Zika Virus and Fertility Treatments
Zika virus was first reported in South America in May 2015. Since then it has rapidly spread throughout Latin America. The virus spreads to humans primarily through infected Aedes aegypti mosquitoes. Once a person is infected, the incubation period for the virus is approximately 3-12 days. Symptoms of the disease are non-specific but may include fever, rash, arthralgias, and conjunctivitis. It appears that only about 1 in 5 infected individuals will exhibit these symptoms and most of these will have mild symptoms.
Zika during pregnancy has been associated with birth defects, specifically significant microcephaly. Transmission of Zika to the fetus has been documented in all trimesters; Zika virus RNA has been detected in fetal tissue from early missed abortions, amniotic fluid, term neonates and the placenta.
There is more that is not known about Zika in pregnancy than is known. The absence of important information about affect in pregnancy makes management and decision making in the setting of potential Zika virus exposure (i.e. travel to endemic areas) or maternal infection, difficult. Currently, there is no vaccine or treatment for this infection.
The mosquito that transmits the virus is currently found in South America, Mexico, Hawaii, the Caribbean but the area of transmission is growing. The CDC keeps an active list of affected areas which can be found at their web site, http://www.cdc.gov/zika/. Unfortunately there are no commercial blood tests available to detect the Zika virus currently. Testing available via the NYS DOH is limited and negative test is not an absolute indication of absence of infection. Additional there is cross reactivity with other virus types.
Avoiding exposure is best. Women who are currently pregnant or planning to become pregnant should avoid exposure to Zika by avoiding travel to the impacted areas. Semen has been shown to contain Zika virus and there are reports of sexual transmission of the disease. As virus can be detected in the sperm for up to 62 days after the infection, men should use condoms for sexual intercourse for 3 months after potential exposure and if their partner is pregnant, for the duration of the pregnancy.
We will require delay in attempting pregnancy with travel to known Zika infested areas. The exact length of time will be determined by the provider and will follow CDC guidelines but is a minimum of 8 weeks.