Patient Counseling on Zika and Pregnancy for People Planning to Conceive

People Planning to Conceive

Before Travel to Areas with a Zika Outbreak (as Indicated by Red Areas on the Zika Map) or Other Areas with Risk of Zika (as Indicated by Purple Areas on the Zika Map)

Healthcare providers should counsel people planning pregnancy about travel to areas with a Zika outbreak or other areas with risk of Zika. Consideration should be given to the health risks and potential consequences of Zika virus infection around the time of conception and during pregnancy as well as a discussion of the patient’s individual circumstances, level of risk tolerance, and plans for having children.

Following Travel to Areas with a Zika Outbreak (as Indicated by Red Areas on the Zika Map) or Other Areas with Risk of Zika (As Indicated by Purple Areas on the Zika Map)

Remind patients that most people infected with Zika remain asymptomatic.

• If a couple has a female partner and only she travels: before trying to get pregnant, the couple should wait at least 2 months after the date of her last possible Zika virus exposure (if asymptomatic) or 2 months after the start of her symptoms of Zika virus disease (if symptomatic).
• If a couple has a male partner and only he travels: before trying to conceive, the couple should wait at least 3 months after the date of his last possible Zika virus exposure (if asymptomatic) or 3 months after the start of his symptoms of Zika virus disease (if symptomatic).
• If a female and male couple travel together: before trying to conceive, the couple should wait at least 3 months after the date of their last possible Zika virus exposure (if asymptomatic) or 3 months after the start of his symptoms of Zika virus disease (if symptomatic).

In addition to a discussion about waiting to conceive, couples should also be counseled about correctly and consistently using condoms to prevent the sexual spread of Zika virus during the waiting period. Condoms should be used during vaginal, anal, and oral sex and while using sex toys. Condoms may be used as a method of birth control alone or in addition to a couple’s chosen method of birth control. Couples may also choose not to have sex during the waiting period.

CDC’s Zika testing recommendations for nonpregnant women and men are available on the Zika and Testing webpage.

People Not Planning to Conceive

Men and women should use condoms correctly and consistently for vaginal, anal, and oral sex and while using sex toys in addition to their chosen birth control method, or abstain from sex if they are concerned about the possibility of transmitting Zika virus to their sex partners. People who live in or travel to areas with risk of Zika should be informed that Zika can be passed through sex, even if the infected person does not have symptoms at the time. The virus may also be passed through sex by a person who has been infected with the virus but never develops symptoms.

Couples can follow the designated timeframes below to minimize their risk for sexual transmission of Zika virus.

• If a couple has a female partner and only she travels to an area with risk of Zika: the couple should consider using condoms or not having sex for at least 2 months after the female partner returns (even if she doesn’t have symptoms) or from the start of the female partner’s symptoms or date of diagnosis.
• If a couple has a male partner and only he travels to an area with risk of Zika: the couple should consider using condoms or not having sex for at least 3 months after the male partner returns (even if he doesn’t have symptoms) or from the start of the male partner’s symptoms or date of diagnosis.
• If a couple has both a male and female partner and they both travel to an area with risk of Zika: they should consider using condoms or not having sex for at least 3 months after their return or from the start of symptoms or date of diagnosis.

Patients should be counseled about contraceptive methods, including the availability and effectiveness of different contraceptive methods and how to use these methods. The decision about what type of contraceptive method to use is a personal decision and should be made by the person or couple in consultation with their healthcare provider.

Persistence of Zika in Semen

Limited data suggest the incidence of Zika virus RNA shedding in semen and its persistence after infection are likely similar for symptomatic and asymptomatic men infected with Zika virus. A review of the literature can be found in CDC’s guidance for preconception counseling and prevention of sexual transmission of Zika virus.