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Dr. Vicken Sepilian debunks major COVID myths about infertility

Ever since the new mRNA based COVID vaccine launched, rumors have been rife about its efficacy and after-effects. One of the most shocking claims we have come across is the belief that the COVID-19 vaccine being administered by Pfizer-BioNTech and Moderna can impair fertility.

Before we dig deeper into this proposition, we thought it would be best to get these myths fact checked by a medical expert.

Double board certified in Obstetrics & Gynecology and Infertility & Reproductive Endocrinology, Dr. Vicken Sepilian specializes in the diagnosis and treatment of disorders involving infertility and hormonal imbalances of the reproductive system. As a regular guest on television and a leading healthcare consultant for the Armenian Executive Government, Dr. Sepilian works tirelessly to educate his patients on infertility issues.

Q. Thank you so much for taking out the time to speak with us on this incredibly important and concerning issue. Could you please shed some light on why are people apprehensive about getting the vaccine, and more precisely, why are there rumors about a connection between the vaccine and infertility?

VS: The root of these concerns, when we talk about the Pfizer & Moderna vaccine and women's health and reproductive potential, comes from the fact that the mRNA vaccines cause the body to make antibodies against a piece of the coronavirus, the spike-protein. The spike protein helps the virus attach to our body cells and hence cause the infection. So, if we have an antibody against the virus's ability to attach to our body cells then that gives us protection. Now the concern has come from a former Pfizer scientist, no longer affiliated with Pfizer, who had raised the concern that the spike protein of the COVID virus has some similarity to another protein that helps the placenta function normally during pregnancy. So, the theory is that, and its a stretch, if the spike protein and the syncitin-1 (the placental formation protein) are related then maybe the resulting antibody can also attack syncitin-1. Now there's no scientific evidence that that is the case.

It's also important to note here that when a person gets infected by the COVID virus itself, the body's natural immune system also makes antibodies against the virus. So theoretically then, if there is cross-reactivity from one end between the two proteins, then the natural infection would also cause adverse effects to a pregnancy which has clearly not been the case.

Q2. So, Overall do you think the COVID infection has had any impacts on fertility in our population?

VS: Not to our knowledge. It does appear that women who are pregnant, if they do contract COVID, have some increased risk of developing severe disease, especially in the third trimester. There's also a slightly higher risk of death from COVID in pregnant women if they develop severe disease as compared to the same age women who're not pregnant. It appears that there maybe a slightly higher risk to pregnant women if they catch COVID while they're pregnant, however being infected with COVID doesn't appear to be related with fertility. I can anecdotally say I've had probably several dozen patients who had contracted COVID before their treatment, subsequently have recovered and have been able to go on and get pregnant without any issues. I also have patients who contracted COVID while they were pregnant, and all of my patients I can say recovered just fine and the pregnancies are ongoing without any issues thus far.

Now having said that we should clarify that we don't have any long term data on the health of pregnant women or the health of babies born to women with COVID, we just don't have it because the infection has been around for only a year and a half and long term data is only going to be evident as time goes on.

Q3. There is also some evidence that the COVID-19 infection is associated with a woman’s waters breaking early. How true is that claim?

VS: In general what ends up happening is that the ability for the lungs to function normally and have the normal capacity is impacted by the growing uterus pushing up. So already in the third trimester pregnant women feel shortness of breath or the inability to fill their lungs up completely so it's not surprising that maybe toward the 3rd trimester, the disease that has trickled to the lung and the respiratory system may present as more severe. However the true reason nobody knows, its just a theory, because in the 3rd trimester the uterus is significantly bigger and pushing up against the lungs, so it would make sense that the lungs maybe more impacted in the 3rd trimester.

Apart from all the talk about the vaccine impacting fertility, a lot of the rumors surrounding it are also regarding the fact that the vaccine was rushed and prepared so fast that it seems some people are not confident that it's safe, and corners were cut to expedite the approval process and I can say that is not the case. Most of the time yes clinical trials do take a long time, because finding volunteers takes a long time. When you are studying a medical condition that might not be that prevalent in the general population, or not that important, the motivation for volunteering to participate in such studies is comparatively low. So it takes a long time to find enough volunteers for the study to be conducted effectively. Which is not the case here clearly as COVID is a disease that impacted the whole world equally, so there was naturally no shortage of volunteers to participate in the clinical trials, which under normal circumstances require between

3000 - 5000 patients to ensure safety. And in this case between the two companies that conducted the studies here in the US, there's more than 60,000 volunteers that were studied. So, there's no indication that corners were cut, just because it was done in a rapid way.

Another myth is that of patients fearing that the vaccine might "give" them COVID, which is not possible because there is no viral particle that's being introduced into the body, it's just the genetic code that's being sent inside the body just so it is well prepared to make the antibody against the actual virus. So there is absolutely no risk of catching COVID by getting the vaccine.

Having said that I still believe factoring in every patient's concerns with due respect and having a discussion with every individual who has any reservations about the vaccine and see what their level of risk is, as well. For instance, some of my pregnant patients have been very worried about this, but they are working from home, they are not outside, their chance of getting exposed to COVID is very low so maybe it's just fine for them to wait until they deliver to get vaccinated. I genuinely feel that the decision should be made on the basis of each individual case, considering where that person lives, what the rate of infections in their area, how at-risk they are, whether they are working in an environment that can increase their risk of catching the virus, these are all factors that a medical professional needs to consider about their respective patients.


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