Prolonged COVID-19 is causing some people to choose not to have children

F:Tessa had long considered freezing her eggs after she turned 30 so she and her partner could have a baby when they felt ready. But his 30th birthday came and went in March, and he hasn’t made a move on his plan.

Tessa, who lives in Massachusetts and asked to be identified only by her first name to protect her privacy, developed Long COVID after contracting COVID-19 last May. Prolonged COVID-19 caused intense fatigue, made it virtually impossible to exercise without following a crash, and worsened a pre-existing nervous system disorder that causes him 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. With her current energy level, she says it’s hard to imagine caring for a pet, let alone a child.

“We’re both doing a lot to take care of myself right now,” Tessa says of her and her partner. “Maybe we’ll get to a place where we can [have a child]but now it feels much more difficult.”

For many patients, prolonged COVID is more than a medical problem. It also affects work, relationships and life plans, including when and how to have children.

More from TIME

According to the U.S. Census Bureau, about 25% of U.S. adults ages 18 to 39 who have had COVID-19 have had symptoms that last at least three months, meaning millions of people have had or are living with prolonged illness. At the peak of the COVID infection. their reproductive years; And while anyone can develop long-term COVID-19, women appear to be at higher risk than men.

Pregnancy is a “stress test” for the body, says Dr. Kathryn Gray, a maternal-fetal medicine specialist at Boston’s Brigham and Women’s Hospital who has studied the effects of COVID-19 vaccines in pregnant women. For someone already dealing with a constellation of debilitating symptoms, it can seem like a test too dangerous to pass.

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 prolonged COVID, she got a clear answer: “Don’t!” don’t even think about it.”

Before the appointment, Louise, who is 37 and lives in California, had hoped to give her now 5-year-old a sibling despite living with lingering COVID symptoms, including migraines and fatigue. She had read that some people with chronic conditions go into remission during pregnancy, at least temporarily, and wondered if that was true for her.

Louise says firing her doctor was sobering but sensible. Her symptoms have since worsened, and working from home and caring for her baby now take most of her energy. He’s basically indoors and usually has enough energy to shower once a week.

“I really don’t think my body can handle” pregnancy and raising a newborn, she says. “If I can’t handle showering when I feel like it, then I really couldn’t handle that extra challenge.”

It’s not entirely clear how long COVID affects pregnancy and reproductive health because it hasn’t been widely researched. Stacey Mismer, a professor of obstetrics, gynecology and reproductive biology at Michigan State University’s College of Human Medicine, recently published a paper finding that people with endometriosis are at long-term risk for COVID, but only after multiple academic journals reported it. : “Lack of interest [women’s health and Long COVID] and the lack of focus on understanding is simply unacceptable,” he says.

However, there is a small amount of research on pregnancy and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a condition with symptoms very similar to those of patients with long-term COVID. In a small 2004 study of people with ME/CFS, about 30% saw their symptoms improve during pregnancy, while about 30% got worse and about 40% stayed the same. After pregnancy, approximately 20% of symptoms improved, while approximately 50% worsened and 30% remained the same.

Despite the similarities between ME/CFS and Long COVID, it is unclear whether these findings apply to both conditions. “Patients with any pregnancy-related medical condition want to know the long-term consequences [and chances] making them worse off,” Gray says. “We don’t have the data right now to guide how we counsel people” with Long COVID.

Researchers know little about how the SARS-CoV-2 virus may affect reproductive health in both women and men. While there is no research to suggest that the COVID-19 vaccine causes infertility, the virus itself can affect reproductive health in many ways.

Among men, some evidence suggests that SARS-CoV-2 may impair sperm count and quality, testicular function, and hormone levels, potentially reducing fertility at least in the short term. Research shows that men with long-term COVID may also experience erectile dysfunction, which can make it more difficult to conceive a child.

Among women, there is some evidence that some fertility markers are lower for at least several months after infection, and people who are infected with COVID-19 during pregnancy may be at increased risk for complications ranging from pre-eclampsia to premature birth. And both the virus and its vaccine have been shown to affect the menstrual cycle, at least temporarily.

Some long-term COVID patients also experience flare-ups of symptoms around their periods, according to a paper published in January. That’s the case of Chimer Smith, 40, who developed COVID-19 long after contracting the virus in 2020. “I can always tell when it’s two weeks before my period,” says Smith, because she develops headaches, nerve pain, eye problems, facial pain. , brain fog, memory loss, and skin rash. She does not experience these symptoms as significantly for two weeks after menstruation.

Smith says she’s “willing to try anything” to break the pattern, including a hysterectomy, but first her doctor prescribed low-estrogen birth control pills to see if that helped her symptoms.

Kate Clancy, professor at the University of Illinois at Urbana-Champaign and author of a forthcoming book Period: The Real Story of Menstruation says inflammation may be a common link between prolonged COVID, menstrual changes, and symptom flare-ups during menstruation. “The uterus is a very immune organ,” says Clancy. It keeps pathogens at bay while allowing the embryo, part foreign organism, to grow safely, and it regularly sheds and regenerates the tissue. The organ is therefore highly responsive to inflammation and other immune responses, Clancy explains.

Heather-Elizabeth Brown, 38, who lives in Michigan, also experienced menstrual changes after being hospitalized with a severe case of COVID-19 in April 2020 and developing lingering COVID symptoms, including fatigue and brain fog. After Brown’s disease, her menstrual cycle changed dramatically, disappearing for months and then coming back heavier than ever.

Concerned about what those changes meant for her reproductive health, she visited a fertility specialist for testing in 2022. His results were mostly normal. But his doctor told him. “We don’t really know how COVID affects your body as a whole, so we don’t really know what will happen during pregnancy,” Brown says.

“No one knows,” he says. “They’re pretty good at grasping at straws” when it comes to reproductive health.

Although the unknowns make it terrifying, Brown is committed to having a baby, whether it requires freezing her eggs, hiring a surrogate or adopting. She admits that being a parent will be even more difficult than for most people because she still crashes if she pushes her energy too far. But “until I got really sick with COVID, it was my heart’s desire,” Brown says. “I’m not going to let COVID take that away from me either.”

More must-reads from TIME

Write Jamie Ducharme at

Source link