Posted on January 14th, 2021by RMANY

Ep 45: The COVID-19 Vaccine and Pregnancy with Dr. Lucky Sekhon

Fertility Forward Episode 45:

One of the most hotly debated topics in fertility right now is whether it is safe to get vaccinated against COVID-19 prior to conceiving, while pregnant, or while breastfeeding. The difficulty of the decision lies in the fact that there is no human safety data regarding the COVID-19 vaccine in pregnancy as the currently available vaccines have not been tested on pregnant women. Accepting a vaccine in pregnancy without safety data from human trials is a hard pill to swallow and, in today’s episode, reproductive endocrinologist, infertility specialist, and board-certified obstetrician and gynecologist, Dr. Lucky Sekhon weighs in on this topic. She explains that, essentially, it comes down to a risk-benefit analysis in the absence of data and she cautions against misinformation, asserting that there is no evidence to support a correction between COVID and pregnancy loss or reduced sperm quality. At the end of the day, it is a very personal decision – remember that you have the power of choice! All you can do is use your expertise, common sense, and understanding of the vaccine and the technology that is being used to make the best decision for yourself. Tune in today to arm yourself with additional information.

Transcript of Episode 45

Rena: Hi everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the Wellness Team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice for medical professionals, mental health specialists, wellness experts, and patients, because knowledge is power and you are your own best advocate.
Dara: Hi everyone. Today we have a recurring guest, Dr. Lucky Sekhon here. We're so excited to have her back on and today we really want to focus on the vaccine and if it's safe for our fertility patients. We are very excited because there are so many questions about this. I know both Rena and I are quite curious and I'm sure so are our listeners. So thanks for being on.
Dr. Sekhon: Thanks so much for having me, Dara.
Rena: We’re so excited to have you on, Dr. Sekhon, our recurring guest. We have, you know, sort of these recurring contributors to the podcast. So a familiar voice, I think to many, one of our amazing reproductive endocrinologists at RMA. And we're so happy to present this episode. I know I'm certainly getting a ton of questions from patients about the vaccine and whether it's healthy, both for those individuals who are contemplating pregnancy or trying to conceive as well as those that are currently pregnant. So we're so happy to bring you this up-to-date factual information. You know, we know the internet can be a super scary place and there's a lot of conflicting viewpoints out there. So we're really happy to have Dr. Sekhon on, who can kind of set the record straight, hopefully set your minds at ease about the vaccine and what it kind of involves. Yeah. Let's have you kind of take it away.
Dr. Sekhon: Yeah. So I'm so happy to be here and talking about this because there are very few moments in medicine where, you know, the field is rapidly evolving the way we're seeing this whole COVID situation unfold. Everything about this virus and its treatments and prevention with the vaccine is completely novel. And it's very exciting and amazing at what science can accomplish and develop in such a short period of time to help us, you know, solve this ridiculously difficult and scary problem that we've all been up against since earlier last year. But at the same time, it's also scary when there's so many unknowns. And when we don't have data to back up a lot of the decisions and the guidance that we're giving patients. It's very exciting that the vaccine was developed by the end of the year and that we had trial data coming from Pfizer and Moderna suggesting that they have a vaccine that's up to 95% effective. And it's also really exciting that they've been developing this technology for the last decade and it's finally come to fruition. This is a new type of vaccine. It's an MRNA vaccine which means messenger RNA. So they're using basically the genetic code, that codes for the spike protein that coats the virus and instead of traditional vaccines, which actually administer an attenuated version of the virus, or, you know, a protein associated with the virus so that your immune system knows how to recognize and attack it, this is giving your body the tools or the code to develop that protein itself. And now that allows your immune system to produce the antibodies that are capable of not only recognizing the virus, but neutralizing it and preventing you from getting sick with COVID-19. So it's just a bit of a different spin on the traditional vaccine, but because it's a newer technology and I think that in combination with the fact that the FDA had this emergency use authorization to really expedite getting this vaccine out to the general public and healthcare workers, namely to begin with, I think that has given people a cause for concern. And, you know, it's understandable that when there's a lack of data or something is really rapidly evolving and we don't have a lot of information on it, it makes people anxious. And this is particularly pertinent to our patient