Zika fears: The women postponing IVF

Ana Paula Coutinho has interrupted her IVF because of fears over the spread of the Zika virus

"I don't have much time left to be a mother, but I'm really afraid" architect Ana Paula Coutinho, 47, says.

She is one of many Brazilian women who, in the last few months, have decided to interrupt their in-vitro fertilization (IVF) procedures because they worry about being infected by the Zika virus while pregnant.

"My husband and I have been doing IVF for seven years with no success," Ms Coutinho explains.

"My latest attempt to get pregnant would have been this January but we were so afraid of Zika that we decided to freeze the embryos and see how this unfolds," she says.

Microcephaly fears

Last October, Brazilian health authorities detected a possible link between a recent outbreak of the mosquito-borne Zika virus and a rise in numbers of babies born with underdeveloped brains.

Researchers found that the virus could be transmitted from mother to baby during pregnancy. They believe that Zika might be the cause of the rise in microcephaly cases.

Ms Coutinho lives in Pernambuco, the Brazilian state with the highest number of suspected microcephaly cases.

She says she and her husband have decided to postpone their IVF for at least three months.

"We don't know for sure what is going on and when it will end," she says. But the 47-year old adds: "We can't wait too long".

Emotional rollercoaster

Ms Coutinho says that IVF is not just a costly, but also a physically and emotionally draining procedure.

Women who undergo the process have to take medication in order to stimulate the production of eggs.

Then the eggs are harvested by doctors, fertilised and implanted in the woman's womb.

If the cycle is not successful, the process has to be started all over again.

"Every time you try, you have fresh hope. And then when it doesn't happen, you're really frustrated," Ms Coutinho says.

"Two years ago, in between procedures, I had a natural pregnancy but I lost the baby," she explains.

"Since then, I've been in treatment in order to try again and now, when everything was perfect and ready, this happens!"

Second thoughts

Fertility doctors across the country say that the number of women who have chosen to postpone their pregnancies has increased by about 10% since October.

That rate is expected to rise further.

"There is still no official data, but this is what my colleagues and I have observed in many states," says Dr Paulo Gallo.

Dr Gallo is the director of Vida, a popular fertility centre in Rio de Janeiro.

Dr Paulo Gallo is the director of a Rio fertility centre

"Five to seven of my patients every month are having second thoughts about getting pregnant now," he says.

Dr Gallo says it is hard for doctors to know what advice to give to their patients.

"What should I tell them? To wait six months? I can't do that because I don't know if we'll have a vaccine or if we'll have eradicated the mosquito by then", he says.

He explains that most of the patients who have decided to delay IVF until the winter, when there are fewer mosquitoes and chances of getting infected by Zika are lower.

'Talk to your doctor'

The official advice from Brazil's Ministry of Health is for women to talk to their doctors about the risks of a Zika infection during pregnancy before they make a decision and to protect themselves against the mosquito bites if they decide to go through with it.

But one of Dr Gallo's patients, who has asked not to be identified, says that is just not enough.

"Every day they discover something new. I got increasingly scared," the 42-year-old woman says.

She had her eggs frozen three years ago and was about to try IVF for the first time this January but decided to delay.

Some women are deciding to keep their embryos frozen and delay IVF

"I want a baby and I pray that it'll be healthy, but I don't want to tempt fate," she says.

"Having to postpone my dream again was hard, but I think I would feel worse if I got pregnant and had the disease," she explains.

'No regrets'

Norma Guimaraes, 34, and her husband tried IVF for the first time in October, when news about the rise in microcephaly cases in Brazil's north-eastern states had already spread.

Norma Guimaraes and her husband decided to go ahead with IVF

"Initially we were startled by the news and afraid of the virus, but we decided to go ahead with it," she recalls.

"Brazil has been living with this mosquito for decades now and it hasn't been able to eradicate it or even produce a vaccine against dengue [fever, spread by the same mosquito which transmits Zika]," she explains their decision.

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"We'll probably have to live with Zika for a long time", she says.

Ms Guimaraes is now 15 weeks pregnant with a girl, whom she is planning on calling Helena.

"We feel happy and confident because our dream is coming true, but not completely, because we must take every precaution to avoid Zika," she says.

She uses repellent religiously, and avoids places were mosquitoes could be present, such as swimming pools.

She has also traded her summer dresses for long sleeves and trousers, to expose as little skin as possible to mosquito bites.

"I'm trying to find a balance between hearing all the bad news and enjoying what I've wanted for so long", she says.

"Not every woman will have Zika and not all of those who have it will have babies with microcephaly. We don't regret our decision, not even for a minute."