The COVID Vaccine and Surrogate Pregnancy: What You Need to Know

Circle Surrogacy & Egg Donation sat down (virtually!) with Infertility Specialists and Reproductive Endocrinologists from some of our partner fertility clinics to discuss surrogacy in the time of COVID, and how the vaccine might affect those who are pregnant, or soon to be pregnant.

Our panel of specialists include:

Dr. Michele Evans, Infertility Specialist and Reproductive Endocrinologist at Pacific Fertility Center of Los Angeles

Dr. Ingrid Rodi, Infertility Specialist and Reproductive Endocrinologist at Pacific Fertility Center of Los Angeles

Dr. Vicken Sepilian, Infertility Specialist and Reproductive Endocrinologist at Pacific Fertility Center of Los Angeles

Dr. Aaron Styer, Infertility Specialist and Reproductive Endocrinologist at CCRM Boston

Dr. Said Daneshmand, Infertility Specialist and Reproductive Endocrinologist at San Diego Fertility Center

Here’s everything you need to know about surrogacy, becoming a surrogate during COVID, and whether or not you should get the COVID vaccine as a surrogate or if you’re planning on becoming pregnant.

Q: I’m worried about traveling for my medical screening and/or embryo transfer and bringing home COVID to my family. What COVID protocols do clinics have in place?

Any type of travel outside of where you reside can be risky. Before you even reach the fertility clinic, it’s important that you follow all CDC guidelines for travel and protecting yourself against COVID-19, including social distancing as much as possible, always wearing a mask, carrying hand sanitizer with you at all times and washing hands frequently. You should never travel if you are not feeling well, or if you feel you’ve been exposed.

Dr. Aaron Styer: We have best-in-class CCRM COVID safety protocols for patients and staff at CCRM Boston. These include appropriate spacing in waiting rooms and clinical spaces, required face mask, compliance with Massachusetts mandates for daily patient occupancy, increased deep cleaning for the facility, expanded in-clinic hand hygiene options, daily symptom and temperature checks for staff, CCRM-based COVID testing when indicated for staff, phone screening for COVID symptoms for all patients day prior to all visit, and mandatory COVID testing for all patients undergoing fertility treatments (e.g. egg retrieval). We are also using telehealth appointments as much as possible for new patient appointments, regroups and financial consults.

What happens if I test positive during my pregnancy for COVID? Can I pass it onto the baby?

Dr. Aaron Styer: If you test positive for COVID, you should monitor your symptoms and self-quarantine in the same way you would if you were not pregnant. While research is still limited, a recent study published in JAMA Network Open found that pregnant mothers who test positive for COVID-19 do not pass virus to their unborn child. Out of 127 pregnant women in their third trimester who participated in the study, 64 tested positive for coronavirus. Among those women, investigators found no evidence of COVID transmission to the newborns.

In small scale studies, some newborns have tested positive for the virus that causes COVID-19 shortly after birth. It is uncertain if these newborns got the virus before, during, or after birth from close contact with their mother. Most newborns who tested positive had mild or no symptoms.

Q: Is being pregnant considered “high risk” and would that move me up in line to get the COVID vaccine?

Dr. Michele Evans: Pregnant women are at higher risk of complications if they are infected with Covid-19.  Even so, being pregnant does not “bump” you into a higher priority category to receive the vaccine. Your place in line will be determined by the health guidelines in the state where you reside, and will be based on your occupation, age, and underlying health issues.

Circle Surrogacy recommends you visit your local or state government websites or the CDC website to learn more about vaccination protocols in your area.

Q: Is the COVID vaccine safe for pregnancy?

Dr. Said Daneshmand: Given the mechanics and physiology of the vaccine, there should theoretically not be any negative effects on the fetus or pregnancy, any more than for non-pregnant patients.  In addition, the vaccine may confer passive immunity to the newborn although the duration is unknown. Of course, the decision to take the vaccine will remain a personal one. The 2 FDA-approved vaccines in the U.S. have yet to report specific data as it relates to pregnancy. There were many patients in both trials who took the vaccine and later became pregnant.  

The World Health Organization’s Director of Immunization, Kate O’Brien, recently stated that “Clinical trials of the vaccine are needed on pregnant women. However, there is no reason to think there could be a problem in pregnancy, we are just acknowledging the data is not there at the moment.”

Q: Should I get the COVID vaccine if I’m going to become pregnant for surrogacy? 

Dr. Aaron Styer: Based upon the guidance of several professional medical societies, including the American College of Obstetrics and Gynecology (ACOG), American Society for Reproductive Medicine (ASRM), and Society for Maternal Fetal Medicine (SMFM), as well as expert opinion, patients planning to conceive (on their own or with fertility treatments), currently pregnant, or breastfeeding, should consider receiving the vaccine since the health risks of contracting COVID greatly outweigh the risks of vaccination.

Dr. Said Daneshmand: The American college of Obstetricians and Gynecologists, as well as the American Society of Reproductive Medicine, have issued guidelines stating that pregnant patients, and patients who wish to become pregnant, should be offered the COVID vaccine. I do not have any reservations based on these recommendations for patients to be administered the COVID-19 vaccination.  The College of Obstetricians in the UK is also recommending the same. There is also no requirement to wait a specific period of time from the vaccination to the IVF treatment or embryo transfer. The only recommendation I have is not to take the vaccine during the active phase of treatment for ovarian stimulation or embryo transfer as it can cause an allergic response and fever, which can affect the eggs in that cycle, or the embryo which is transferred.  