population because the trials, you know, for Pfizer and Moderna vaccines did not include pregnant women or women that were intending to conceive during the duration of the trial. And so automatically, you know, that raises a lot of questions for our patients who are going through fertility treatments, for patients who have already become pregnant or who may become pregnant during the course of receiving the vaccine or in the weeks after receiving the vaccine. And so it really is a difficult issue because we as doctors who are giving our patients guidance, we want to be able to point to studies and point to prove, to demonstrate efficacy, but also most importantly, to pregnant women, you know, the safety of this. Is it safe to be taking this vaccine when you're pregnant, trying to become pregnant or when you're breastfeeding? And so we have to, in the absence of data, look at how the vaccine works and compare it to other types of vaccines that are taken in pregnancy. And we have to critically examine the situation and think through our decisions and weigh the potential benefits of the vaccine against the theoretical risks. Right? And so luckily as the situation unfolded quite rapidly and the vaccine became available in what seemed like overnight, I mean, we were all talking about the FDA approving the vaccine, but then, you know, there was a really fast turnaround time where all of a sudden, a lot of healthcare workers, and I treat a lot of doctors and nurses, were getting emails saying, schedule your vaccine. So we had a very short period of time to make this decision, but luckily we've gotten some guidance from reputable sources, like the American College of OBGYNs, American Society for Reproductive Medicine. The CDC has chimed in about this and a lot of healthcare workers having weighed the risks versus the benefits, pregnant healthcare workers, many of them have made the decision to get vaccinated in pregnancy. And many women have decided to continue breastfeeding despite getting vaccinated. And, you know, I think it's a risk benefit calculus. We have to first ask ourselves what are the theoretical concerns? Right? So the first question that a lot of people had was could this impact my ability to get pregnant? So I definitely want to talk about that. And, you know, there was a viral article or blog post going around initially that there were concerns that the protein that's targeted by the antibodies that are created as a result of this vaccine could have a very similar structure to placental proteins. And so that's where a lot of concerns about the COVID vaccine and fertility came from initially. And you know, what I will say about that is we know that the MRNA that's injected in the vaccine is injected locally. That clears from your system very rapidly. Yes, there might be some similarities, but probably not enough similarities between the protein in question that's targeted by the COVID vaccine versus the placental proteins. And in addition, there tend to be very similar structures, not just with placental proteins, but other types of proteins that are found everywhere in our bodies, such as hemoglobin or collagen. So if this type of cross-reactivity was a very real threat or problem then this should theoretically have been seen in all of the data coming from the trials. Right now, what we know about the two vaccines that are being administered currently, the Pfizer vaccine and the Moderna vaccine, are that the main side effects are very mild, right? Fever, injection site soreness, mild viral or flu-like symptoms. And there have been a handful of more severe reactions like anaphylaxis, maybe like 21 cases out of the 1.8 million doses that were studied over a week period of time in December. And really beyond that, there's nothing else that's really been reported. So I think that's very reassuring.
Dara: Oh, definitely.
Dr. Sekhon: Additionally, I will say, even though the, the, um, trials really weren't geared towards pregnant or breastfeeding women or women trying to conceive, there were some women during the course of the trial that conceived about, you know, two dozen and so far, there's nothing concerning there. And obviously they're going to continue to evaluate and follow those cases. And obviously all of the women that are deciding to become vaccinated in pregnancy now or while breastfeeding, a lot of them are enrolling in trials and they're going to be followed in a longitudinal fashion. We at RMA did actually some studies that were presented at the American Society for Reproductive Medicine’s annual meeting last fall, where we were able to show that as a New York City center, performing thousands of embryo transfers pre and the post COVID era, we were able to show that there was no major difference in pregnancy rates from the embryo transfers that were performed and even more reassuring, there was no difference in the pregnancy loss rate.
Dara: Wow, that's great to hear. And my, I mean, my assumption would be, especially with someone who is pregnant, your immune system is naturally weakened. So my thought would be that it would be very important for people to get vaccinated, just, you know, similar, you know, in terms of a flu vaccine, I believe that's recommended also for pregnant women. Isn't that correct?
