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Vaccinations During Infertility Treatment and Pregnancy

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October 15, 2012

An update from The Practice Committee of the American Society for Reproductive Medicine advises women of reproductive age to advocate for their health and proactively track their immunizations, particularly prior to infertility treatment and pregnancy. One study showed that fewer than 60% of OB-GYNs surveyed routinely asked their patients about vaccination history and only 10% offered vaccinations recommended to women in their reproductive years. National vaccination standards are established by the Centers for Disease Control and Prevention (CDC) and were last updated in February 2012.

Vaccinations Before Infertility Treatment and Pregnancy

As a precaution, immunizations should be administered before infertility treatment or pregnancy due to the fact that some vaccinations are not proven safe during pregnancy. Vaccinations protect women and their unborn fetus from potential serious illness, and passive immunity once the child is born.

Samantha M. Pfeifer M.D., Chair of the ASRM Practice Committee and Associate Professor of Obstetrics & Gynecology, Director of Reproductive Surgery at the University of Pennsylvania Medical Center tells us: “[The ASRM Practice Committee recommends] that fertility patients are aware of what vaccinations are recommended in their age group and are up to date with their vaccines. It is also important these patients are aware of what vaccines are acceptable to receive while pregnant or attempting pregnancy and also be aware that some vaccines should not be given while actively attempting pregnancy or when pregnant”.

Some doctors may hesitate to immunize pregnant women, but the committee assures us this is due to the possibility for congenital anomalies or spontaneous abortions being falsely attributed to the vaccination. There are very few vaccinations contraindicated during pregnancy , and in some cases the benefits of the vaccination outweigh the risks. This is especially true in instances of military service or travel to countries where a disease is highly prevalent, occupations that present risks for exposure to a disease, and those who are immuno-compromised or chronically ill.

Routine Vaccinations

Measles, Mumps, Rubella (MMR)

  • Recommended for women without confirmed immunity to rubella.
  • Contains live attenuated virus.
  • Vaccination should be administered before pregnancy to avoid potential intrauterine infection.
  • Pregnancy should be avoided for 1 month after vaccination.

There are no confirmed instances of birth defects or significant intrauterine infection attributed to the MMR vaccination. Inadvertent administration of the vaccination to a pregnant woman is not cause for pregnancy termination.


  • Recommended for all adults without confirmed immunity.
  • Contains live attenuated virus.
  • Prior to pregnancy, adults should receive 2 doses of the vaccine 1 month apart. If exposed to varicella prior to pregnancy, vaccine should be administered within 96 hours of exposure and pregnancy avoided.
  • Pregnant women who do not show signs of immunity should receive the first dose of the vaccine upon giving birth or termination of the pregnancy and before discharge from the hospital.

Cases of congenital varicella after immunization have been reported.


  • Annual influenza vaccination is recommended for all individuals over the age of 6 months.
  • Injectable vaccination contains inactivated virus and is safe during pregnancy; Intranasal vaccination contain live attenuated virus and should not be administered during pregnancy.
  • Pregnant women or those planning on becoming pregnant should be vaccinated due to the risk for medical complications during pregnancy.
  • Optimal immunization time is between October and November as flu season spans from January through March.

Despite previous concerns regarding thimerosol-containing vaccine administered to pregnant women, there is no scientific evidence which correlates negative health effects in children born to women who have taken the thimerosol vaccination. The influenza vaccination is recommended to pregnant women with or without thimerosol.

Tetanus-Diphtheria-Pertussis (Tdap) and Tetanus-Diphtheria (Td)

  • Recommended for adults 19-64 years of age who anticipate close contact with an infant less than 12 months of age.
  • Women who are pregnant or might become pregnant and have not previously received the Tdap vaccination should be immunized. Pregnant women should receive the Tdap vaccination after 20 weeks’ gestation, preferably. If not given during pregnancy, Tdap should be administered immediately following completion of a pregnancy to ensure pertussis immunity and reduce transmission to the newborn.

Non-Routine Vaccinations


  • Recommended for any person at increased susceptibility of pneumococcal infection, including those with asplenia, sickle cell anemia, chronic cardiovascular illness, diabetes, HIV, or other immuno-compromised diseases.
  • Women at high risk of contracting pneumococcus should be vaccinated prior to pregnancy.

Hepatitis A (HA)

  • Recommended for any woman at high risk of contracting Hepatitis A, including those with chronic liver disease, those receiving clotting factor concentrates, women occupationally exposed to HA, intravenous drug users, and those travelling to countries of high prevalence.
  • Contains inactivated virus; poses no known risk to the fetus.
  • Can be administered during pregnancy.

Hepatitis B (HB)

  • Recommended for any woman at high risk of contracting Hepatitis B, including those receiving clotting factor concentrates or hemodialysis, those with occupational exposure to blood, intravenous drug users, women with multiple sexual partners or contracted sexually transmitted infection, those travelling to countries of high prevalence, and women living with an individual infected with HB.
  • Contains noninfectious DNA particles; poses no known risk to the fetus.
  • Can be administered during pregnancy.


  • Recommended to any person at risk of meningococcal infection, including those in areas of high prevalence such as college dormitories and high endemic countries.
  • Limited to pregnant women not previously immunized.

High risk women should be vaccinated prior to pregnancy because data on this population is limited.

Click here to view the full CDC vaccination schedule.


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