How To Think About The Coronavirus Impact On Fertility
We are all concerned about the Covid-19 coronavirus pandemic, and my patients are asking if the coronavirus impact on fertility and pregnancy is a concern. The short answer is we aren’t sure. We don’t know much about the virus; scientists have only been studying it for a few short months. We haven’t heard any reports from hard-hit countries regarding increased miscarriage due specifically to the virus; so that’s good. The biggest symptoms of the coronavirus are fever, cough and difficulty breathing, sometimes diarrhea. So let’s look at these symptoms, and extrapolate what they could mean.
Mild vs Severe Illness
Many people will catch this illness, and suffer only mild symptoms. You might feel a bit hot, have a bit of phlegm in your chest, cough a bit, and then shake it off in a week. In this case, as in any case of a mild cold, it’s not really going to impact your fertility much. Take good care of yourself, and your fertility will be good.
If you get hit hard, and have the high fever, difficulty breathing, and phlegm accumulation in your chest, there will possibly be an impact on your fertility, both male and female.
A Likely Coronavirus Impact On Male Fertility Because Heat Kills Sperm And Damages DNA
High fever symptoms are the big concern for fertility, more so for men than women. I’ve had patients whose husbands have a good sperm analysis when they start the IUI or IVF testing process, have an illness involving a fever, and BAM! The sperm analysis for 3 months after shows a lot of dead sperm or dramatically decreased numbers of sperm. That’s because sperm are highly sensitive to heat, and exposure to a fever (in Covid-19 fevers can spike to 103-106F) kills sperm. Living in Las Vegas, I see this heat sensitivity all the time in men who work outside during the summer. The coronavirus impact on fertility in men is a concern.
***UPDATE: A recent study examined the effect of Covid-19 on sperm. It found no effect on sperm quality in mild cases, but moderate cases did result in sperm damage. There is no evidence at the present time that Covid-10 is sexually transmitted. Assessment of Covid 19 in Human Semen
While the study did not attempt to determine why the damage happens, the results are consistent with what we know of the effect of fevers on sperm: heat causes damage.
Recognize that heat also damages DNA. This can’t be measured on the sperm analysis; the sperm DNA fragmentation test can. Cooking meat is a good analog for what happens. Applying heat to meat makes it tender, and the way it does that is by breaking down bonds in the amino acids in the muscle tissue. What is DNA? Amino acids. So heat damages DNA. If you can find a doctor that will run a sperm DNA fragmentation test, it will let you know if there is an issue post fever.
Furthermore, ibuprofen which is used to reduce fever, is also sperm toxic. Clinically, I’ve had patients whose partner hurt their back, took ibuprofen daily for a few weeks to deal with the pain, and dramatically decreased their sperm count as a result.
So two possible effects are reduced sperm count or decreased DNA quality in men. If your partner gets Covid-19, recognize that retesting sperm is a good idea before doing a procedure or trying naturally. If it has dropped dramatically, waiting 3 months will allow the count and quality recover, since it takes 3 months to develop healthy sperm. One way to increase sperm quality, and often quantity, is to follow the procedures I outline in the module on male health in my course on www.fertilityresetonline.
Heat Isn’t Great For Eggs, Either
Your eggs are more protected from heat than sperm are, but it’s still not great for them. If you are tracking your BBT, you’ll notice a spike. There isn’t much point in tracking when you have a fever, so wait until the fever settles before you track. It will throw off the calculation of your ovulation day.
Dehydration is a real problem for egg health; blood flow to your ovaries will decrease in favor of addressing the fever and keeping your vital organs hydrated. If ovulation occurs while you are ill, most certainly it will dry out cervical mucus, making TTC naturally conception harder. So make sure you drink plenty of fluids.
Gastro-Intestinal Issues Affect Your Nutrient Absorption
If you react to the virus with diarrhea, nausea or vomiting, then you are not going to be absorbing the nutrients you need. Malabsorption can affect egg and sperm health, though only a few days of it isn’t an issue. If you can’t eat well for several weeks, then it’s going to have a bigger impact on your fertility. It’s not something that can be measured, but it isn’t good.