Dr. Sekhon: Definitely. We know for a fact that influenza is much more deadly in pregnant women and in children. And so for that reason, you know, we actively push pregnant women to get the vaccine and get vaccinated early, during cold and flu season. When we initially were hit as the first epicenter of COVID the COVID pandemic in the States, the first preliminary data that was coming out of New York City hospitals was that pregnant women were surprisingly doing well. And we were surprised because we figured that this would behave like influenza, right? In general, women who are pregnant tend to be younger and have less chronic health conditions overall and we know that COVID disproportionately affects the elderly or patients with chronic health conditions. So I think in general, it's important to know that the absolute risk of a pregnant patient who catches COVID becoming seriously ill being hospitalized, needing mechanical ventilation, facing really severe disease or death is on the lower end. But the CDC did look at our national data over the course of the entire year that we've been facing this and they showed a real increase in the risk of all of those things in pregnant women. So I think pregnancy now is a widely accepted risk factor for more severe disease for being hospitalized and for needing to be on mechanical ventilation and just having poorer outcomes. And additionally, there are some fetal risks too. There's a suggestion from that data reported by the CDC that the children of women who catch severe COVID illness in pregnancy have increased risk of preterm delivery. The reassuring thing that came out of that data is that this doesn't appear to be a virus like Zika where there's an association with birth defects, which is really, really important information as well. But yes, I agree with everything you said, Dara, it is definitely a risk factor to be pregnant in the setting of COVID. And for that reason, you know, a lot of healthcare providers feel strongly that the vaccine, you know, the benefits of the vaccine probably far outweigh the theoretical risks.
Dara: Dr. Sekhon, what about men, men who are going through the ART treatments? Do they need to get vaccinated or should they hold off? Is there any research supporting getting vaccinated?
Dr. Sekhon: There definitely is little to no research right now that's available about the effect of the vaccine on sperm quality or anything like that. But based on how the vaccine works, I cannot theorize or think of any potential risks to men in fertility or sperm quality. And so for that reason, you know, we don't have a specific recommendation. And I would think that the benefits of the vaccine would far outweigh any theoretical concerns. There's no real mechanism that we can think of that would link taking the vaccine to any sort of ill effects on male fertility.
Rena: So it sounds like if a patient comes to and says, you know, listen, what's your recommendation, you know, black or white yes or no. Should I get the vaccine or should I not? You know, I'm trying to conceive. That the recommendation would be like, yes, you should go ahead and get it and rest easy. It's, it's going to have no impact.
Dr. Sekhon: So the recommendation coming from all the major societies where you can get reputable information on COVID and the vaccine in general, ACOG, ASRM, CDC, the vaccine should be offered to pregnant patients, breastfeeding women who are in groups that are eligible to obtain vaccination. And I think that that eligibility is going to continue to expand, right? Initially it was just healthcare workers. And when you think about any individual group or person, you have to weigh what their level of exposure is. So healthcare workers, obviously at a high risk because they can't do their job from home and they're constantly interfacing with patients who may or may not be asymptomatic carriers. You have to take into account your personal risks, your age, whether you have chronic health conditions or predispositions, and then other considerations, right? Like for patients who maybe want there to be more data about specific groups, like taking the vaccine in pregnancy and they just, they have choices, right? You don't have to get vaccinated, but it should be offered to you. And then it's a personal decision of whether or not you take it. If you choose not to take it, you could choose to defer it and say, you know, I'll wait to give birth and then take the vaccine. Maybe that's an okay decision for you as long as you don't have other risk factors for severe complications from COVID. And maybe you don't have potential exposures as much as, you know, someone who is going into their job every day. If you're able to and willing to make other modifications, to really reduce your risk of exposure to COVID that could be another solution in the interim period. There are some patients that may choose to wait for a more traditional type of vaccine to become available that's more, you know, like the flu shot or the TDAP vaccine, not an MRNA vaccine, but we don't know if and when that will become available. So it's, it's a personal decision, but certainly I having reviewed the data and understanding the mechanism of how the vaccine works would not dissuade a patient and tell them that I thought there was any reason to wait whether they're in the midst of fertility treatment whether they're pregnant or whether they're breastfeeding.
Dara: That's reassuring to hear. Definitely. And I believe, aren't they in the works now for, I believe a third vaccine? I don't know if it's MRNA related and I believe it's only one dose. I think it's, is it Johnson and Johnson? I haven't really read up on it, but I know there's another one I believe in the works. That will be interesting to see also how it's different.
