Content derived from DocTalk with OB-GYN Clive Liu, MD of Valley Women’s Healthcare Clinic
What do you recommend now for those who are planning their family? Continue to consider social distancing practices, good hand hygiene, and ideally getting the COVID-19 vaccine. It is safe to start planning a family.
What do you advise about getting the COVID-19 vaccine?
The data for the COVID-19 vaccine and pregnancy shows that it is safe. Those who are already pregnant who get the vaccine have lower rates of getting COVID-19. Recent data also shows that babies who are born from mothers who got the vaccine have passive antibodies protecting them against the virus. Antibodies are also secreted in the breast milk, so babies are further protected through moms who choose to breastfeed. There is no known link between the COVID-19 vaccine and infertility: The rates of miscarriage, live births and other diseases we screen for during pregnancy are at the same rates as they were before COVID-19 vaccinations.
Do you recommend a pre-conception visit with a healthcare provider?
It is a good idea to meet with a provider before you get pregnant, whether it’s with your primary care provider or a general OB-GYN. With the current times, it’s good to check in with them, even more so if the mother-to-be has certain chronic illness or is taking any medications for these illnesses. It’s best to stop taking certain medications during pregnancy, so it can be good to look at your current medications with a provider and find other options when needed.
How long after stopping birth control should you wait before trying to conceive?
As soon as you stop taking birth control pills, you can start trying to get pregnant. I usually advise patients to wait until after their having first period before actively trying. It makes tracking the potential pregnancy easier when the date of the period is known.
After having your IUD or implanted contraceptive device removed, how long do you have to wait before trying to conceive?
After an implant comes out, you can try getting pregnant almost immediately. These forms of birth control do not affect fertility. With the Mirena® IUD and Nexplanon® implant, they may cause some women to become amenorrheic (they do not get their period) for a time after removal. After they are removed, it is safe to get pregnant.
Considering lifestyle factors for both parents, what advice do you have for optimizing your health?
For both parents, it is ideal to have a healthy diet and take part in physical activity. If the mother-to-be is having monthly periods and doing moderate exercise or more, it should be safe to continue this level of exercise. More extreme sports may need to be dialed back. Alcohol, smoking, and any illicit or recreational drugs should be stopped before getting pregnant. Smoking can cause babies to be small and growth-restricted, and may have effects on the lungs and lower oxygen levels. No alcohol is recommended during pregnancy because it places the baby at risk for fetal alcohol syndrome. Recreational drugs can have many side effects that impact both mom and baby, including slowing growth and development of the baby which could lead to developmental delays.
If you haven’t been successful in getting pregnant, when should you seek fertility care?
If after 12 months of actively trying to get pregnant while tracking periods and timing intercourse when ovulation is occurring and pregnancy has still been unsuccessful, it’s time to seek medical help for infertility. The recommendation is to see an OB-GYN, who can do a basic work-up to help figure out what is going on. If more support is needed, you may be referred to a reproductive endocrinologist and infertility specialist. With regard to age, for women who are 35 years and younger, we follow the one-year rule. Above age 35, we consider potentially decreasing that amount of time to six months. Above age 35, egg quality and infertility tends to go down, so we want you to have as much time as possible to conceive.
