As part of a new patient’s workup, we check for immunity to two diseases: varicella (also known as chicken pox) and rubella (also known as German measles).
Let’s talk about varicella first. You might say “Oh, I remember having chicken pox when I was a kid”. Unfortunately, having the illness or even getting the vaccine years ago doesn’t always mean you have developed enough antibodies to the virus to prevent you from contracting the disease again. With a simple blood test, we can check to see if you have enough antibodies to protect you now.
If the blood test results indicate that you are either non-immune or equivocal (not definitely immune), your doctor will recommend that you get the varicella vaccine from your primary physician. The vaccine is given in two doses four weeks apart. It is very important that you do not become pregnant from the time of your first dose until 30 days after the second dose. Therefore, you should not have unprotected intercourse during that time, and you cannot have an insemination or an embryo transfer during that 60 day period as well.
The reason for these restrictions is that contracting varicella while pregnant (whether from exposure to someone who has the illness or from the vaccine itself which contains a weakened strain of the virus) can have very serious consequences for both the mother and her unborn child. According to the Centers for Disease Control (CDC), 10-20 % of pregnant women who get varicella also develop pneumonia with the chance of death as high as 40%. If the pregnant woman gets chicken pox during the first or early second trimester, there is as small chance (2%) that the baby could be born with birth defects that include scarring of the skin, low birth weight and problems with development of arms, legs, brain and eyes. Furthermore, if the mother contracts the illness close to the time of delivery, the newborn can then be infected with the chance of death as high as 30%.
So you can see why it is so important for us to check your immunity to varicella and how strongly we recommend that you get the vaccine if you are not immune. However, if you are not fully immune and if after being informed of the risks you still do not want to get the vaccine, you can sign a waiver indicating that you are aware of the possible complications but choose not to get the vaccine.
We feel though that a short delay in starting infertility treatment is worth the peace of mind that you will have knowing that you are helping to insure a healthy pregnancy for you and your baby.
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