Dr. Sekhon: Yeah. Right now the two that are available Pfizer and Moderna are both similar. They're both and MRNA based vaccines Pfizer, you know, you can take it if you're at least 16 years of age, Moderna, 18 years of age. And there are two dose vaccines that are either three weeks or a month apart. But certainly, you know, not only is it going to be interesting to see what other vaccines become available, but I think, you know, all of us who are choosing to get vaccinated, I think it's important for all of us to pay it forward and do our part. And, you know, if you have an adverse reaction, whether it's mild or not, I think there is an app that the FDA has available for us to download and use to track our symptoms and report any adverse outcomes. There are tons of studies that are springing up everywhere. One of the examples is, you know, the Mother to Baby organization, which is tracking pregnant women and breastfeeding women that choose to get the vaccine and trying to, you know, just track their outcomes long-term so that we can build up a repository of hopefully reassuring data. I would be very surprised if anything comes out of that data suggesting that there's any ill effects or concerns about the vaccine. Again, just based on the information that we have about how the vaccine works. You know, we have very little concerns that it should cause issues with the placenta and I think that, you know, the potential benefits of reducing your risk of COVID infection, especially now that we know that it can be more severe in pregnant patients and the fact that, you know, and we still don't have data to show this, but it makes sense that potentially women who are developing these antibodies, you know, they could pass them through the placenta onto their baby and that might be protective and women who are breastfeeding, you know, maybe those antibodies are getting into the breast milk and it could be somewhat protective for their, for their newborn or infant. So I think, you know, obviously there's a lot of work to be done and we have a lot to learn about this, but so far we think that we have enough data, or I should say enough information to make an educated decision. And I think it's important for women to know that based on all of this information, the major societies and their doctors would be very supportive and encouraging if they decide that they want to take the vaccine.
Rena: I feel like I know my patients and I think that so many people, they want a black and white answer, you know, there there's so much more that goes into using assisted reproductive technology to conceive. And so for people to hear, I think sometimes the power of choice. I want people to remember, you have the power of choice. I think this is going to probably increase or cause anxiety in a lot of patients because they're going to be searching for an answer. They want to listen to a podcast, or they want to go to their doctor and they want you to tell them like yes or no. And it's not black or white, because again, you have the power of choice. You know, you can defer, you can choose not to, but I want people to remember again, that you have the power of choice and that is an action plan and that is powerful.
Your doctor can't tell you, absolutely. Yes or no. It's not like that. You know, it sounds like, and correct me if I'm wrong, Dr. Sekhon, again, this sort of, you know, from all the societies that we work with, that we go to for research and guidance, they're all saying that it should be safe. But again, based on someone's own personal choices, you can certainly elect to not get the vaccine. And that doesn't mean that you're going to get COVID nor does getting the vaccine mean that you are then going to, you know, do harm to yourself or, or a fetus if you're pregnant. I think it's just important to kind of reiterate those facts because I think sometimes again, in health care, especially with COVID with all the uncertainty, people often just want like a yes or no, right. And it's not that simple.
Dr. Sekhon: Right. Exactly. And I think it's important for women, especially those who haven't been through pregnancy yet to know that it's not unheard of to receive vaccines during pregnancy. This is just a different type of vaccine. And I think a common misconception is that because of this pandemic and this crisis that we've been faced with as a society that perhaps corners were cut and things were rushed along. But it's important to understand that this technology has been in the works for over a decade. And really there haven't been steps that have been skipped in terms of analyzing the safety. I mean, there was a robust trial with thousands and thousands of patients. And I feel like when you look at the actual numbers, one thing that people have been very concerned about is this report of anaphylaxis which is a severe allergic reaction that can be, you know, potentially life-threatening, that affecting 21 people out of 1.8 million people or more is a very low incidence. Right? And so I think it's important to be really mindful of that. There tend to be, you know, lots of sensational headlines. And that was something that really bothered me really early on. I know it bothered all of us at RMA seeing reports that the vaccine might cause infertility. And I think it was really important to nip that in the butt, because no one actually thinks that who understands how the vaccine works. And like I said, I think based on the fact that women got pregnant inadvertently during the trial who were enrolled as participants, our data, and we're a large clinic with thousands of cycles, and we did not see a difference in pregnancy loss rates or in the rates of pregnancies from embryo transfer cycles. And that's comparing around 2000 data points from pre COVID and then 500 or so data points from after the pandemic hit New York where a lot of people were positive. So I think all of this should be very encouraging to our listeners.
