{"id":3109,"date":"2023-04-04T15:52:31","date_gmt":"2023-04-04T20:52:31","guid":{"rendered":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/?p=3109"},"modified":"2023-04-04T15:52:49","modified_gmt":"2023-04-04T20:52:49","slug":"long-covid-is-making-some-people-choose-not-to-have-kids","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/2023\/04\/04\/long-covid-is-making-some-people-choose-not-to-have-kids\/","title":{"rendered":"Long COVID Is Making Some People Choose Not to Have Kids"},"content":{"rendered":"
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Time<\/a> <\/p>\n\n\n\n

For a long time, Tessa thought about\u00a0freezing her eggs<\/a>\u00a0once she turned 30, so she and her partner could have a child when they felt ready. But her 30th birthday came and went in March, and she\u2019s made no moves to act on her plan.<\/p>\n\n\n\n

Tessa, who lives in Massachusetts and asked to be identified by only her first name to protect her privacy, developed Long COVID after a case of COVID-19 last May. Long COVID brought on intense fatigue, made it virtually impossible to exercise without crashing afterward, and worsened a preexisting nervous-system disorder<\/a> that causes her to feel faint. Tessa is still able to work from home, but most days, she only has the energy to get out of the house for a short walk. At her current energy levels, she says it\u2019s hard to imagine caring for a pet, let alone a child.<\/p>\n\n\n\n

\u201cWe\u2019re both doing a lot just to take care of me right now,\u201d Tessa says of herself and her partner. \u201cIt\u2019s possible we\u2019ll get to a place where we\u2019d be able to [have a child], but it feels a lot harder now.\u201d<\/p>\n\n\n\n

For many patients, Long COVID is more than a medical issue. It also affects\u00a0work<\/a>,\u00a0relationships<\/a>, and life plans\u2014including when, how, and whether to have children. <\/p>\n\n\n\n

According to data from the U.S. Census Bureau<\/a>, about 25% of U.S. adults ages 18 to 39 who have had COVID-19 have experienced symptoms lasting at least three months\u2014meaning millions of people have had or are living with Long COVID at the peak of their reproductive years. And while anyone can develop Long COVID, women appear to be at higher risk<\/a> than men.<\/p>\n\n\n\n

Pregnancy is a \u201cstress test\u201d on the body, says Dr. Kathryn Gray, a maternal-fetal medicine specialist at Boston\u2019s Brigham and Women\u2019s Hospital who has\u00a0researched<\/a>\u00a0the effects of\u00a0COVID-19 vaccines among pregnant people<\/a>. For someone already facing a constellation of debilitating symptoms, it can feel like a test too risky to take.<\/p>\n\n\n\n

When Louise (who asked to be identified by her middle name to protect her privacy) asked her doctor if she was healthy enough to get pregnant in early 2021, about six months after developing Long COVID, she got a firm answer: \u201c\u2018Don\u2019t even think about it.\u2019\u201d<\/p>\n\n\n\n

Before that appointment, Louise, who is 37 and lives in California, was hopeful about giving her now 5-year-old child a sibling, despite living with Long COVID symptoms including migraines and fatigue. She\u2019d read that some people with chronic conditions go into remission during pregnancy<\/a>, at least temporarily, and wondered if that might be true for her.<\/p>\n\n\n\n

Louise says her doctor\u2019s dismissal was sobering but has proven wise. Her symptoms have since worsened, and working from home and caring for her child now take most of her strength. She\u2019s essentially housebound, and usually only has enough energy to shower once per week.<\/p>\n\n\n\n

\u201cI really don\u2019t think my body could handle\u201d pregnancy and raising a new baby, she says. \u201cIf I can\u2019t handle showering whenever I feel like it, then I really wouldn\u2019t be able to handle that extra challenge.\u201d<\/p>\n\n\n\n

It\u2019s not entirely clear how Long COVID affects pregnancy and reproductive health because it hasn\u2019t been widely researched. Stacey Missmer, a professor of obstetrics, gynecology, and reproductive biology at Michigan State University\u2019s College of Human Medicine, recently published a\u00a0paper<\/a>\u00a0finding that people with endometriosis are at increased risk of Long COVID, but only after multiple academic journals passed on it. \u201cThe lack of curiosity about [women\u2019s health and Long COVID] and the lack of focus on understanding is just not acceptable,\u201d she says. <\/p>\n\n\n\n

There is, however, a small amount of research on pregnancy and myalgic encephalomyelitis\/chronic fatigue syndrome<\/a> (ME\/CFS), a condition with symptoms that closely resemble those of many Long COVID patients. In one small 2004 study<\/a> of people with ME\/CFS, roughly 30% saw symptoms improve during pregnancy, while about 30% got worse and about 40% stayed the same. After pregnancy, approximately 20% reported improved symptoms, while about 50% got worse and 30% stayed the same.<\/p>\n\n\n\n

