April 25, 2016
Zika-carrying mosquitoes have not yet been reported in the United States, but a new survey shows that two out of five American adults say they are delaying pregnancy because of the virus linked to birth defects.
“It’s still a relatively rare thing, but I think this highlights the point that when educated, people really are very concerned about and interested and proactive,” said Dr. Jason Franasiak of Reproductive Medicine Associates (RMA) of New Jersey, which sponsored the survey for its 2016 Trends in Infertility report.
Fellow fertility specialist Dr. Thomas Molinaro said that the statistics reflect what he’s hearing from patients at his clinic.
How often does he answer questions about Zika? “Only every single day,” he said. “Three patients on Friday.”
For the report, RMA of New Jersey surveyed 1,000 U.S. adults online in early March. The polling company included men and women ages 18 to 40, and did not limit it just to people who were seeking to become pregnant.
Related story: I cancelled my trip to Florida for my unborn baby
While Zika is a concern, it is not the sole reason couples are delaying pregnancy. Seventy-eight percent of respondents said they are delaying parenthood in order to pursue a career or education, because they can’t afford them or because they are not sure if they want kids to begin with.
There have been 388 Zika disease cases in the United States, according to the CDC, but all of them were detected in people who'd traveled abroad (see a complete list of Zika-affected regions here).
Dr. Jacqueline Gutmann, a specialist at RMA of Philadelphia, noted that most of her patients have not met resistance from employers if they wanted to cancel business travel to Zika-affected areas.
“My sense is that most work travel that the employers are really very understanding about allowing them to cancel. The one that is a little bit more complicated is when the male partner is traveling for work … he theoretically wears condoms for the next nine months,” said Gutmann.
Doctors do not yet know if there is a safe time during pregnancy to travel to an area with Zika, and they also do not know how likely it is that contracting Zika will cause a birth defect.
For couples who have not yet conceived a child, the CDC is currently recommending that men and women who travel to Zika-affected regions or have sexual contact with someone who has should delay pregnancy plans for at least eight weeks. They should also take steps to avoid mosquito bites for three weeks after they return -- so insects can’t pass the virus to others.
If someone definitely has the virus or has shown symptoms, then they should wait at least eight weeks if they are a woman and six months if they are a man before having unprotected sex. The truth is, however, no one yet knows for sure how long the Zika virus lasts in semen.
One issue, Molinaro said, is that tests for the virus are in such high demand right now that only people who are pregnant or showing symptoms can get one. For example, a man who has travelled to a Zika region but shows no symptoms would not get to take the test.
“All of this testing is going through the CDC in Atlanta and so the states are regulating whose blood gets to Atlanta, because that lab can only do so many tests,” said Molinaro.
“The FDA has fast-tracked two new tests but we’re probably not going to see them before the summer,” he continued. However, he warned, “They’re going to be coming out with a test that has not been fully explored, so we won’t know the sensitivity of it.”
Even if a test did confirm that someone has Zika, there’s no vaccine or medicine to make it disappear. The patient would simply have to watch and wait.
The rest of the report, released in time for National Infertility Awareness Week, explored people’s understanding of fertility treatments and their relationship with doctors. Overall, it found that only around one in four women have had a conversation with their OB-GYN about fertility.
The report also sought to highlight common misconceptions. For example, the report found that 81 percent of respondents think that multiple embryos are needed for IVF, but in fact around 70 percent of RMA patients have a single-embryo transfer, which is considered safer for both mother and child.
Doctors at RMA Philadelphia are hosting free, live web chats from Monday to Friday this week to help raise awareness about infertility and possible treatments.