrent miscarriages,” and specific testing is recommended for both partners to try to find an explanation and establish a possible treatment.

If I had coronavirus while pregnant, is my child immune in any way?

This is a new pandemic, and information is scarce and changing. At the moment, it has not been established that there is fetal immunity secondary to the mother’s infection during pregnancy.

After testing positive for COVID, how long do I have to wait to resume hormonal fertility treatments?

From the moment specialists discharge the patient for COVID-19, meaning no symptoms and a negative PCR test, it is possible to resume fertility treatment. In any case, it will depend on the severity of the infection, the type of symptoms, etc.

Is it advisable to self-isolate in the final stages of pregnancy to avoid contracting COVID-19?

The risk always exists, throughout the pregnancy, so preventive measures must ALWAYS be present. Self-isolation may be an option depending on the situation and risk factors of each pregnant woman.

If I have coronavirus during pregnancy, can I transmit it to my baby?

To date, cases of transmission from mother to fetus are anecdotal, so the true risk of mother-to-child transmission cannot be established. Among the rare cases, there are more cases of transmission to the child during childbirth, but without sequelae so far. Everything also depends on the severity of the mother’s infection.

Is it advisable to allow visits to meet the baby at home given the COVID situation?

Currently, the Ministry of Health’s recommendation is to initially avoid visits to the baby and reserve care or contact with people in the baby’s closest circle.

In an egg donation, are all the eggs the donor retrieves in that cycle for the recipient? Do you guarantee a minimum number of viable eggs?

At our center, donations are generally exclusive to the recipient, and we guarantee a minimum of eight eggs. If we don’t obtain this minimum of eight, we discuss it with the patients and resolve the issue as fairly as possible.

Could freezing embryos and transferring them at a later time affect the pregnancy rate?

With the current vitrification freezing technique, pregnancy rates are similar for fresh versus frozen embryo transfers. In some patients, these rates are even better with frozen embryos.

Does having longer periods mean a higher chance of getting pregnant?

There is no relationship between longer periods and a higher chance of pregnancy.

Why is fertilization sometimes not achieved during ICSI?

In ICSI, despite injecting a sperm into the egg, it is normal for not all oocytes to fertilize. The causes can be very varied, but it can primarily be a problem with the quality of the sperm or egg.

Is it advisable to take antioxidants after ovarian puncture and while waiting for embryo transfer?

The recommendation in this case will depend on each woman’s diagnosis. The use of antioxidants between the puncture and the transfer has not been shown to improve pregnancy rates.

Is it possible to get pregnant with an irregular cycle?

The chances of pregnancy and irregular cycles depend on the cause of the irregularity and the woman’s age. After the age of 44, irregular cycles are normal, and the chances of pregnancy are very low, even if cycles return to normal.