Since the end of 2015, authorities around the world have raised the alarm about the Zika virus. The most important danger is risk of transmission by pregnant women to the fetuses that they carry. Because the virus carries important implications for developing fetuses, both the American Centre for Disease Control (“CDC”) and Health Canada have issued special warnings to donors, recipients, and anyone planning on becoming pregnant.
While there is no vaccine and no treatment for Zika, its symptoms of fever, rash, joint-pain, and red eyes are common, so adults often recover without even knowing they were infected. However, children who are infected while in utero have high chances of developing a birth defect known as microcephaly, a condition where the brain does not fully develop.
Various health authorities have advised donors, recipients, and anyone wanting to conceive to take preventative measures. In January 2016, the CDC issued a warning advising pregnant woman to postpone travelling to regions with a Zika outbreak. Health Canada urged women returning from outbreak areas to delay their pregnancies for at least two months afterwards.
Before the first confirmed Zika infection in Brazil in 2015, outbreaks had historically been limited to Southeast Asia, the Pacific Islands, and Africa (it was discovered in Uganda in 1947). The current outbreak of Zika has been concentrated in the Americas, but recently cases have reached the United States and Canada. With the warm summer months approaching, no one can accurately predict whether the Zika virus will start to circulate in continental North America.
Because the virus usually appears in equatorial regions, many people associate Zika only with mosquitos. But Zika can also be transmitted sexually. A recent case in Ontario was linked to sexual transmission. In February 2016, Health Canada issued an advisory that men returning from a Zika outbreak area should use a condom for six months afterwards to reduce any potential risks of transmission, and the CDC has issued its own, albeit shorter, recommendation. As of the date of this article, there is no definitive word on how long the virus is present in semen after infection.
While the Zika virus began spreading in isolated tropical regions, it has transformed into a global issue and no one can accurately predict the path of viral circulation. Because the virus can be transmitted not only through mosquito bites but also through unprotected sex, Zika has become as much an infectious disease issue as a reproductive health one. Pregnant women and anyone wishing to become pregnant should assess those risks carefully. If you are not yet pregnant, but are about to start fertility treatments, you may wish to bank sperm in advance of your male partner’s travel, and discuss all your options with your IVF physician.
If you are pregnant, or planning on becoming pregnant, you can speak to your physician, and make your own plans. But what if your fetus is being carried by a surrogate? What if she already has travel plans, or her sexual partner often travels for work?
If you are embarking on surrogacy, there are so many discussions that are ahead of you, and now travel and the Zika virus will be one more potentially awkward topic of conversation. A few suggestions:
- Don’t be shy. Ask your surrogate, or potential surrogate about any future planned travel for her or her sexual partner.
- Ask about any travel in the past six months. If there has been travel to an area in which Zika is circulating, discuss possible testing with your physician.
- If her partner does travel to Zika areas, ask if the surrogate is willing to use latex condoms for the duration of the pregnancy. Ask her sexual partner as well, just to make sure you get the same answer!
- Exercise caution, and don’t let anyone take advantage of the situation. Many intended parents would choose to ask a surrogate to cancel a planned trip if there was risk of Zika transmission, and you can certainly reimburse a surrogate for any out of pocket expenses incurred as a result. However, ask for all receipts, proof of initial booking, and confirmation of cancellation before you reimburse any of those expenses.
Zika is easily transmitted, and can result in devastating consequences. Your IVF physician can help answer questions, or at least help you ask the right questions.
Sherry Levitan is a fertility lawyer practising in Toronto, and is a Fertility Matters Board member. For more information on matters related to third party reproduction check out her website: www.surrogacylawyertoronto.com or follow her on Twitter: @sherrylevitan