While medicine may have expanded fertility options, it can feel like there are so many more decisions to make about when to start a family or how to preserve fertility. If you’re wondering: should I freeze my eggs? you’ve come to the right place. Make sense of egg freezing and why it might be an option to consider.

What Is egg freezing?

Known in official medical circles as mature oocyte cryopreservation (OC), egg freezing is the process by which a doctor takes eggs (oocytes) from your ovaries. These eggs can then be frozen and stored until you decide you’re ready to use them. At that point they are thawed, mixed with sperm in a laboratory, and re-inserted into your uterus (womb) through your cervix, hopefully leading to pregnancy.

Who’s freezing their eggs in the U.S.?

Nationally, the number of egg freezing cycles increases every year. The Center for Disease Control (CDC) reports there were more than 22,000 egg freezing cycles in 2019, up from around 18,000 in 2018 and 14,500 in 2017.

• It’s becoming more common for people under the age of 35 years to preserve their fertility through egg freezing.
• White patients freeze their eggs more than people of color, although more minority groups are freezing their eggs, especially Asian women.
• University-educated or professional people are more likely to pursue elective egg freezing.

Why might you want to freeze your eggs?

People choose to press pause on becoming a parent or growing their family for many reasons. Elective egg freezing is now safer, more affordable, and more common. Some of the reasons people give for choosing electively to freeze their eggs include:

• Not being in a relationship with a partner they want to parent with 
• Wanting to be financially stable before starting a family
• Working in a demanding career where being pregnant could come at a professional cost
• Having access to employer-subsidized egg freezing benefits

Other people may turn to egg freezing because they have a medical condition that threatens their future fertility. One out of five women in one study reported choosing egg freezing because of underlying health conditions. Women and their health care providers may consider egg freezing if they:

• Have a condition impacting fertility such as sickle cell anemia, autoimmune diseases such as lupus, or premature ovarian failure
• Have a cancer diagnosis or other illness and need to receive chemotherapy or radiation that could harm their ovaries

Egg freezing also helps LGBTQ+ people keep their parenting options open. Gender-affirming surgery or medical treatments can limit fertility so some transgender men choose egg freezing before beginning their transition.

When should I freeze my eggs?

According to the American Society of Reproductive Medicine (ASRM), elective egg freezing is most successful for women younger than 38 years. The more eggs you can harvest and freeze, the better your chances for pregnancy down the road. As you get older, it gets harder to harvest enough high-quality eggs. Here’s what the science tells us:

• Egg quality peaks between 16 and 28 years old
• Women in their mid-reproductive years (29 to 37 years old) produce enough high-quality eggs to make egg freezing cost effective
• People who freeze their eggs before age 34 have the highest overall live birth rates.
• One 2015 study found that the biggest difference in live birth rates between people who did and didn’t freeze their eggs was at age 37. At younger ages, the differences in live birth rates in people who did and did not freeze their eggs were smaller.
• There is little benefit (no comparative increase in the number of live births) for women ages 25-30 to freeze their eggs

From a straight biological perspective, the younger you are when you freeze your eggs, the better your chances for good egg quality and number harvested.

Egg freezing and deciding what’s right for you

Decisions about fertility and parenting are individual and personal — egg freezing is no different. It can be helpful to think of egg freezing as an insurance plan rather than a guarantee for a baby. It is a way to increase your chances of being able to be a parent, without being limited by your biological clock or life circumstances. That said, it can be very expensive and so is not a good option for everyone.

Reviewed by the Ovia Health Clinical Team

Read more:

• Egg freezing step by step
• Egg freezing FAQ

Sources 

• Katler QS, Shandley LM, Hipp HS, Kawwass JF. National egg-freezing trends: cycle and patient characteristics with a focus on race/ethnicity. Fertil Steril. 2021 Aug;116(2):528-537. doi: 10.1016/j.fertnstert.2021.02.032. Epub 2021 Mar 30. PMID: 33795141.
• Inhorn MC, Birenbaum-Carmeli D, Birger J, Westphal LM, Doyle J, Gleicher N, Meirow D, Dirnfeld M, Seidman D, Kahane A, Patrizio P. Elective egg freezing and its underlying socio-demography: a binational analysis with global implications. Reprod Biol Endocrinol. 2018 Jul 23;16(1):70. doi: 10.1186/s12958-018-0389-z. PMID: 30037349; PMCID: PMC6056999.
• Mayo Clinic Staff. “Egg Freezing.” Mayo Clinic. Mayo Foundation for Medical Education and Research. April 23, 2021. https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556. 

• “Assisted Reproductive Technology (ART) National Data.” Centers for Disease Control and Prevention (CDC). CDC. 2019. https://nccd.cdc.gov/drh_art/rdPage.aspx?rdReport=DRH_ART.ClinicInfo&ClinicId=31&ShowNational=0. 
• Kylie Baldwin, Lorraine Culley, Nicky Hudson & Helene Mitchell (2019) Running out of time: exploring women’s motivations for social egg freezing, Journal of Psychosomatic Obstetrics & Gynecology, 40:2, 166-173, DOI: 10.1080/0167482X.2018.1460352
• Amato, Paula. “Fertility Options for Transgender Persons.” UCSF Transgender Care. University of California, San Francisco. June 17, 2016. https://transcare.ucsf.edu/guidelines/fertility. 
• “Can I Freeze My Eggs to Use Later If I’m Not Sick?” ReproductiveFacts.org. American Society for Reproductive Medicine. 2014. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/can-i-freeze-my-eggs-to-use-later-if-im-not-sick/. 
• Mesen, Tolga B et al. “Optimal timing for elective egg freezing.” Fertility and sterility vol. 103,6 (2015): 1551-6.e1-4. doi:10.1016/j.fertnstert.2015.03.002

Step 1: Choosing your fertility clinic or doctor

The American Society for Reproductive Medicine (ASRM) suggests scheduling a consultation with prospective fertility clinics to ask about their egg freezing methods, success rates, costs, storage, and policies for disposing of unused eggs. Most importantly, you should choose a doctor you feel comfortable with and trust. 

Step 2: Your baseline fertility evaluation

Once you choose your doctor, you will have several appointments and evaluations. These include appointments for:

1. Consultation with your fertility doctor (aka reproductive endocrinologist)
2. Transvaginal ultrasound to count the number of eggs (follicles) on your ovaries. (If this baseline testing is encouraging, you might decide to opt out of egg freezing completely or to delay egg harvesting.) 
3. Blood test examining your fertility hormones
4. Follow-up appointment several weeks later to review lab test results and your ovarian stimulation protocol

Ovarian stimulation protocol is the name for the sequence of medications you will give yourself over the next 3 to 4 weeks to stimulate your ovaries to produce multiple mature eggs.

