The day after she returned from her destination wedding in Puerto Rico, Elizabeth Agraz, of Los Angeles, received some unexpected news at a fertility appointment: Due to concerns about the Zika virus, she would have to delay her long-awaited pregnancy at least two more months.
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“It’s been a battle,” Agraz, whose efforts to get pregnant had been previously thwarted by thyroid cancer and other medical issues, told ABC News.
Agraz and her husband, Justin Sanchez, started planning their trip in 2014, long before Zika -- the virus now known to cause birth defects -- began making headlines. They had paid for the majority of the wedding. Many family members had already purchased their tickets. So, they decided to go ahead with it.
“We really didn’t think it was going to affect us,” Agraz said.
How Long to Wait?
Dr. Kristin Bendikson, the fertility specialist Agraz met with shortly after her wedding in May, said that the majority of her patients did not know about the official travel warnings for couples hoping to get pregnant.
“We’re trying to get the word out to our patients,” said Bendikson, who also teaches at USC Keck School of Medicine.
The U.S. Centers for Disease Control and Prevention recommends waiting at least two months after traveling to Zika-affected areas before having unprotected sex and trying to conceive. If the male partner is diagnosed with Zika, the CDC raises the bar to six months due to the virus’ ability to linger in blood and body fluids, particularly semen.
The U.S. Food and Drug Administration has also set guidelines for donated tissues, which include sperm and eggs: Those diagnosed with Zika, and even those who risk contracting the virus through travel or sexual contact, are considered ineligible for anonymous donation for six months. These recommendations do not apply to couples.
Couples Get Proactive
Given these risks, couples like British Olympian Greg Rutherford and his partner Susie Verrill have opted to see fertility specialists long before traveling to South America. Verrill wrote in Standard Issue on Tuesday about their decision to freeze Rutherford’s sperm before the Olympics.
“It’s just another thing we don’t want to chance,” she wrote.
Bendikson said she, too, has seen patients who decided to freeze sperm before traveling to South America.
“I think it's a fantastic idea for people who don't want to delay,” she said, adding that a two- or six-month wait may seem short to younger couples, but for women over 35, “every month counts.”
Pursuing fertility procedures like in vitro fertilization can require a series of costly and time-consuming visits to harvest and fertilize eggs, Bendikson said. For women who schedule these visits during the summer -- like the many teachers Bendikson sees in her practice -- having to wait a couple more months can cost women a full year, she said.
'You Can't Be Scared Forever'
Agraz and Sanchez, however, hoped to avoid waiting any longer. Throughout their wedding, they lathered up with bug spray and wore mosquito repellent bracelets on their arms and legs.
“We still got bombarded by mosquitoes,” said Sanchez, who also traveled to Rio de Janeiro in February for his bachelor party. However, neither developed symptoms, so the couple hoped they might be in the clear.
It is difficult to rule out having been infected with Zika, which is why experts recommend waiting anyway. Most adults who contract the virus experience no symptoms. Furthermore, testing is only recommended by the CDC for travelers who are already pregnant or for those who have experienced symptoms.
Couples like Agraz and Sanchez, who had no symptoms but planned to get pregnant, are not included in these testing recommendations, according to Dr. James Segars, who sat on the Zika guidance committee for the American Society for Reproductive Medicine.
“For our couples who are infertile, Zika is a problem,” Segars, a professor of obstetrics and gynecology at Johns Hopkins University, told ABC News. “I’m not surprised that people are thinking of ways around this.”
In addition, tests can take weeks for the results to come back, and some tests are not able to distinguish between Zika and similar viruses like dengue and chikungunya. According to CDC documents, a test may suggest a patient has had Zika when in fact he or she has not.
“If the test is not 100 percent accurate, you’re going to have to wait [to get pregnant] anyway,” Bendikson said.
Despite the disappointing wait, however, Sanchez said he sees their story as a positive one -- a welcome contrast to countless reports about families whose lives have been turned upside-down by Zika.
“There’s still people out there that are moving forward with life,” he said. “You can’t be scared forever.”