Dara: Oh, for sure. If anything, I feel like, you know, I know with our patients often love Dr. Google which unfortunately can bring people down a really slippery slope of misinformation just like, as you said, that thing that went viral was saying that the COVID vaccine can actually cause infertility. Are there any credible resources that you would suggest to our listeners that they should follow so they can get at least more sound information?
Dr. Sekhon: Yeah. I mean, I think going directly to the source is the best way to go about it. All of these societies while they are there to provide guidance to scientists and doctors, they have a lot of really helpful patient materials that are easy to understand for lay people and, you know, I think that if you guys are willing to, maybe we can put together a list of resources that you can put up on your Instagram or if you have a newsletter and that way people can actually check out the links for themselves. But I think, you know, the CDC does a good job of putting out information, ACOG, the American College of Obstetrics and Gynecology. And, you know, there's also a really helpful document that was put together by UMass Baystate. And it's a really helpful pamphlet or guide for women who are considering obtaining the vaccine while pregnant and or breastfeeding. And it just synthesizes the information in a really simple way. So I highly recommend checking that out.
Dara: There’s a lot of quality that’s out there.
Rena: So people can check the show notes or Instagram and we'll put it out there. So they feel like they have somewhere to turn to.
Dr. Sekhon: And at baseline, we all know vaccines are a very charged issue. And I think it's important to keep the dialogue open. And for people that are concerned, whether, you know, it's your friend or your family member, your coworker, as this vaccine becomes available to, you know, a broader part of society, I think it's important for all of us to just try to be as open as possible and really listen to what people's concerns might be and help point them in the right direction where they're getting good information from reputable sources.
Rena: Totally. I think that's super important to remember that we don't want this to become a divisive issue. And, you know, as you said, you know, we all know sort of this BAX or anti-vaxxer thing already was a hot button issue pre COVID. And we don't want this to become something that further divides people. You know, I think that's really important to remember that we're all in this together. Certainly people are afraid, they're scared and that can certainly be driving decisions. And so, you know, the best way is to, you're talking to a friend or a family member, you know, you want to remember to meet someone with kindness and be empathic. This is not simple. And I think too, as you touched upon, you know, people often hear these stats like, okay, well, a small percentage of people have this anaphylactic shock and that's what they hook upon. When, if you zoom out and you realize that's such a low percentage and in terms of, you know, probably had nothing to do with this. But I think too, you know, I deal with my patients all the time who will watch a video about, you know, starting reproductive technology and they get really scared because, you know, they hear the side effects. And so usually I'll sort of try and provide levity of the situation and say, well, you know, when we hear these drug commercials on TV, it's like the only thing we remember is not the good impact this can have on your life but you know, all these side effects that they have to say like,
Dara: The potential, the potential side effects.
Rena: Oh, like your leg’s going to turn blue or you’re going to lose your nose. Like, is that likely going to happen? No, but they have to say it. And so I think to remind people to remember, that's a super small percent, very, very unlikely.
Dr. Sekhon: And what's interesting about this situation is that because the way the vaccine rollout has gone, I would say most physicians have, at this point been offered the vaccine and probably taken it. And so we can actually speak to the experience of getting vaccinated and talk to our patients. And so that's been helpful in my practice because I get asked about this every day, all day as of the last month. And I can say like, I've had my first dose and it honestly wasn't that bad. I had some mild symptoms, but it was transient. You know, I'm, right now, I have a five month old and I'm breastfeeding. And I had to make that personal decision for myself. Do I continue to breastfeed? Or do I say, Oh, there is no data on breastfeeding women who've taken the vaccine. So I'm going to err on the side of caution because of the lack of data. And I made that personal decision to continue and my hope is that it might actually be helpful or protective. Maybe I'm going to be passing on some antibodies, who knows? So, you know, we're all human beings trying to navigate this very complicated issue. And all we can do is use our expertise, really use our common sense and our understanding of the vaccine and the technology that's being used and make the best decision. And it's always about that risk benefit calculus. What's the more likely thing to be problematic - COVID infection, you know, versus some rare outcome that was never uncovered in a trial that included tens of thousands of people? Right? So I think we all just have to kind of weigh the risks versus the benefits and think about what's important to your risk factors and your level of comfort. And so, you know, two people in the exact same situation might come to a completely different conclusion and it's a very individualized discussion that needs to take place. And I will say, this is a discussion you should have with your doctor.