Step 3: Ovarian stimulation

In a normal monthly cycle, your ovaries form multiple fluid-filled sacs called follicles, but only one mature egg, which your ovaries release when you ovulate.

Ovarian stimulation medications mimic your natural menstrual hormones (estrogen and progesterone), but fool your ovaries into growing multiple mature eggs simultaneously.

Most of the medications used for ovarian stimulation must be injected with a needle. You or your partner or family member can do this. You will have another appointment with a nurse to review the medicines, how to mix them and inject them, and to review the timeline and plan for your egg retrieval process.

Where you are in your cycle, timing, and the results of your fertility evaluation determine the best protocol for you. Here is a typical ovarian stimulation protocol and commonly-used medications:

1. A short course (1-2 weeks) of birth control pills, estrogen, Lupron, or Aygestin (a form of progesterone) before starting injections. 
2. Self-administered hormonal injections medications for the next 9-12 days. The injections will most likely be some combination of follitropin alfa or beta (Follistim AQ, Gonal-f) or menotropins (Menopur) to stimulate your ovaries.
3. Hormonal injections on days 9-12 to prevent your ovaries from releasing an egg too soon. Medications could include leuprolide acetate (Lupron) or cetrorelix (Cetrotide).
4. A trigger shot 36-37 hours before your scheduled retrieval procedure time to complete the “ripening” of your eggs. These injections are usually Lupron (leuprolide acetate) or hCG (human chorionic gonadotropin), sold as Ovidrel or Novarel. 

The purpose of the first 1-2 weeks of medications is to help align your follicles so they all start maturing simultaneously.

During days 9-12 of the fertility injections, you can expect to have 5-7 monitoring appointments with blood tests and vaginal ultrasounds to evaluate your response to the medications. These appointments typically take about 30 minutes.

Step 4: Egg harvesting

Your doctor will schedule your egg harvesting or egg retrieval appointment once ultrasounds and bloodwork show that you have enough mature eggs. Egg retrieval is usually 9-12 days after starting the fertility injections in a typical cycle.

The actual harvesting procedure only takes about 15 minutes and is not painful. You will be given anesthesia and pain medication to keep you comfortable and very briefly asleep (conscious sedation). Next, your doctor will use ultrasound to safely direct a special suction needle through your vagina to remove mature eggs from your ovaries.

Clinics usually monitor you for one to two hours after the procedure before sending you home to rest. Plan on taking the rest of the day off from work and avoid heavy lifting or intense exercise for the next week to protect your ovaries.

Step 5: Flash freezing your eggs

After harvesting, your eggs are quickly frozen in a process called vitrification. Vitrification prevents harmful ice crystals from forming and results in higher egg freezing success rates. Eggs will be stored at subzero temperatures until you are ready to use them.

Once you’re awake, your care team should tell you how many eggs they retrieved. It will probably take 24 hours to know how many mature eggs were frozen.

When the time is right, your eggs can be thawed, and hopefully fertilized with sperm in a lab, and implanted in you or a gestational carrier’s uterus through in vitro fertilization (IVF).

Step 6: Live your life and plan your future fertility

The decision to freeze your eggs is as complicated as all the steps in the egg freezing process. Egg freezing can offer you more options, but it does not guarantee you a future baby. If you have more questions about the egg freezing process, head over to our FAQ. 

Reviewed by the Ovia Health Clinical Team

Read more

• Should I freeze my eggs
• Egg freezing FAQ

Sources

• “Transvaginal Ultrasound: Medlineplus Medical Encyclopedia.” MedlinePlus. U.S. National Library of Medicine. April 1, 2022. https://medlineplus.gov/ency/article/003779.htm. 
• Mayo Clinic Staff. “Egg Freezing.” Mayo Clinic. Mayo Foundation for Medical Education and Research. April 23, 2021. https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556.

When should I freeze my eggs?

According to the American Society of Reproductive Medicine (ASRM), elective egg freezing is most successful for women younger than 38 years. Elective egg freezing is when you voluntarily choose to freeze your eggs as a type of insurance plan against natural aging — not because you have a medical condition such as cancer that might harm the eggs in your ovaries (called oocytes).

With age, the likelihood of problems with the chromosomes inside your eggs increases. Chromosomes are the building blocks of your DNA or genetic information. Egg freezing allows you to use “younger” eggs when you want to get pregnant. With age, there are:

• Higher rates of infertility
• Fewer eggs can be harvested
• Lower IVF success rates
• Increased rates of miscarriage
• Higher rates of congenital disabilities
• Higher-risk pregnancies for people who are pregnant when they are older than 35 increase

People who freeze their eggs before age 34 have the highest overall live birth rates. So, while egg freezing does help you slow down your biological clock, you can not push pause forever. Data from fertility centers indicate that most women 38 and younger can expect to harvest 10-20 eggs per cycle. The more eggs your doctor can collect, the higher your chances of a successful live birth. So, the ideal window for egg freezing is somewhere between 34-38 years old.

How much does egg freezing cost?

You can expect to pay $30,000-$40,000 to freeze your eggs. The average cost per cycle of just the medical procedure (harvesting) ranges between $10,000-$20,000. It will cost $500-$600 per year to store your eggs.

Costs will increase or decrease depending upon how many cycles you need to do to freeze the recommended number of eggs (usually around 10). The average person must go through about two cycles to reach this number. The older you are, the more likely you will need multiple cycles, and your medication costs may increase. 

Some commercial health insurance plans will cover the cost of some of the prescription medications used to stimulate your ovaries. However, without any insurance coverage, drug costs can run $2,000-$5,000 per cycle.

Where you live in the country can impact how much egg freezing will cost you, and costs vary even city by city within the same state. If you live far from medical centers, lost wages due to medical appointments and transportation costs can add up quickly.

Employer-financed egg freezing or fertility benefits changed many people’s financial calculus for egg freezing. As of 2020, about one out of every five (20 percent) US companies offered coverage for egg freezing. Apple and Facebook pay their employees up to $20,000 for egg freezing.

Egg freezing costs do not include the cost of thawing and implantation via in vitro fertilization (IVF), which as of 2019, ranged from $10,000-$15,000 per IVF cycle, according to the Society for Assisted Reproductive Technology (SART). Some people will also need to factor in the potential purchase of donor sperm (around $1,000), other assisted reproductive technologies (like assisted hatching or ICSI treatment), or embryo freezing ($200-$800 annual storage fee).

How long does the egg freezing process take?

One egg freezing cycle takes approximately 3-4 weeks. This includes:

• 1-2 weeks of birth control pills or other medication to temporarily turn off your natural hormones
• 9-10 days of hormone injections to stimulate your ovaries and ripen multiple eggs.

During the ten or so days of hormone injections, you will have to make frequent visits (usually at least five appointments in ten days) to your fertility clinic or doctor for vaginal ultrasounds to monitor your eggs and find the right time for harvesting.

