How long should a woman delay pregnancy after contracting Zika virus?

Pregnancy Delay After Zika Virus Infection

Women who contract Zika virus should wait at least 2 months (8 weeks) after symptom onset or last possible exposure before attempting to conceive, while their male partners should wait at least 3 months. 1

Gender-Specific Waiting Periods

For Women with Zika Infection

• Wait at least 2 months (8 weeks) after symptom onset if symptomatic, or after last possible exposure if asymptomatic, before attempting conception 1
• This timeframe applies whether the woman had confirmed infection or only possible exposure to Zika virus 1
• The couple should use condoms or abstain from sex during this entire 2-month waiting period 1

For Male Partners with Zika Infection

• Wait at least 3 months after symptom onset if symptomatic, or after last possible exposure if asymptomatic, before attempting conception 1
• This represents an updated recommendation from the previous 6-month waiting period, based on new data about viral clearance 1, 2
• The 3-month timeframe is critical because Zika virus RNA can persist in semen for extended periods, though most individuals clear the virus within 90 days 3, 4

When Both Partners Have Exposure

• Follow the male partner's timeline of 3 months from his symptom onset or last possible exposure before attempting conception 1
• This longer waiting period takes precedence because of the prolonged persistence of Zika virus in semen compared to other body fluids 1, 4

Critical Rationale for These Timeframes

The differential waiting periods reflect important biological differences in viral clearance:

• Zika virus RNA clears from blood relatively quickly but persists significantly longer in semen, with mean clearance time of approximately 54 days 3
• At >90 days after illness onset, ≤7% of individuals had detectable Zika virus RNA in bodily fluids 3
• Sexual transmission has been documented from men to women, men to men, and women to men, with 52 confirmed cases of sexual transmission reported in the United States by July 2018 5
• Zika virus infection during pregnancy causes serious birth defects, including microcephaly, arthrogryposis, dysphagia, deafness, and visual impairment—collectively considered a congenital syndrome 6

Shared Decision-Making Considerations

While the CDC provides these specific timeframes, couples may choose to wait shorter or longer periods based on individual circumstances such as age, fertility status, or details of exposure, through shared patient-provider decision-making 1

Common Pitfalls to Avoid

• Underestimating viral persistence in semen is a critical error, as Zika virus RNA has been detected in semen for more than 180 days after illness onset in some cases 5, 4
• Failing to counsel about both mosquito bite prevention AND sexual transmission prevention represents inadequate patient education 5
• Assuming asymptomatic exposure carries no risk—the same waiting periods apply regardless of whether symptoms developed 1
• Not using barrier protection during the waiting period—couples must use condoms or abstain from sex for the entire recommended timeframe 1