Rena: Well, thank you so much for sharing your personal story. I think that's going to be super helpful for people and to resonate. They're definitely going to take comfort in that patient advocacy is really important. You know, no question is stupid. There is no bad question. You know, it's totally within your rights it’s, you know, encouraged that you ask your doctor these questions, you know, so you can make an informed choice and you can come to a place of no regrets and feel like you're making the right choice for you so that you can sleep at night. And again, remember you have the power of choice here. It's not black and white, but that doesn't have to be scary. You know? So if you're really struggling, if this conversation has sort of left you feeling like, well, thanks for the info, but I still don't know what to do, start by making, you know, a cross benefit analysis, make a pros and cons list. Write up for yourself what you see the positives of getting the vaccine with the negatives and then a column of questions for your health care provider, and then call up, make a video visit, you know, make whatever appointment you have to make. If you're able to be in touch with your team via email, you can, you know, email them your questions. I think knowledge is power. So start there. And I think, you know, hopefully that will be helpful in terms of easing some anxieties around what is certainly a hot button issue.
Dr. Sekhon: I totally agree. I think it's just such an individualized decision and you know, it, it doesn't have to be a decision you make right now. I think you can make your decision to just defer your decision and that's totally fine. So you should just feel well supported and you should feel like you're armed with the necessary information and you should only make this decision when you feel comfortable
Rena: And remember too, you know, hold your power. You know, I know there's a lot of social media out there with people posting pictures that they did the vaccine, this and that. You know, if that's stressing you out, I'm really big on digital detoxes. Don't go on and remember, you don't have to disclose your choice to anybody. Tthat is within your power. So if you're not comfortable sharing with friends or family, come up with a line that you feel is comfortable for you, that kind of is a non-answer that says you're not really comfortable saying what your choice was. You shouldn't feel pressure either way. And that is your personal decision. So you don't have to share.
Dr. Sekhon: Yeah, I agree. I was joking with someone the other day that if you get the COVID vaccine and you didn't post on Instagram, is it still 95% effective? And the answer is yes, yes it is.
Rena: So well, I’ll be honest here and tell you, so I got the vaccine and I didn't post it because I just felt a lot of mixed emotions about it. And I just didn't. I felt like it was the right choice for me. I didn't. And so I think it's great that people are doing it and posting it. I think it's super empowering, but I didn't. I just felt like it was very personal. Obviously, now I'm sharing on this podcast, which is a platform, but for a lot of reasons, I just felt like this is my business and my choice. And it's just not something that kind of want to put out there for the social media world.
Dr. Sekhon: I totally respect that.
Rena: Remember, it's your choice. You don't have to disclose, come up with, you know, an answer. If, if anyone asks you about it, you know, think, come up with, I like to call it like a cocktail response. So just a one-liner that you can deliver, which basically shuts down the conversation. You know, it's not angry, it's not lashing out at anybody. It's not alienating the person that asked the question, but it kind of a peaceful and dignified response that protects you and your choice. It's your health, your body, your choice. So just remember that.
Dr. Sekhon: I think that's, yeah, I think that's such an incredible point. I have to be honest, I didn't even think about that aspect of this topic coming onto this podcast to talk to you guys about vaccines today, but I can imagine there's a lot of peer pressure in either direction depending on who you're speaking with. So I think that this is such an invaluable point and I'm so glad you guys brought that up.
Rena: I mean, I think not even to delve further into this, but I think it just, it opens it up to judgment for people then to ask you, because I felt that myself like, Oh, are you even going into your office? Are you even around people? And it's like, that's not your business and that's not, you know, how is that your, your business? And I just think that that gets into a little bit of the sort of like judgment zone. And then that's not what this is about. You know, I just feel like we have to stick together. And again, your body, your choice. They're unrolling the vaccine, how they are in terms of who it's available to.