The actual egg retrieval procedure takes only about 15-30 minutes, however, you will need to spend several hours after your retrieval at your clinic for observation before you can head home. People report that they usually can return to work and other normal activities within 1-2 days.

It takes most people 2-3 cycles to harvest the recommended 10-20 eggs for freezing. So, depending on your baseline fertility, age, and response to the ovulation stimulation medications, you can count on your egg freezing endeavor taking somewhere between 9-12 weeks, best case scenario.

Is egg freezing safe?

The actual procedure to harvest your eggs is a very low-risk surgical procedure. Egg harvesting carries about the same amount of risk as undergoing IVF. Surgical procedures like egg harvesting and IVF have small risks such as:

• Problems with the anesthesia (the medicines used to put you to sleep for the procedure)
• Injury from the needle passing through your vaginal wall to remove the eggs from your ovary
• Infection after the surgery

The main risks associated with egg freezing come from the regimen of fertility medications you take before egg harvesting (the ovarian stimulation protocol). These medications send your ovaries into overdrive, stimulating multiple eggs to develop simultaneously.

Fertility medications can cause something called ovarian hyperstimulation syndrome (OHSS). If the medicines over-stimulate your ovaries, they can swell, become painful, and cause fluid to build up in your belly, making you nauseous and bloated. One out of three women has symptoms of mild OHSS during controlled ovarian stimulation, but very few women go on to develop severe OHSS, which requires hospitalization.

Egg freezing also carries the emotional risk of undergoing a complicated and uncertain medical procedure. Many fertility medications can cause mood changes. The stress of navigating complex medication injections, multiple doctors’ appointments, and the unpredictability of the results can take a mental toll.

Navigating fertility or infertility can have psychological, financial, and socio-cultural consequences and it’s essential that you look out for your mental wellbeing. 

How many eggs should I store?

This calculation is based upon the biological reality that not every egg makes an embryo, not every embryo makes a pregnancy, and not every pregnancy makes a baby. Eggs are lost at each stage, from thawing, to fertilization, to development into an embryo, to transferring the embryo into a womb. And so, the chance that a single frozen egg will lead to a live birth is about 2 to 12 percent, according to the American Society for Reproductive Medicine. 

So what is the magic number? Fertility experts and clinics worldwide seem to land on the number ten. Research shows you may expect to retrieve about 14 mature eggs on average if you’re 36 and under, about ten if you’re 37-39, about nine if you’re 40-42, and about seven if you are 43 or older.

How long can eggs stay frozen?

Babies have been born from eggs frozen for as long as 14 years. Most people store eggs for five to 10 years. In vitrification, scientists remove the fluid from your eggs and replace it with a chemical version of antifreeze that increases successful fertilization, implantation, and live birth rates.E mbryos do tend to thaw better than unfertilized eggs. If there is a partner in the picture or already a plan to use donor sperm, it’s worth considering freezing embryos. It’s possible to do a mix of both embryos and unfertilized eggs.

The bigger time limits on egg freezing are age and the cost of storage. As people become older (in their 40s and 50s), IVF success rates decline, and they are at higher risk for miscarriage and other pregnancy complications. The chance of becoming pregnant after implantation is roughly 30 to 60 percent, depending on how old you are when you freeze your eggs. Some people opt for a surrogate, which carries a separate set of considerations and costs. 

Your egg freezing decision

The decision to freeze your eggs can seem almost as big as deciding whether you want to become a parent. Egg freezing is one option that can buy you some time as you consider parenthood. However, it’s not for everyone. If you’re in the process of making this decision, speak with your provider for guidance and to your community for support. 

Reviewed by the Ovia Health Clinical Team

Read more

• Should I freeze my eggs
• Egg freezing step by step

Sources

• Mesen, Tolga B et al. “Optimal timing for elective egg freezing.” Fertility and sterility vol. 103,6 (2015): 1551-6.e1-4. doi:10.1016/j.fertnstert.2015.03.002. 
• Cil AP, Bang H, Oktay K. Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis. Fertil Steril. 2013 Aug;100(2):492-9.e3. doi: 10.1016/j.fertnstert.2013.04.023. Epub 2013 May 24. PMID: 23706339; PMCID: PMC3888550.
• “Cost of Egg Freezing.” USC Fertility. University of California, San Francisco. January 27, 2019. https://uscfertility.org/egg-freezing/cost/. 
• Carnegie, Megan. “More Companies Offer Fertility Benefits. It’s Only the Beginning.” Wired. Conde Nast. December 1, 2021. https://www.wired.com/story/fertility-benefits-work/. 
• “Frequently Asked Questions.” SART. Society for Assisted Reproductive Technology, https://www.sart.org/patients/frequently-asked-questions/. 
• “Ovarian Hyperstimulation Syndrome (OHSS).” Reproductive Facts. American Society for Reproductive Medicine. 2014. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/ovarian-hyperstimulation-syndrome-ohss/. 
• Kumar, Pratap et al. “Ovarian hyperstimulation syndrome.” Journal of human reproductive sciences vol. 4,2 (2011): 70-5. doi:10.4103/0974-1208.86080. 
• Hasanpoor-Azghdy, Seyede Batool et al. “The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study.” Iranian journal of reproductive medicine vol. 12,2 (2014): 131-8.
• Vaughan DA, Leung A, Resetkova N, Ruthazer R, Penzias AS, Sakkas D, Alper MM. How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one-and-done approach. Fertil Steril. 2017 Feb;107(2):397-404.e3. doi: 10.1016/j.fertnstert.2016.10.037. Epub 2016 Dec 1. PMID: 27916206.
• R.H. Goldman, C. Racowsky, L.V. Farland, S. Munné, L. Ribustello, J.H. Fox, Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients, Human Reproduction, Volume 32, Issue 4, April 2017, Pages 853–859, https://doi.org/10.1093/humrep/dex008
• Mayo Clinic Staff. “Egg Freezing.” Mayo Clinic. Mayo Foundation for Medical Education and Research. April 23, 2021. https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556. 
• “Can I Freeze My Eggs to Use Later If I’m Not Sick?” ReproductiveFacts.org. American Society for Reproductive Medicine. 2014. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/can-i-freeze-my-eggs-to-use-later-if-im-not-sick/. 

hCG level testing

About 10 days after your transfer, your doctor will have you come in for a blood test to check your human chorionic gonadotropin (or hCG) levels. hCG levels rise when an embryo implants in the uterus and a blood test can typically detect the hormone before at-home urine pregnancy tests. hCG levels below 5 mIU/mL are considered negative for pregnancy. Anything between 6-24 mIU/mL is a gray area, which could indicate a biochemical pregnancy, a type of early pregnancy loss. 

