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Patient Counseling

Couples Planning to Conceive

Health Alert Notice: CDC issued a Health Alert Notice (HAN) to share emerging evidence about interpreting Zika IgM antibody test results of women who may have been exposed to Zika virus, particularly women who live in or frequently travel to areas with a CDC Zika travel notice, before conception. For women planning to become pregnant who might have been exposed to Zika previously, healthcare providers can consider testing for Zika antibody before pregnancy. Antibody test results before pregnancy should not be used to determine if it is safe for a woman to become pregnant. Rather, testing before pregnancy can help determine whether a woman becomes infected during pregnancy. CDC is currently updating its webpages with this information.

With Exposure to Areas with CDC Zika Travel Notices

For women and men who have been diagnosed with Zika virus or had exposure to an area with a CDC Zika travel notice, even if they have no symptoms, CDC recommends that healthcare providers advise:

  • If a woman is exposed, the couple should wait at least 8 weeks after her symptoms started or last possible Zika virus exposure before trying to get pregnant.
  • If a man is exposed, the couple should wait at least 6 months after his symptoms started or last possible Zika virus exposure before trying to conceive.
    • During the waiting periods after their possible exposure, couples should also be counseled to correctly and consistently use condoms for vaginal, anal, and oral sex, in addition to their chosen method of birth control, or to not have sex.

Given the limited data available, men and women with possible Zika virus exposure might choose to wait longer than the recommended time period to conceive, depending on individual circumstances and risk tolerance.

With Exposure to Areas with Risk of Zika but No Travel Notice

Decisions about pregnancy are personal and complex, and the circumstances for women and their partners will vary. The level of risk for Zika virus infection in these areas is unknown. For this reason and because information is limited about the risk of infection around the time of conception, healthcare providers should counsel women and men who are trying to conceive about travel to these areas and their risk of Zika virus infection. This conversation should address the potential consequences of becoming infected with Zika around the time of conception in the context of the couple’s plans to have children, their individual circumstances, and risk tolerance.

Zika virus testing is indicated for non-pregnant women and men who have exposure to these areas and who experience symptoms of Zika virus disease. Those who test positive for Zika should follow the suggested timeframes above before trying to conceive.

With Ongoing Exposure to Areas with Risk of Zika

Ongoing exposure means living in or frequently traveling to (e.g., daily or weekly) to an area with risk of Zika. Given the ongoing possible exposure to Zika, healthcare providers should counsel couples about how they can protect themselves against Zika, the potential consequences of becoming infected with Zika around the time of conception (in the context of the couple’s plans to have children), and their individual circumstances.

Zika virus testing is indicated for non-pregnant women and men who live in or frequently travel to any area with Zika risk and who have symptoms of Zika. Those who test positive for Zika should follow the suggested timeframes above before trying to conceive.

Couples Not Planning to Conceive

Men and women should use condoms correctly and consistently for vaginal, anal, and oral sex 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.

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

CDC is aware of reports of Zika virus RNA detected in semen more than 90 days after symptoms began, with the longest report at 188 days. However, it’s unknown whether Zika virus RNA in the semen represents infectious virus. There have also been reports of men without symptoms who are infected with Zika transmitting Zika virus to their partners through sex. Without definitive data showing a difference in the risk for men with and without symptoms to spread Zika through sex, the recommendations are the same for both groups.

To date, Zika virus has been cultured (shown to be infectious) from semen collected within 3 months after symptoms started. Given the limited information available at this time and the potential for severe birth defects from congenital Zika infection, CDC recommends men wait 6 months before attempting pregnancy with their partner. This recommendation will be updated as new data become available.

Recommendations by Geographic Location

Clinician Resources

Preconception Counseling Guide for Men and Women Living in Areas with a CDC Zika Travel Notice Who are Interested in Conceiving

Counseling Travelers: Women and Men of Reproductive Age

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