Q: If I’ve already started medication for IVF can I get the vaccine or do I have to wait? 

Dr. Sepilian: It is not necessary to postpone vaccination if one is in the midst of an IVF cycle. According to the COVID Task Force of the American Society of Reproductive Medicine the Covid vaccine should not be withheld from patients who are planning to conceive, who are currently pregnant, or who are breastfeeding and this includes patients undergoing IVF. The task force does encourage patients undergoing fertility treatments to receive the vaccination based on current eligibility criteria, which varies based on region and availability of the vaccine. Each patient should have an extensive discussion with their healthcare and fertility team and make an informed decision about the vaccine accordingly. 

Q: Is it safe to start a surrogacy journey now during COVID?

Dr. Sepilian: Indeed it is safe to start a surrogacy journey as the journey requires several months from selection to screening to IVF treatment, to pregnancy and ultimately to live birth. However, ensuring the safety and well-being of all the parties involved is a major consideration. Recent studies have suggested that pregnancy is a risk factor for severe Covid-19 disease which may have implications on the health of the surrogate carrier as well as the fetus. Strong consideration should be given for the SARS-COV-2 vaccine for all parties undergoing fertility treatments to minimize risk, including intended parents undergoing IVF and surrogates based on the availability of the vaccine. A shared decision should be made between all parties after being well informed of the latest information available to ensure the best and healthiest outcome for intended parents, the newborns and the surrogates alike. 

Dr. Aaron Styer: If you practice standard hand hygiene, social distancing, and wearing masks, it is absolutely safe to begin the surrogacy journey.

If you are interested in starting a surrogacy journey, you can read more about how to become a surrogate, and applying to be a surrogate during COVID-19.

A special thank you to the team of experts who contributed to this blog post.

Dr. Michele Evans, PFCLA

Dr. Michele EvansInfertility Specialist and Reproductive Endocrinologist
An expert in her field, Dr. Evans has received numerous awards such as Pasadena Top Doctor, Los Angeles Times Best Docs in Southern California, and Top Doc Los Angeles.

She has discussed reproductive health issues on the Discovery Health Channel and NPR, and lectures on preimplantation genetic diagnosis and screening at UCLA. She has also published numerous articles on women’s health topics.

 

 

 

 

Dr. Ingrid Rodi, PFCLA

Dr. Ingrid RodiInfertility Specialist and Reproductive Endocrinologist
Dr. Ingrid Rodi is board-certified by the American Board of Obstetrics and Gynecology in both Obstetrics and Gynecology and the subspecialty of Reproductive Endocrinology and Infertility.

She is a Fellow of the American College of Obstetricians and Gynecologists. A Clinical Professor (Voluntary) of OBGYN at the Geffen School of Medicine at UCLA , she continues to be involved with clinical research.

 

 

 

Dr. Vicken Sepilian, PFCLA

Dr. SepillianInfertility Specialist and Reproductive Endocrinologist
Double board certified in Obstetrics & Gynecology and Infertility & Reproductive Endocrinology, Dr. Sepilian specializes in the diagnosis and treatment of disorders involving infertility and hormonal imbalances of the reproductive system.

Because there are many factors that can affect a couple’s ability to conceive and carry a child to term, the doctor works with both men and women to uncover potential problems with their reproductive system that may hamper their ability to produce a child.

 

 

 

 

Dr. Aaron Styer, CCRM Boston

Dr. StyerInfertility Specialist and Reproductive Endocrinologist
Dr. Aaron K. Styer is a reproductive endocrinologist, founding partner, and medical director of CCRM Boston. He is board certified in obstetrics and gynecology and the subspecialty, reproductive endocrinology and infertility. He is an associate professor of obstetrics and gynecology at Harvard Medical School.

He is nationally recognized for his publications and clinical expertise in ovarian reserve, IVF, LGBTQ family building, egg freezing, egg donation, and gestational surrogacy. He has been honored with Boston Magazine’s Best of Boston Top Doctor for the past several years and has been interviewed locally and nationally in the Boston Globe, Good Morning America.com,  The New York TimesNewsweek, Cosmopolitan, Allure, Marie Claire, and Self for topics regarding infertility, pregnancy, and egg freezing.

 

Dr. Said Daneshmand, SDFC

Dr. DaneshmandInfertility Specialist and Reproductive Endocrinologist
Dr. Said Daneshmand is an internationally recognized fertility specialist with extensive experience in providing third-party reproductive services. Dr. Daneshmand serves on the board of several surrogacy advocacy groups. He has collaborated to develop in vitro fertilization (IVF) protocols to improve pregnancy rates, including PTEC (post-thaw extended culture), which is one of the most successful IVF regimens currently available.

These groundbreaking findings were published in the internationally respected medical journal, Fertility and Sterility, where Dr. Daneshmand also served as a reviewer. Dr. Daneshmand completed his fellowship and residency at UCLA. He is specialty board certified in Obstetrics and Gynecology and sub specialty board certified in Reproductive Endocrinology.