Dr. Sekhon: I would also tell people to be mentally prepared for their decision, because I don't know about you guys, but even as a physician, because I'm not in the ER or the ICU, I automatically assume like this, wasn't going to be a thing me probably until the end of January, maybe sometime in February. So, you know, I think things are moving very rapidly and it's a good idea to start thinking about this. Even if you're in a group that right now is not eligible, it would be a good idea to start thinking about this issue and thinking ahead, because you want to be ready for when the opportunity comes to make a decision that you're comfortable with. So it's good to think it through right now.
Rena: I think that's great. Yeah. And again, I mean, we'll post resources on our Instagram and our, our channels. And if anyone has questions on this or wants any sort of follow up, you know, send us a DM because we'll do anything we can to try and sort of facilitate that and help people as they struggle with what is, you know, a difficult and complex decision.
Dr. Sekhon: That sounds great.
Rena: Before we wrap up, we like to end each episode with notes of gratitude as our listeners know and each go around and share something we're grateful for. Dr. Sekhon, do you want to go first?
Dr. Sekhon: So this might seem really simplistic, but I'm really grateful that I had access to the vaccine and that I received my first dose and I'm planning to get my second dose this upcoming weekend. I just feel really grateful for the scientists and the amazing technology that facilitated all of this. I feel grateful to Mount Sinai for making sure that we were all able to get the vaccine. It just seems surreal to me. And this is a moment in history I'm never going to forget. And even though we still have a long ways to go, it just feels like such a light at the end of a very long tunnel.
Rena: Dara
Dara: I have yet to get my vaccine, but I am definitely eager. But I'm grateful that my parents actually just a couple of days ago, they're in Miami and have been very worried and on edge about their health and the potential of getting COVID. So the fact that they had access to getting vaccinated just, you know, helps me breathe a sigh of relief for them and hopeful to be able to get it myself soon enough. What about you Rena?
Rena: I was sort of reflecting this morning as I had a burst pipe in my apartment and was dealing with that, which the universe did that to me two Januaries ago. So I wasn't sure what it is about January and burst pipes in my life. But I was reflecting, you know, as this sort of the past year. And, you know, as I continue to evolve and grow how prior to the pandemic or this, you know, work I've done to continue to grow as a person that totally would have thrown me off. You know, I would have been super upset, not only about the loss but about how it affected my day. It would have been much harder for me to pivot. I'm someone who likes to be on time to everything, super professional. And it would have just really thrown me off. And again, I don't know if it's because of the past year or what it just was like, okay, whatever. And it was just such a minor thing. Whereas before I think it would have been such a major thing. So I'm just sort of grateful for that, you know I'm someone who thinks who sees that there's a lot of positives to come out of the pandemic or I like to view it that way. Obviously honoring and respecting the horrible loss and everything, but I'm just someone who likes to also try and find the positives in it. And also too, you know, I've found that the vaccine experience really emotional and definitely got pretty teary. I just felt like it was emotional for a lot of reasons and I kind of just sat there and honored the experience and felt really, really grateful to be there. So that was my long-winded answer for today.
Dara: I'm proud of you. You're able to let go. I don't know if I was, if I was in the same position in terms of having that leak and you know, still showing up, you said late, but you were on time. I mean, that's pretty impressive.
Rena: Well, this one was minor compared to the last one. So that was also…
Dara: Well, Dr. Sekhon, we love having you on. You really have been able to really inform ourselves and our listeners on the vaccine and how it relates to pregnancy and fertility and really reassured us in many ways by, you know, giving us the information that's out there thus far. And we would love to have you back on sooner rather than later.
Dr. Sekhon: Thank you so much for having me. I feel like this is such an important topic because it's rapidly unfolding. And obviously from week to week, I think we always learn new information, but I'm looking forward to hopefully getting a lot more reassuring data that will put people at ease, especially people that are very data-driven and need to see it to believe it. But, you know, I, I definitely think that the best is yet to come and hopefully the worst is behind us.
Rena: Yes. I love that. And so, yeah, I think people stay tuned. It sounds like, you know, they'll certainly have you come back for part two, part three, et cetera, you know, as this continues to unfold. So we'll do our best to keep everyone up-to-date and current on this. So thank you so much.
Dara: Thank you so much for listening today and always remember: practice gratitude, give a little love to someone else and yourself, and remember you are not alone. Find us on Instagram @Fertility_Forward. And if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.

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