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Should I Take the COVID-19 Vaccine When I’m Trying to Conceive?

There have been a lot of questions about the COVID vaccine (and more than a bit of misinformation). One question some people have asked is whether the COVID-19 is safe for pregnant people.

By extension, some also wonder if it’s safe for would-be parents who are trying to conceive.

Does the COVID-19 Vaccine Make You Infertile?

The short answer is: No.

The long answer is: There is absolutely no indication that the vaccine impacts fertility, and no plausible mechanism by which it would.

Soon after the mRNA vaccines were approved, a myth began circulating that the vaccines would cause the immune system to attack the placenta, causing female infertility. The theory was that the vaccine would cause the body to attack syncytin-1, a protein that shares a little bit of DNA with the coronavirus spike protein. The fact is that the two things are a long way apart (although, interestingly enough, the DNA used to create syncytin-1 originally came from a virus!). There’s absolutely no way the vaccine (or COVID-19) could cause your immune system to mistakenly go after your placenta.

Could the Vaccine Affect Conception?

With that out of the way, what about a transitory effect on your ability to conceive. There have been some anecdotal reports of people experiencing menstrual irregularities after getting the vaccine. No link has been proven, and menstrual irregularity can be caused by all kinds of things including anxiety (and thus, possibly, fear of needles).

However, if the vaccine does affect your cycle, it might have a very short term and transitory effect on your ability to conceive.

There’s absolutely no evidence that getting vaccinated will make you infertile even for a short period of time.

In fact, multiple trial participants got pregnant during the trials (despite the fact that they were supposed to be using birth control).

COVID-19 Vaccine Side Effects

What about side effects? The mRNA vaccines in particular have been associated with some unpleasant side effects, especially after the second shot. Women report more side effects than men, although this may be reporting bias.

Systemic side effects can include fatigue, headache, muscle pain, chills, fever and nausea. These side effects generally last no more than a few days and you could get lucky.

While the vaccine won’t affect your fertility, side effects might affect your interest in, shall we say, the process of attempting to conceive. Because of this, you might consider avoiding either you or your partner getting the shot during your most fertile period so the side effects don’t interfere.

Is the Vaccine Safe in Early Pregnancy?

All data indicate that the vaccine is, in fact, safe through all stages of pregnancy. While the data remain limited, no safety concerns have been identified and there are no recorded cases of pregnancy loss. The figure of 82% of pregnant trial participants having miscarriages which has been circulating comes from a flawed understanding of statistics in a study that actually concluded there was no difference in miscarriage rates between vaccinated people and the general population.

In fact, being vaccinated means that your antibodies will transfer to the baby and they will be born with some protection against COVID-19. We’re not sure how much, but it will definitely be better than nothing. This is more likely to happen if you get vaccinated later in pregnancy, but you should not wait.

How COVID-19 Might Affect Conception

The other side of the coin is to consider how COVID-19 itself might affect your ability to get pregnant.

First of all, there are indications that COVID-19 can cause male infertility. There is evidence that the virus can take up residence in the testicles, and multiple studies have shown that:

  • The virus can be expressed in semen, potentially infecting a sexual partner.
  • Postmortem testicular samples showed abnormal spermatogenesis. That is to say, COVID-19 infection can result in the production of less sperm or lower quality sperm.
  • Male patients have reported testicular pain.
  • COVID-19 may also alter hormones needed for normal sperm production.

As COVID-19 affects blood vessels, it can also damage the vessels which supply blood to your penis, resulting in impotence, and in some cases this might be permanent.

That is to say, if you get COVID-19, it might affect your future ability to get somebody pregnant for an unknown period of time. If you are trying to get your partner pregnant, it is vital to get vaccinated against COVID-19.

Additionally, post viral sequelae, so-called “long COVID” might affect your ability to conceive, your interest in sex, and your ability to handle a pregnancy and care for a child. Some cases of long COVID have lasted for over a year and there is a very real fear that a small number of people may experience permanent disability.

How COVID-19 Affects Pregnancy

COVID-19 is known to be particularly dangerous to pregnant people. If you are pregnant, you are likely to get more sick than other people in your age group.

High fevers in early pregnancy can raise the risk of birth defects (which is why pregnant people and those trying to get pregnant need to get their flu shot). COVID-19 does not appear, however, to be associated with early pregnancy loss. There are associations with premature delivery, which those further into pregnancy should consider.

Basically, the takeaway is this:

  1. There is no evidence that the COVID-19 vaccine affects either male or female fertility, even for a short period of time. However, side effects might affect your ability to attempt to conceive…but only for a few days.
  2. COVID-19 is more dangerous to pregnant people and can potentially have lasting effects on male fertility and sexual function.

So, not only is it safe to get the COVID-19 vaccine while trying to conceive, it is very unsafe not to. Not protecting yourself against this nasty disease could have consequences for you, your fetus, and your ability to get pregnant in the future. While you might consider scheduling your appointment to avoid the most fertile part of your cycle, you should get vaccinated against COVID-19 as soon as possible.

Sy Le, M.D.
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