Sum Total Coronavirus Impact on Fertility: You Should Consider Delaying TTC Naturally and Possibly IVF for a Month Or Two If You Get Sick
Will it affect egg health? Harder to say compared to the obvious effect on sperm. From a Chinese medicine point of view, it’s not going to do your egg health any favors. The coronavirus impact on fertility for women is not as straightforward, but I still suggest delaying TTC naturally for the month that you are ill, and possibly the month after, especially if you notice lingering symptoms. It’s much harder to say what to do with IVF because of medication schedules. If you are on stimulation meds for IVF, and get actively sick call your RE immediately. They likely won’t do retrieval or transfer until you are recovering. If you are on birth control, delay for sure until you are recovered.
Why? Because your body is going to spend its energy on healing you, not developing eggs. Our bodies are wise, and it will divert energy, nutrition and effort into the most vital functions first. Fertility is not an essential function: it is an optional goal for your body, and is the result and beneficiary of health. The coronavirus impact on your fertility, when it affects your nutrient absorption, your energy levels, and your egg health is an insidious one: it drains your vitality and deprives your eggs. Fertility demands a lot of your resources, so your body will want you mostly healthy before directing blood, energy and effort into fertility.
Your Lungs As A Guide To The State of Your Health
The virus attacks the lungs, causing coughing, phlegm and difficulty breathing. If you’ve ever lost your breath or had the wind knocked out of you, you know how scary it can be. It also makes you weak, because you need air. The difficulty breathing that many Covid 19 patients experience will decrease your energy levels not only while you are sick, but leave you depleted during recovery. Use your breathing and overall energy levels as a guide. If normal activities leave you short of breath, you still aren’t recovered and need to wait. Lung health is a rough guide to your overall health: if they aren’t recovered, your body still isn’t going to fully nourish your eggs.
Pregnancy May Make You More Susceptible
One of the amazing things about the female body is the ability of the immune system NOT to attack the fetus. The baby has different DNA than you do, and normally, that would trigger an immune response. However, women’s immune system programming is flexible, so when you are pregnant your immune system relaxes its guard and doesn’t attack the baby. In effect, you are immune compromised. The downside is that you are more susceptible to getting sick when you are pregnant.
If you are pregnant, you need to act like you are in a higher risk category.
Being sick when you are pregnant is no fun. The symptoms may be more severe, it may take you longer to recover, high fevers are not good for the baby, especially in the first trimester, when they might cause birth defects.
It’s in your best interest to take the precautions that the CDC is recommending seriously.
In addition, be smart about your decisions. The best cure is prevention: eat healthy, get plenty of rest and water, don’t eat junk, don’t attend events with a lot of people. Social distancing means not attending events with lots of people. This covers everything from concerts and other entertainment to church and other weekly gatherings.
Coronavirus Covid-19 is Going to Mess Things Up for While: The Upshot
This virus is going to affect everything, from our day to day lives to global trade and markets. There’s not much we can do about the big picture stuff, but you can be personally prepared and make good decisions.
So here are your takeaways.
- Follow the CDC recommendations: this links to the CDC website. https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html
- If your male partner gets severely sick, track how is sperm count is doing; consider sperm DNA fragmentation to make sure his DNA is ok, especially if you are doing IVF
- If you get severely sick, consider delaying TTC naturally or IVF until you are fully recovered, so your body will be able to give your eggs what they need.
- If you are pregnant, you are immune compromised. Protect your baby and stay out of crowd situations that are more likely to pass on the virus.
Wash your hands, take care of yourself, and do what you can to stay healthy.
Love, Dr. Lisa
Virus: Image by Arek Socha
Sick Woman and Bear by Image by Alexandr Litovchenko
Breathing Woman Image by Image by Alfonso Cerezo