hep c positive women and invitro treatment
Feb 23, 2013
I have been diagnosed with hep c while undergoing checks for in-vitro treatment. At the same time we have received a letter from Chelsea and Westminster Hospital that they can do in-vitro despite my hep C (we have funds from NHS for two treatments). They require letter from my virologist in which he will not object to in-vitro. My doctor wants me to undergo treatment, but I am keen to try in-vitro first. I am 38 years old and afraid that if I do not try in-vitro now it will be too late for me (I must start before my 40th birthday which is September next year). My genotype is 3a and the treatment would take about 24 weeks, then we will have to wait another 6 months to check if I am cured. I do not really know what to do, at this moment my virologist is saying no and want to see me in 6 months time. He is blocking me from in-vitro now and I think he wants to make me to do the hep c treatment first. If I do the treatment and clear myself out of hep, will I be able to have in-vitro after a year? If within a year I do not clear myself from hep - will I be still able to try in-vitro? It is all very confusing for me and the time is rather important.
Response from Dr. Taylor
Interferon and ribavirin are not safe medications to take during pregancy. These medications can last in the body for a long time so it is recommended that a person wait at least 6 months after stopping these medications to become pregant. I recommend waiting at least 9 months after stopping these medications before becoming pregnant. Ribavirin can cause damage to a developing fetus. Interferon may increase risks for spontaneous loss of pregnancy. So regarding your timeline for becoming pregnant, factor in needing 9 months after taking ribavirin to attempt in vitro.
There is no reason why a hepatitis C virus (HCV)-infected woman must be cured of HCV before becoming pregnant. The risk of passing HCV to a developing fetus is approximately 5%, so 95% of the time the infant does not acquire HCV from the pregnant woman. If the woman is HIV-infected, the risks of passing on both HIV and HCV are higher. HCV is not spread via breastmilk.
I do not think it is just for a physician to block you from in-vitro based on your HCV. Some women prefer to be cured of HCV before becoming pregnant. Since the risks of passing HCV along are so small, other women feel differently. You have the additional pressure of time regarding your age and in-vitro. These decisions should be made by you based on your priorities for child-rearing. I would ask your doctor to clarify what the rush is regarding your HCV treatment. If your liver is not very sick you should be able to wait until after your pregnancy, as long as you are willing to take the very small risk of passage of HCV to your child.
I hope you can get a second opinion from another HCV doctor if need be. No one should make ultimate decisions about your childbearing except for you. I am sorry to hear of your stressful situation and wish you the very best.
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