Research suggests that pregnancies with hCG levels that reach at least 100 mIU/mL within 10 days of a five-day transfer or 12 days following a three-day transfer are the ones most likely to result in a successful pregnancy. Although high hCG levels are typically a more promising sign, rising hCG levels are more important than the initial number. Your fertility clinic will want to check your hCG levels every few days, and then weekly, to make sure the levels continue to double every 48 hours.

The ultrasound

You will have your first ultrasound when you are five weeks pregnant to confirm that there is a gestational sac — a fluid-filled body containing the embryo. Then, when you’re six weeks pregnant, you’ll return for another ultrasound, this time where you’ll be able to hear the baby’s heartbeat. Later, toward the end of your second trimester, you’ll have a full anatomy scan, taking a detailed look at baby from head to toe. 

Graduating from the fertility clinic

Fertility clinics typically monitor IVF pregnancies up until weeks eight to ten of pregnancy. During this time, you will be prescribed progesterone suppositories or injections. Studies show that progesterone increases the pregnancy rate following IVF and helps decrease the risk of miscarriage. Once you graduate from your fertility clinic, you will see your obstetrician At a traditional schedule with several weeks between appointments. Though this can be nerve-racking, especially considering how closely your fertility clinic monitors you, it’s the normal schedule of appointments. If you have a high-risk pregnancy due to a health condition or a history of pregnancy loss, you may have more frequent appointments. 

It can be hard to feel calm after getting pregnant using IVF, even after you reach your second and third trimesters. Your road to parenthood might not look like what you expected, and that’s OK. You worked hard for this pregnancy, so you deserve to enjoy it. If the fear of pregnancy loss feels all-encompassing, try opening up about these complicated feelings to a friend, trusted loved one, or mental health professional. It’s important to take time to celebrate each milestone, no matter how small. The IVF process takes away some of the big firsts, like the randomness of a positive at-home pregnancy test, or, for some, being surprised by the sex of the baby, but that doesn’t mean you can’t make your own unique memories. 

Reviewed by the Ovia Health Clinical Team

Sources

• American Society for Reproductive Medicine. “Progesterone Supplementation During In Vitro Fertilization (IVF) Cycles.” https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/progesterone-supplementation-during-in-vitro-fertilization-ivf-cycles/.
• Coomarasamy, Arri, Adam J. Devall, Jan J. Brosens, Siobhan Quenby, Mary D. Stephenson, Sony Sierra, Ole B. Christiansen et al. “Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence.” August 2020 https://pubmed.ncbi.nlm.nih.gov/32008730/.
• King, N., L. A. Bernardi, J. Tolentino, J. Zhang, A. Lawson, and R. B. Barnes. “Serum HCG values are as predictive of live birth after single embryo transfer as early pregnancy ultrasound.” November 2017. https://www.fertstert.org/article/S0015-0282(17)31536-4/pdf.

Dear Ovia, My husband and I have been trying for a third kid for the last year and a half. He wants to stop trying and says it’s taking away from us appreciating the beautiful babies we do have. But I’ve always dreamed of a big family and I don’t feel ready to give that up. 

First of all, secondary infertility isn’t something we talk about enough — and I hope this answer helps you know for certain that you’re not alone! 

So many families hesitate to talk about fertility struggles. And when you’re already parents you may feel the social pressure to just be grateful for the kiddos you have (which I am sure you are!). I’m here to tell you that feeling like there is an empty seat at your family’s table is a valid feeling whether you have 0, 1, 2, 3 or 9 children. The tough part is that you’re both having valid feelings — and they’re not the same. There may be middle ground in taking a break from TTC for a period of time or continuing to try for “X” number of months before starting a break. 

At the end of the day, it sounds like expanding your family is something that would make you both happy if it could happen with the wave of a wand. So, try to focus your conversations with him around the challenges of the journey (the process of TTC), rather than the destination (the decision to have another baby).

In any case, you need an ongoing and open dialogue, but it can be hard to find a good and private time to talk (especially when you have other children in the house). It’s common for people to either avoid tough subjects or to bring them up at times that are not conducive to conversation (like when you’re getting into bed). 

If you’re avoiding the conversation or one of you is bringing it up at less-than-ideal times, it’s essential that you create a space where you can both actively listen to each other. Try scheduling some time to talk, that way you can both come to the conversation prepared to share and listen. 

Having a disagreement hanging over your heads makes the whole situation more stressful.

Some tips:

• Avoid talking about it before bed when everyone is tired and sex is on the table. 
• Sometimes a drive is helpful because you have a little bit of emotional distance, can break endless eye contact, and sex is (usually) off the table. 
• Agreeing on how to move forward may take more than one discussion, but it should be simple to make a plan for more chats. Breathe, you’ve got this. 
• Fertility journeys start, pause, and end for a variety of reasons, and it often takes a toll. It’s always okay to look for more support from family, friends, or professionals. 

More from this series

• Dear Ovia, My partner isn’t sure if he wants kids
• Male fertility testing

What you can control

Timing of intercourse or introducing sperm

Making a baby is all about timing and, thankfully, you have control over how often and when you have sex or introduce sperm. Checking your cervical fluid and tracking your basal body temperature can help you know when you are ovulating to maximize your chances of success. For couples TTC through intercourse, the highest rates of pregnancy happen for those who have sex every day or every other day during the fertile window, which is the day of ovulation plus the 5 days beforehand. 

Your health

Having a healthy body is important overall, and it’s no different for baby making. This goes for your partner too. Having healthy habits such as eating nutritious food and integrating movement into your day can help prime your body for when you finally do get that positive test. Cutting down on alcohol and caffeine, avoiding smoking, and taking a folic acid supplement can help in your efforts to get pregnant.

Your mindset

It’s common to feel sad or frustrated when you’ve been TTC for a while with no results. Even if it’s taking a little longer than expected, with practice you can aspects of how you think about the situation. Staying relaxed and having a positive attitude can help make the process a little easier. And if you just rolled your eyes, we hear you. There are some specific things you can do to improve your mindset like talking to a therapist and setting boundaries around work. Even spending time outside has been shown to increase happiness.

Things you can’t control

How long it will take

Although it would be nice to have a crystal ball and know exactly when conception will happen, unfortunately there’s just no way to know for sure. Studies show that most couples (about 84%) will get pregnant within their first year of trying. This is reassuring, but of course, every person is different. Some may get pregnant on their first try while others may take 6 months or more.

Your fertility

Having a condition that affects fertility is not your fault. About 12% of women ages 15- 44  have difficulty getting pregnant or carrying a pregnancy to term. And even though it’s common, struggling to conceive can feel extremely isolating. It’s essential that you have a support system and/or a professional to speak with. 

When your friends get pregnant before you

When you’ve been TTC with no luck, hearing of a friend’s pregnancy can be bittersweet. Of course, you’re happy for your friend, but you may also feel a sense of sadness. Acknowledging your feelings, focusing on self-care, and remaining optimistically realistic can all be helpful in moving forward.

