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As we proceed with the first efforts to vaccinate against SARS-CoV-2; many patients are scrambling to decide how they feel about receiving a vaccination. The current efforts are complicated by opinions that are often driven by politics. The goal of this clinical conversation is provide you with the science—so that you can make your own evidence based decision.  It is also worth nothing that organizations that guide healthcare professions are supporting the use of the vaccine for women that are pregnant or breastfeeding. These organizations include The American College of OB/GYN (ACOG), The American Society for Reproductive Medicine (ASRM), The American Society for Maternal-Fetal Medicine (SMFM) as well as the US Center for Disease Prevention and Control (CDC). In case you don’t want to listen to the entire conversation, here’s the listening guide.

Fertility Treatment+COVID+Vaccine (26:09): https://youtu.be/WpQ0M_IreLQ

1:10  Become informed so you can make your own choice

1:45  Perspective on status (mid December 2020)

4:20 What makes these first vaccines unique ?

6:15 Why are these new vaccines considered so safe?

                ***Listener’s note; this recorded live and I correct myself a couple of times for

                                Mistakenly using the word “virus” instead of  “vaccine”

10:30 [UPDATE] This vaccine has now been approved and is in use

11:45 Why does these vaccines use two injections?  

14:00 Recommendations for women currently going through fertility treatment

17:00 What about women that are currently pregnant or breastfeeding?

20:00 What about vaccines for other preventable diseases like measles?

21:45 Importance of being informed so that you can make an educated decision

23:00 Experience of other democratic countries and how they’re dealing with this pandemic

25:00 Note of gratitude

Stay informed,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

UPDATE:

ACOG Statement on the Johnson & Johnson COVID-19 Vaccine

On April 13, 2021, ACOG released a statement following the CDC and FDA decision to put the Johnson & Johnson COVID-19 vaccination program on hold.

“At this time, there is no clear phenotype of women who are more or less likely to experience this rare complication. However, until there is a better understanding of the frequency and impact of this finding, it will be important to encourage pregnant and postpartum women who wish to be vaccinated to receive the mRNA vaccines: Pfizer or Moderna.

“Individuals who have been vaccinated with the Johnson & Johnson vaccine within the last 21 days who experience severe headache, abdominal pain, leg pain, or shortness of breath should seek immediate evaluation. They should be certain to communicate that they have received the Johnson & Johnson vaccine to prompt appropriate evaluation. Given the elevated risk for thrombosis experienced by women during pregnancy or the postpartum period and while using birth control pills, evaluation of acute thrombosis is commonly performed in our specialty. Rapid treatment with anticoagulation is the standard; however, this is not the same event and anticoagulation for treatment of CVST is dangerous.” Read the full statement.

Too many people rely upon their fertility center to create results. In reality, one of the most important aspects of fertility treatment in determining success is egg quality. I’ve been doing a deep dive on the latest research to try to determine what can be done to optimize egg quality. Attached is a link to a Clinical Conversation created to begin analyzing this topic. The goal is to provide women with data-driven practical tips. I hope that you find this helpful as well as motivating to help you begin making some healthy choices to insure your success:

Egg Quality Part 1 (23:10): https://youtu.be/QTr8M-Pij30

• 1:20 natural pregnancy rate
• 3:00 Comparison of Sperm Quality vs Egg Quality and how they impact natural rates
• 5:00 Components for estimating Egg Quality
• 7:00 Aspects of egg quality
•                 —DNA
•                 —Mitochondria
•                 —Other physical components of the egg
•                 —Metabolism of the egg
• 9:00 A new perspective on fertility treatment
• 10:45 Age and egg quality / egg number
• 13:00 Emerging view of egg development
•                 —wave theory vs. continuous recruitment
•                 —DNA markers vs age (~15:00)
•                 —Hottest topics—>new data on genetics of eggs
•                 —Individual variation offers hope for intervention
• 19:30 Egg quality if often a key component of “Unexplained Infertility”

With kindness and optimism,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

As we continue to adjust to life during the SARS-CoV-2 outbreak it is important that we adjust our activities. Fertility treatment is ESSENTIAL care for those that need it. Our goal is to continue continue to provide this care for all of those seeking treatment–but it will require their assistance as well. Here in Colorado our use of social distancing has clearly reduced the severity of the outbreak. I’ve summarized in a videoblog the recommendations to keep our patients, our staff  and our community safe: https://youtu.be/7sBN7WgC35I .

So please continue to stay safer-at-home when possible and follow established social distancing when out in public place.

With kindness and support,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

 

As fertility treatment resumes following the pause created by the COVID19 Outbreak, we have experienced marked improvement in air quality. Many are unaware the of the unfortunate effects that pollution has upon fertility. Here on the 50th Anniversary of Earth Day is a great time to update you on how our improved environment can boost your chances of achieving and maintaining a healthy pregnancy: https://youtu.be/Iq93CXlrp4Q .

I hope that you found that information to be encouraging. Let’s see if we can take it a step further and make some better choices as we move forward in to the future.

REFERENCES from this video: 

• Air pollution and ovarian reserve: https://www.sciencedaily.com/releases/2019/06/190625181939.htm
• Air quality and male fertility: https://www.bmj.com/company/newsroom/air-pollution-linked-to-poorer-quality-sperm/
• Air pollution, IVF Treatment Outcomes: https://www.reuters.com/article/us-health-pregnancy-ivf-pollution/air-pollution-linked-to-fertility-treatment-failure-idUSKBN1HX3AW

Treatment for fertility patients has been challenging during the COVID19 Outbreak. There is agreement that fertility treatment is essential and not elective. But whether or not it was urgent created some confusion as whether or not treatment should be continued or halted during the early days of the outbreak in the United States.

At this point, it is becoming more apparent that various regions are experiencing this pandemic very differently. Here’s the latest update for patients seeking care at our center in Colorado: https://youtu.be/Ky5lcP-Rzus.

Stay safe, stay well and if you can please stay home.

With kindness,

~Robert Greene, MD, FACOG