Despite the similarities between ME\/CFS and Long COVID, it\u2019s not clear if those results apply to both conditions. \u201cPatients who have any medical condition going into pregnancy want to know the long-term effects [and chances] of worsening their condition,\u201d Gray says. \u201cWe don\u2019t have data right now to guide how we counsel people\u201d with Long COVID.<\/p>\n\n\n\n

Researchers do know a bit about how the SARS-CoV-2 virus can affect the reproductive health of both women and men. While there is no research to suggest<\/a> the COVID-19 vaccine causes infertility, the virus itself can affect reproductive health in multiple ways.<\/p>\n\n\n\n

Among men,\u00a0some evidence suggests<\/a>\u00a0that SARS-CoV-2 can impair sperm count and quality, testicular function, and hormone levels,\u00a0potentially decreasing fertility<\/a>\u00a0at least in the short term. Men with Long COVID may also experience erectile dysfunction,\u00a0studies show<\/a>, which could make it more difficult to conceive a child.<\/p>\n\n\n\n

Among women, there is some evidence to suggest<\/a> that certain fertility markers are lower for at least a few months after infection, and people who contract COVID-19 during pregnancy may be at increased risk of complications ranging from preeclampsia<\/a> to preterm birth<\/a>. And both the virus and its vaccine have been shown to affect the menstrual cycle<\/a>, at least temporarily.<\/p>\n\n\n\n

Some Long COVID patients also experience symptom flare-ups around their periods, according to a paper<\/a> published in January. That\u2019s the case for Chim\u00e9re Smith, 40, who developed Long COVID after catching the virus in 2020. \u201cI can always tell when it\u2019s two weeks before my period,\u201d Smith says, because she develops headaches, nerve pain, eye issues, facial pain, brain fog, memory loss, and skin rashes. She doesn\u2019t experience those symptoms as significantly in the two weeks after her period.<\/p>\n\n\n\n

Smith says she\u2019s \u201cwilling to try anything\u201d that would break the pattern, including removing her uterus\u2014but to start, her doctor has prescribed a low-estrogen birth control pill to see if that helps with her symptoms.<\/p>\n\n\n\n

Kate Clancy, a professor at the University of Illinois Urbana-Champaign and author of the forthcoming book\u00a0Period: The Real Story of Menstruation,\u00a0<\/em>says inflammation may be the common link among Long COVID, period changes, and symptom flares during menstruation. \u201cThe uterus is very much an immune organ,\u201d Clancy says. It keeps out pathogens while allowing an embryo\u2014a partially foreign organism\u2014to grow safely, and it regularly sheds and repairs tissue. The organ is therefore highly responsive to inflammation and other immune responses, Clancy explains. <\/p>\n\n\n\n

Heather-Elizabeth Brown, who is 38 and lives in Michigan, also experienced menstrual changes after being hospitalized with a severe case of COVID-19 in April 2020 and developing Long COVID symptoms including fatigue and brain fog. Brown\u2019s menstrual cycle changed dramatically after her illness, disappearing for months at a time and then coming back heavier than ever.<\/p>\n\n\n\n

Worried about what those changes meant for her reproductive health, she visited a fertility specialist for testing<\/a> in 2022. Her results came back mostly normal. But her doctor told her, \u201c\u2018We really don\u2019t know how COVID has fully affected your body, so we really don\u2019t know what will happen during a pregnancy,\u2019\u201d Brown says.<\/p>\n\n\n\n

\u201cNobody knows,\u201d she says. \u201cThey\u2019re pretty much grasping at straws\u201d when it comes to reproductive health.<\/p>\n\n\n\n

Though the unknowns make it scary, Brown remains committed to having a child, whether it requires freezing her eggs, hiring a surrogate, or adopting. She acknowledges that being a parent will be even more difficult than it is for most people, since she still crashes if she pushes her energy too far. But \u201cbefore I got really sick with COVID, it was a desire of my heart,\u201d Brown says. \u201cI\u2019m not going to let COVID take that from me as well.\u201d<\/p>\n<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"

Time For a long time, Tessa thought about\u00a0freezing her eggs\u00a0once she turned 30, so she and her partner could have a child when they felt ready. But her 30th birthday came and went in March, and she\u2019s made no moves to act on her plan. Tessa, who lives in Massachusetts and asked to be identified […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[15],"tags":[],"class_list":["post-3109","post","type-post","status-publish","format-standard","hentry","category-psychological-and-sociological-impact"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3109","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/comments?post=3109"}],"version-history":[{"count":1,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3109\/revisions"}],"predecessor-version":[{"id":3110,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3109\/revisions\/3110"}],"wp:attachment":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media?parent=3109"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/categories?post=3109"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/tags?post=3109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}