Reviewed by the Ovia Health Clinical Team

Sources

Mayo Clinic Staff. “How to get pregnant.” Mayo Clinic. Mayo Clinic. October 5, 2019. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/how-to-get-pregnant/art-20047611.

“Trying to get pregnant.” National Health Service. NHS. December 2, 2020. https://www.nhs.uk/pregnancy/trying-for-a-baby/trying-to-get-pregnant/.

“How long does it usually take to get pregnant?” National Health Service. NHS. September 4, 2018. https://www.nhs.uk/pregnancy/trying-for-a-baby/how-long-it-takes-to-get-pregnant/.

Ever wondered, “What’s the difference between an STI and STD”, “Is HIV the same as AIDS” or “What’s a finger condom”? Rather than taking the query to your search bar, keep reading.

What you should know about sexually transmitted infections (STIs)

Below, you’ll find definitions of all the terms in the sexually transmitted infection lexicon you could possibly need to know, broken down by categories.

First, what’s the difference between an STI and STD

STD: STD stands for sexually transmitted disease. Disease implies symptoms. So, sexually transmitted infections are only diseases when there are symptoms (for example: bumps, itching, or discharge) present.

STI: The now-preferred term in the sexual health space, STI stands for sexually transmitted infection. The switch from disease to infection took place to reduce stigma around these infections and to acknowledge the fact that the majority of these infections are asymptomatic.

All STIs are either curable or treatable

Curable: A curable STI is an STI that can be cleared up completely with the proper medication. Curable STIs include: gonorrhea, pubic lice, chlamydia, syphilis, and trichomoniasis.

Not only can curable STIs be cured, but they should be — leaving an STI untreated puts you at risk for things like pelvic inflammatory disease, infertility, and even death in the case of syphilis. That’s why it’s so important to get tested after every new sexual partner. And, if positive to talk to your provider and come up with a cure plan.

Treated: STIs that cannot be cured can be treated. Meaning, the symptoms associated with that STI can be managed with the help of lifestyle changes, and/or medication. Treatable STIs include: HIV, HSV, and HPV.

An example of treating — but not curing — an STI, might include taking valacyclovir or acyclovir, an oral antiviral medication that can either be taken daily (suppressive therapy) or at the first sign of outbreak (intermittent therapy). What makes most sense for you will depend on factors like cost and frequency of outbreaks. Because research has suggested a link between the number of outbreaks in HSV-positive people and stress, managing stress levels is another example.

Types of sexually transmitted infections, explained

AIDS: Also known as HIV Stage 3, AIDS (acquired immunodeficiency syndrome) develops when the HIV virus severely damages a person’s immune system.

In the U.S., most people who are HIV-positive never develop AIDS because they’re on medications that prevent the infection from progressing to AIDS. Due to lack of access, globally AIDS is much more common, but numbers are dropping.

Chlamydia: Caused by a bacteria, chlamydia is a curable STI that infects 4 million Americans each year, the majority of who are under 25 and women.

When symptoms appear, they usually include abnormal discharge, pain or frequent urination or bleeding after sex and/or between periods — but chlamydia is usually asymtomatic. The infections and accompanying symptoms can be cured up with proper antibiotics.

Crabs: Also known as pubic lice, crabs are itty-bitty parasites that feast on blood that are found on pubic hair (and other course body hair). Typically, crabs are transmitted during intimate contact between the pubes of a person with crabs and the pubes of someone else.

The most common symptoms of crabs is genital itching, but you may also be able to see the white-colored, micro-crabs crawling around between your legs. Crabs can be cured through special over-the-counter creams or shampoos. Important: Because crabs lay eggs (known as nits), after treatment then nits need to be removed with fingernails or comb.

Genital Warts: Genital warts are fleshy skin tags caused by a few strains of HPV (see “HPV” below). These contagious warts may be accompanied by itchiness, but can be treated with topical medication or by being removed by a healthcare provider.

Gonorrhea: Also caused by bacteria and also curable, gonorrhea is an infection responsible for half a million new STI cases in the United States each year.

Much like chlamydia, gonorrhea is hard to recognize due to its often asymptomatic nature. But, when symptoms do pop up they usually include: genital itching, bleeding, abdominal pain, abnormal genital discharge, and soreness and sore throat. To diagnose and get the medicine that will eliminate the infection from your body, go to your local walk-in clinic or healthcare provider.

HIV

Short for human immunodeficiency virus, HIV is a viral infection that attacks the body’s immune system making it hard for the body to fight any other infection, including common, everyday viruses. Wrongly known as a gay man’s virus, HIV is an STI that can affect all people.

Hepatitis A

A contagious viral liver infection caused by the Hepatitis A virus, Hepatitis A typically clears up on its own within a few months. Hepatitis A is not just sexually transmitted — it can also be transmitted through contaminated foods.

Hepatitis B

Hepatitis B is a contagious viral liver infection caused by the Hepatitis B virus that can be transmitted via exposure to the bodily fluids of an infection person. The difference between this form of Hepatitis, however, and the others is that Hepatitis B can be prevented with a vaccine.

Hepatitis C

Hepatitis C is a viral liver infection that can be spread through blood, breast milk, or pregnancy. Untreated, the infection can become life-threatening. But diagnosed and with proper treatment, the infection can be cured 90 percent of the time.

HPV

With more than 100 different strains, human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Symptoms, long-term health risks, and treatment vary strain-by-strain.

HSV

Better-known by its full name, herpes, HSV is a lifelong viral infection caused by the herpes simplex virus that can be managed with proper care.

There are two distinct strains of the herpes infection: HSV-1 and HSV-2. Often, these are incorrectly re-named as “oral herpes” or “genital herpes” but both strains can affect areas like the vagina, anus, penis, or mouth.

Molloscum Contagiosum

Molloscum contagiosum is a viral infection spread through skin-to-skin contact, that causes benign bumps along infected areas. Sometimes the bumps will fade away on their own, other times they are removed through cryotherapy, laser therapy, or topical therapy with the help of  a healthcare professional.

Trichomoniasis

Often called “trich”, trichomoniasis is a sexually transmitted infection caused by a parasite that can be cured with a dose of antibiotics. Symptoms are trichomoniasis are rare — especially in people with penises. But when symptoms do appear, they often include discharge, genital itching, and pain while urinating.

Syphilis

Syphilis is a progressive bacterial infection spread through sexual contact. The symptoms of the infection vary based on how long it’s been in your system, and range from a skin sore to fatigue and fever to liver dysfunction. If caught early enough it can be cured with a single shot of penicillin, but left untreated for too long the infection can spread to the brain and other organs, becoming life threatening.

Barrier methods and birth control

Here’s some information on protection options people can apply to help stay safe during sex.

