For couples like Gabriel and Dariana Perez, being pregnant in Puerto Rico is a mix of anticipation and anxiety. Dariana is due “any day,” and while she’s confident she will make it through her pregnancy Zika-free, her husband worries.
“You [can be] born OK now, but they don’t know how it’s going to affect you 5 years from now,” notes Gabriel.
As much as Zika worries those in the middle of a pregnancy, it presents a whole new set of concerns to those trying to arrange one.
Dr. Kevin Winslow, founder of Florida Institute for Reproductive Medicine in Jacksonville, calls Zika “the hot topic” in fertility circles. He has been fielding lots of questions from clients, including whether they should store sperm before visiting affected areas or until the virus epidemic has passed.
Others want to know whether to put their family plans on hold.
Delaying pregnancy can hurt the odds of getting pregnant, especially for older women. That concern is more pressing for those already struggling with fertility problems. But with so much still unknown about Zika, fear is a powerful restraint.
“We’ve been fortunate, to date – knock on wood – that we don’t have any known cases that are endemic to Northern Florida,” Winslow says. “[But] patients are still very concerned about it, and rightfully so. It has very serious ramifications in terms of the unborn.”
Donor sperm raise additional issues. Even before Zika, sperm banks were required to hold samples for 6 months to rule out the presence of infectious diseases. The U.S. Food and Drug Administration now bars anonymous donors for six months if they have received a Zika diagnosis, traveled to an affected area or had sex with someone who may have been infected. But as yet, there is no FDA-approved donor test for Zika.
Orlando-based Cryos International, which bills itself as the largest sperm bank in the world, recently announced it would voluntarily collect donor blood and quarantine donor eggs, storing both – along with sperm – until the FDA approves a donor-screening test.
Winslow’s clinic doesn’t collect donor sperm, but does have a large donor egg bank. He says they currently follow “very conservative” CDC guidelines, testing donors who have traveled to Zika endemic areas, or who have had sexual contact with someone from that region.
Eggs are generally less of a concern for Zika contagion, Winslow says, because eggs are washed, rather than stored aren’t stored in bodily fluids. Women also process Zika more quickly than men – 8 weeks compared to 6 months for men.
But with consequences so dire, the impacts are being felt in the fertility industry – especially in Puerto Rico, ground zero for the disease in the U.S. “We’ve already heard of a couple of reproductive and endocrine programs that have shut down because of the virus and the concerns there,” says Winslow.
Whether fertility clinics in the continental U.S. begin to feel similar pressure is – like so much with this disease -- still unknown.
“When we start seeing more cases of endemic virus in the north Florida area,” Winslow says, “we’ll be doing a lot more testing.”