Barrier

Barrier is the general terms for a physical barrier that is designed to prevent direct skin-to-skin contact or fluid exchange during a sex act. Most common is the external condom. But there is also the internal condom, dental dam, glove, and finger condom.

Occasionally, certain birth control methods which do not prevent skin-to-skin contact or fluid exchange, but are highly effective at preventing a sperm from meeting an egg during vaginal intercourse — the sponge, cervical cap, diaphragm, and spermicide — are also qualified as a barrier.

Birth Control

Also known as contraception, birth control is designed to help prevent unwanted pregnancy. There’s a variety of different types of birth control options, which all function differently as well as feature  slightly different levels of effectiveness.

Condom

There are a few different types of condoms: finger condoms, internal condoms, and external condoms. But typically when people say “condom” they’re referring to the external variety. (See: “external condom” below).

Dental Dams

Dental dams are sheaths of latex designed to prevent direct contact between a mouth and an anus or vagina, and therefore reduce the risk of STI transmission.

External Condoms

External condoms are tight latex, polyurethane or polyisoprene tubes designed to go over a penis during vaginal, anal, or oral intercourse to protect against STI transmission and/or pregnancy. They are also often used on dildos and other pleasure products to increase ease during clean-up as well as to allow for sex-toy sharing between non-fluid-bonded partners.

Finger Cots

Sometimes called finger condoms, finger cots are micro-sized external condom designed to fit over a single digit. While most commonly worn by doctors sporting paper cuts, they can also be warn during vaginal or anal fingering to keep from or reduce the risk of STI transmission.

Fluid Bonded

Refers to sexual partners who have intentionally decided to forgo barriers and exchange bodily fluids during sex. Prior to becoming fluid-bonded, sexual partners typically discuss current STI status, potential risks, pregnancy prevention (if applicable), as well as relationship rules moving forward.

Internal Condoms

Formerly known as female condoms, internals condoms are soft, long tubes that are designed to line the vaginal or anal canal in order to prevent fluid exchange or skin-to-skin contact during vaginal or anal sex. Bonus: They are typically made out of nitrile as opposed to latex, making them a great alternative for those with latex allergies.

PEP

Post-exposure prophylaxis is a series of pills someone who was (or may have been!) exposed to HIV can begin taking up to 72 hours after exposure to prevent transmission of the virus.

PrEP

Pre-exposure prophylaxis, as the prefix suggests, is a daily oral medication that can be taken by an HIV-negative person at risk of coming into contact with the virus, in order to greatly reduce the risk of the virus being transmitted.

Reviewed by the Ovia Health Clinical Team

Sources

• “Chlamydia – CDC Fact Sheet (Detailed).” January 19, 2021. Centers for Disease Control and Prevention (CDC). CDC. January 19, 2021. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm.
• Cohen F, Kemeny ME, Kearney KA, Zegans LS, Neuhaus JM, Conant MA. Persistent Stress as a Predictor of Genital Herpes Recurrence. Arch Intern Med. 1999;159(20):2430–2436. doi:10.1001/archinte.159.20.2430. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485171.
• “Sexually Transmitted Diseases.” National Institute of Allergy and Infectious Diseases. NIH. August 6, 2015. https://www.niaid.nih.gov/diseases-conditions/sexually-transmitted-diseases.

By Gabrielle Kassel, Contributing writer

PSA: Sexually transmitted infections are not the only infections that can make home in or on your genital area. Yeast infections, bacterial vaginosis, and urinary tract infections are all totally curable infections that can people can get, even if they’ve never ever had sex. Really!

Important things to consider about genital infections

Read on to learn more about the three types of infections — including intel on how they differ from sexually transmitted infections also found in genital areas.

What is a urinary tract infection?

A urinary tract infection takes place when bacteria (usually E. coli) gets lodged in the urethra, occasionally traveling up the urinary tract to the bladder and/or kidneys.

What causes UTIs, exactly? Anytime outsider bacteria gets introduced to the urethra, there’s risk for infection. This could happen in a number of ways, including through sex. A UTI could also be caused from bacteria from the anus being brought forward towards the urethra, for example while wiping or during sex.

While people of all genitals can get UTIs, urinary tract infections are far more common in those with vaginas than penises because the urethra is so much shorter. This means that the distance the bacteria has to travel in order to get to the bladder is shorter, increasing the odds that the infectious agent makes it to the infection-site.

Common symptoms include:

• Frequent urination
• Pain or discomfort while urinating
• Urine that is cloudy or pink in color
• Lower abdominal or pelvic pain or cramping
• Rectal pain

A UTI can be diagnosed with a quick urine sample — for more information on how to properly collect a urine same, head here. If tested-positive, your healthcare provider will prescribe a round of antibiotics which will begin to clear the infection up in as little as 24 to 72 hours. The type of antibiotics will vary based on the type of bacteria found in the sample, as well as the location (urethra, bladder, or kidneys) of the infection.

What is a yeast infection?

Also known as candidiasis, a yeast infection occurs when there is an overgrowth of the fungi “candida” in the body.

Anybody can get a yeast infection. But those with vaginas are far (far!) more likely to be infected — nearly 75% will have a yeast infection at least once in their lifetime. Less than 1% of those with pensises will get a yeast infection in their lifetime.

The health of the internal canal of the vagina is regulated by something called the vaginal microbiome which is made up of millions of bacteria, yeast, and fungi that work the vagina’s bodyguard and janitorial staff, keeping the it clean while also warding off infectious pathogens.

When the vaginal microbiome becomes disrupted — which can occur from a variety of things including antibiotic use, pregnancy, uncontrolled diabetes, sitting in wet or sweaty clothes, oral contraceptives, interaction with another person’s natural genital bacteria, or use fragrant body washes — the owner becomes susceptible to a yeast infection.

Common symptoms include:

• Cottage-cheese-textured discharge
• Itching and irritation on the vulva, penis, or taint, or inside vaginal canal
• Pain or burning while urinating or during sex
• Redness, swelling, or irritation

Yeast infections can be diagnosed with a pelvic exam or lab test. Usually, they can be cured with a one to seven day regimen of anti-fungal topical or oral medication. However, if left untreated long enough the infection can travel elsewhere in the body and require a more rigorous course of treatment to be eliminated.

What is bacterial vaginosis?

Bacterial vaginosis names the condition in which there is an overgrowth of certain bacteria in the vaginal microbiome. As the name suggests, BV is a condition that only affects those with vaginas.

Similar to yeast infections, anything that upsets the vaginal microbiome can result in BV. However, things like douching, having sex with someone new, using fragrant washes and detergents, and smoking can all increase the risk.

Common symptoms include:

• Fishy or foul smelling odor
• Thin or loose discharge
• Vaginal or vulvar itching
• Burning while peeing

Bacterial vaginosis can be diagnosed through a pelvic exam, vaginal secretion or vaginal pH test. To treat bacterial vaginosis, your healthcare provider may prescribe an oral or intravaginal cream that should clear up the infection within a few days.

How are these infections different from STIs?

The main difference is how the infections are classified. Yeast infections, bacterial vaginosis, and UTIs are not classified as STIs.

While sex can increase risk of yeast infection, bacterial vaginosis, and UTIs, they are not considered sexually transmitted infections because they are not infections transmitted from one person to another. All sexually transmitted infections are strictly transmitted from an STI-positive person, to someone who is not positive for that STI through direct skin-to-skin contact or through exchange of bodily fluid exchange.

Another difference is that all of the infections mentioned here are totally curable with adequate treatment. While some STIs are curable (gonorrhea, syphilis, chlamydia, trichomoniasis, and pubic lice), there are also some viral STIs that can be treated, but cannot be cured.

However, all genitals infections can be asymptomatic. Or, result in similar symptoms like itching, burning, or pain during sex or while urinating.

So…how do you know which of the genital infections you have?

Talk to your provider about your concerns and which genital (or other) infections you are worried about. Together you can come up with a plan for testing and treatment to get you feeling better as soon as possible.

Reviewed by the Ovia Health Clinical Team

Sources

• Mayo Clinic Staff. “Urinary Tract Infection (UTI).” Mayo Clinic. Mayo Clinic. October 14, 2020. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
• Mayo Clinic Staff. “Yeast infection (vaginal).” Mayo Clinic. Mayo Clinic. March 17, 2021. https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999

Sex Ed. class 2.0

Here, we’ve rounded up five things you should have learned from sex ed. class before reading this article, but will be useful to you long after you close it.

1. It is normal and healthy to masturbate

Masturbation is not just expected by boys and men, but encouraged. Yet, common cultural narratives tell girls and women that masturbation is dirty and wrong.

Here’s the thing: Nothing could be further from the truth. For people of all genders, masturbating is both normal and healthy! Benefits of masturbating include: reduced stress, boosted mood, and increased self confidence long term. And beyond being healthy, masturbating also feels good, which is absolutely reason enough to partake!

In summary: You should have been taught that masturbation is healthy. Further, you should have been encouraged to touch yourself in whatever locations, using whatever pressures, at whatever speeds, for however long, and however often you want.

2. STIs can be transmitted during oral sex

Despite the fact that many sex education curriculums rely on fear-mongering, few programs acknowledge sex acts other than penis-in-vagina intercourse exist, and therefore do not touch on potential risks of such acts. Like, oral sex for example.

From fellatio and cunnilingus to analingus, oral sex can bring Big Time pleasure for the giver and receiver alike. Still, important to know the potential risks. Ready?

While the risk is lower than it is during vaginal or anal intercourse, an STI can be transmitted during oral sex from a mouth or throat, to a penis, vagina, vulva, or anus — and vice versa. That means that, yes, an STI can infect body parts other than the genitals.

When oral STI symptoms do appear, they may include: sore throat, pain during swallowing, sores around the lips, sores and blisters in the mouth, and swollen lymph nodes. But as is true with STIs located elsewhere in the body, the most common symptom of an oral STI is no symptom at all. And that’s why it’s so important to get tested for oral STIs, between (oral sex) partners or once a year (whichever comes first). Oral STI testing involves a simple mouth or throat, and treatment typically involves an oral antibiotic or prescription mouthwash.

What can you do to reduce risk of STI transmission during oral hanky-panky? Glad you asked. With a partner who’s STI status you don’t know or who has an STI , you can use an external condom or dental dam to reduce risk of transmission.

3. PReP can be taken by all genders

PReP (pre-exposure prophylaxis) is a daily oral medication that can be taken by HIV-negative people to greatly reduce their risks of contracting HIV, if exposed to the virus. Highly effective, PrEP is one of the best additions to the sexual health space…ever.

While there is more that can be done to spread awareness about PReP to all people, cis-women in particularly tend to be less likely to take PReP. The problem is that people of all sexual orientations, genders, and genitals are susceptible to HIV, if exposed to the virus through sex, intravenous drug use, contaminated blood transfusion, or pregnancy. In fact, globally more than half (52%) of HIV-positive people in the world are women.

No matter your gender, to figure out if you’re a good candidate for PrEP read the federal guidelines put out by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) and/or talk to your healthcare provider.

4. Sex is not supposed to be painful

No, not the first time you have it. No, not during anal sex. No, not postpartum. Pain is the body’s way of telling you that something is wrong — and it’s a message worth listening to.

Sometimes pain during sex is a sign that you need additional lubrication or that your not-yet aroused-enough for what’s happening. In these instances, slowing down and adding lube can turn your sex session from “ouch” into “ooh!”.

When sex is consistently painful, however, or you experience these symptoms outside of sex (for example: while urinating or inserting a tampon) there may be an underlying condition. Pain during sex is a common symptom of conditions like hypertonic pelvic floor, endometriosis, vaginitis, vulvodynia, vaginismus, and pelvic inflammatory disease.

If you’re experiencing pain during sex, stop. If you want to continue having sex, try slowing down and/or add a store bought lubricant. If the pain becomes more chronic, bring it up with your healthcare provider or seek out the guidance of a trauma-informed pelvic floor specialist.

5. Consent is an informed, ongoing, and enthusiastic agreement to engage with someone that can be withdrawn at any time

As of 2020, only 9 states required consent be taught in sex education curriculum. That means that a whopping 41 states don’t teach students the importance of receiving “Y-E-S”, nor validated the decision to say “N-O” at any point during a sexual encounter.

The failure of this absence becomes obvious when looking at the responses from a recent survey of people ages 18 to 25. In it, 53% admitted that they didn’t realize that consent can be withdrawn once someone is already naked (it can!) and just 13% said they’d feel comfortable discussing consent with their sexual partner.

While the staggering sexual assault statistics cannot be blamed on any one thing — curriculums in sex ed. class suffer from widespread avoidance of consent, and it certainly isn’t doing anything to help reduce the number of people assaulted.

If you’re reading this and haven’t yet learned about consent, take the time to read The Consent Checklist by Meg-John Barker and/or Beyond Yes & No by Kai Werder.

Reviewed by the Ovia Health Clinical Team

Sources

• “Facts and figures: HIV and AIDS.” UN Women. UN Women. July 2018. https://www.unwomen.org/en/what-we-do/hiv-and-aids/facts-and-figures. 
• “Pre-exposure Prophylaxis (PrEP) Care System”. CDC. CDC. September 10, 2020. https://www.cdc.gov/hiv/effective-interventions/prevent/prep/index.html#About-PrEP. 

Here’s the latest from the Ovia Health Clinical Team, including answers to your questions and some practical guidance. 

If I’m pregnant and I get COVID-19, will the infection be worse?

It’s possible. Research indicates that pregnant people and recently pregnant people (within 42 days of giving birth) are at higher risk for significant complications from COVID-19 than their non-pregnant peers. This means that while the overall risk for severe illness is low, there is an increased risk of hospitalization, intubation and mechanical ventilation, blood clots, and requiring intensive care. There is also an increased risk of adverse pregnancy outcomes, including preterm birth and possibly an increased risk of pregnancy loss when compared to pregnant women who did not get COVID-19. 

These risks are compounded for Black pregnant people, who have long experienced nearly twice the risk of preterm birth when compared to white people. Many studies have demonstrated that race is likely an independent risk factor when it comes to healthcare outcomes like preterm birth, separate from other risk factors like income or education. That race-related risk may stem from chronic stresses of societal racism as well as the race-related inequalities that have been identified within the healthcare system. 

Pregnant parents who test positive for COVID-19 should be offered a discussion about the medication Paxlovid. You can read more about that here.

What can I do to prevent infection?

Prevention is no different for pregnant people than it is for anyone else. Follow the advice that you receive from your local health department, from the CDC, and from your healthcare provider. Avoid going to public places if you think or know you have COVID-19, to prevent spreading it to others. 

If you know local rates of Covid are high, wear masks when indoors and practice social distancing. Being vaccinated has been shown to provide protection against severe COVID-19 disease. However, you can still get sick and pass the illness on to vulnerable people who aren’t vaccinated or cannot be vaccinated (like newborns).

Is hand sanitizer safe in pregnancy?

Yes, Yes, YES. The CDC reports [3] that handwashing with soap and water is more effective than hand sanitizer. However, you can’t take the sink in your car or on a walk or to the grocery, so make sure you use hand sanitizer regularly in addition to handwashing. Furthermore, it’s often much easier to wipe hand sanitizer on your children’s hands than it is to get them properly washed, so consider this a regular habit as well.

If I get COVID-19, will I pass it to my fetus?

The most recent research on the topic says that transmitting COVID-19 while pregnant is very rare – for moms in North America, the rate was about 0.1%. This does not include the risk of passing it to your newborn during routine care postpartum. However, studies suggest that people who tested positive for COVID-19 during pregnancy are more likely to have complications, such as preterm birth [6]. There is no evidence that cesarean delivery reduces the risk of infection for Baby, so this is not recommended.

What about during and after birth?

It is extremely important that you call your healthcare provider before you go to the hospital if you think you have COVID-19. Once at the hospital, your provider knows what to do to reduce the risk that your baby (and the healthcare professionals who care for you) will become infected.

Keep in mind that testing positive for COVID-19 when in labor may cause changes to your birth plan and hospital stay. You may want to consider extra precautions in the last weeks of pregnancy to avoid this.

What is the risk to my baby? And what about the risk to my other children?

Children seem to be at less risk of becoming really sick with COVID-19 than adults are, but infants make up the bulk of serious cases and hospitalizations in children under 17. Current evidence suggests that babies are not likely to get COVID-19 from their mothers as long as preventative steps are taken, such as wearing a mask around your baby, washing your hands for 20 seconds prior to holding your baby, and having them sleep 6 feet away from you. You should still do everything you can to reduce the risk of exposure. Children with certain underlying conditions are at risk for complications from COVID-19, so it is important to keep them safe and communicate with their pediatrician.

Is breastfeeding safe if I think I have COVID-19?

There are many benefits to breastfeeding for parents and babies. It appears unlikely that COVID-19 can be transmitted through breast milk, though helpful antibodies can be passed along! 

If you test positive for COVID-19, this may impact the care of your newborn. In-hospital, the CDC recommends discussing with your provider the risks and benefits of caring for your newborn while sick. Mildly ill people generally room in and care for their newborns. If you are seriously ill, this may not feel like a physically possible or safe option. Once you are home, wash your hands frequently — and always before touching your baby. Wear a mask when you are within 6 feet of your baby or another person. If you have a caregiver who lives with you, they should also wear a mask whenever caring for your baby.

We know that with other illnesses, you pass antibodies to your baby through your breast milk. Antibodies are what your body makes to help fight off illness. The research into COVID antibodies in breastmilk is really encouraging and suggests that antibodies are passed through breast milk after infection or vaccination. 

What if I’m trying to conceive and not yet pregnant?

There’s no evidence that COVID-19 or any similar viruses impact conception or cause birth defects if you are sick when you conceive.

Should pregnant people get the COVID-19 vaccine?

Multiple well-respected clinical organizations, including the ACOG (the American College of Obstetricians and Gynecologists) and the ACNM (American College of Nurse-Midwives), recommend the vaccine to people who are trying to conceive, pregnant, and breastfeeding [11].

The first clinical trials for the COVID-19 vaccines manufactured by Pfizer-BioNTech, Moderna, and Novavax did not include participants who were known to be pregnant or breastfeeding. This is typical for pharmaceutical research. Recent studies have included pregnant people and show that there is no increased risk and that vaccines given in any trimester do not negatively impact pregnancy outcomes. In addition, vaccinating in the second or third trimester may offer additional protection to your newborn.

Additionally, none of these COVID-19 vaccines contain a “live” virus. This means you cannot get COVID-19 from the vaccines. In general, vaccines that do not contain “live” viruses are safe during pregnancy and do not have increased risks for infertility, miscarriage, fetal anomalies, or stillbirth. Side effects of the COVID-19 vaccines include pain at the site of injection, fever, fatigue, and chills. These typically go away after a couple of days. These side effects are normal and expected and are indicators of your immune system doing its job to learn to protect you from the virus. There have been very rare reports of unexpected, adverse reactions from the vaccines. A severe allergic reaction called anaphylaxis can happen in very rare cases. The incidences of these adverse events are so low that getting vaccinated remains safer than potentially getting infected with COVID-19. [12].

You can also reach out to the experts at Mother to Baby for more information. Your midwife, doctor, or other healthcare professional is also a great resource for more information about the COVID-19 vaccine. Ultimately, you are the one who knows what is best for your body and your family.

Reviewed by the Ovia Health Clinical Team

Sources:

Dara D. Mendez, Vijaya K. Hogan & Jennifer F. Culhane “Institutional racism, neighborhood factors, stress, and preterm birth”. Ethnicity & Health. 19:5, 479-499. October 18, 2013.

Jasmine D. Johnson et al., “Racial Disparities in Prematurity Persist Among Women of High Socioeconomic Status,” American Journal of Obstetrics & Gynecology 2. 2(3), 100104. Nov 10, 2020

James W. Collins Jr et al., “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination,” American Journal of Public Health. 94(12), 2132–2138. December 2004.

Braveman Paula, et al. “Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes” Frontiers in Reproductive Health. Vol. 3. 684207 September 2, 2021.