As of early 2025, there is no universal definition for long COVID (aka post-COVID-19 syndrome). However, according to the Mayo Clinic, experts often define the illness as a “long lasting, chronic condition triggered by the virus that causes COVID-19”.
In medicine they refer to this as an infection-associated chronic condition.
Researchers are still working to learn more about long COVID, so definitions, symptoms, and risk factors may change as future studies are conducted and published. But it’s clear from the studies we do have, as well as the lived experience of many people around the world, that long COVID is a pressing issue, impacting the health of a significant percent of the population.
According to Statistics Canada, about 3.5 million Canadian adults report experiencing long-term symptoms following a COVID-19 infection. This has made its mark on people’s wellbeing in many ways. Fertility and family planning are among them.
While researchers aren’t exactly sure how COVID-19 causes long-term illness, their theories include the following:
- The virus that causes COVID-19 upsets immune system communication
- Viruses that haven’t been cleared out of the body are awakened by COVID-19
- Upset gut ecosystem
- Cells that line the blood vessels are affected by the virus
- The virus damages the vagus nerve, which controls automatic functions in the body
Symptoms and Risk Factors:
More than 200 symptoms have been linked to long COVID in research studies. The most common impacts are as follows:
- Extreme tiredness
- “Brain fog” or problems with memory
- Light-headedness
- Problems with taste or smell
- Sleep issues
- Shortness of breath
- Cough
- Headache
- Fast or irregular heartbeat
- Digestion problems
Some illnesses may be caused by or made worse by long COVID. These include migraines, lung disease, autoimmune disease, and chronic kidney disease. Almost half of Canadians who report having long COVID symptoms also report that their struggles have not improved over time.
Most research suggests that the risk factors for long COVID include being female and having cardiovascular issues prior to a COVID-19 infection.
The Link Between Long Covid and Fertility:
A study published by the National Institute of Health suggests that there has been an underreporting of post-COVID ovarian suppression, infertility, and menstrual abnormalities. The article says that post-COVID-19, there was an “upsurge of menstrual abnormalities such as prolonged cycles and decreased volume of menstruation”.
Additionally, some patients with COVID-19 have abnormal levels of sex hormones, such as inappropriately high concentrations of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The conclusion of this study says that COVID-19 may lead to disturbances in the functions of the female reproductive system, possibly impacting fertility.
In another study for the NIH, researchers say “an urgent need” exists for the prioritization of long COVID as it applies to women’s reproductive health. The findings of their review indicate the serious impacts of long COVID, including menstrual irregularities, impaired ovarian function, and fertility concerns.
Family Planning:
In a 2023 article for Time magazine, journalist Jamie Ducharme delves into the impacts long Covid has on people’s decision to have kids.
“For many patients, long COVID is more than a medical issue,” she says. “It also affects work, relationships, and life plans—including when, how, and whether to have children.”
Ducharme writes about the millions of people in the United States of childbearing age who have lingering COVID-19 symptoms, even months or years after their infection. She speaks to a woman with long Covid whose doctor told her not to even think about having kids due to the severity of her symptoms.
There is so much that needs to be studied and further understood about long COVID, and, as Ducharme says, “the unknowns make it scary”. Having children can be a difficult and stressful decision to face at the best of times. With uncertainty comes even more trepidation, especially when trying to navigate a chronic illness that may or may not go away.
In 2024, journalist Hayley Gleason also wrote about the pandemic’s “untold fertility story”, and how long COVID is impacting patients’ dreams of having children. She speaks to several individuals who have been totally disabled by long COVID: people experiencing debilitating fatigue, cognitive dysfunction, and allergic reactions, among other frightening symptoms. People who are unable to work, socialize, exercise, or live independently. For many of them, having children feels like an insurmountable challenge.
On top of that, patients worldwide are struggling to receive appropriate care. According to Stats Canada, 1 in 8 Canadians who sought help for long-term symptoms after a COVID-19 infection felt they received inadequate care. Part of this is likely because there is not enough known about the condition, and that more research is seriously needed. But research is only funded when an illness is taken seriously by our leaders and the population as a whole. Because of “COVID fatigue”, or the understandable but ultimately detrimental urge for us to move beyond the pandemic entirely, the messaging around long Covid is not helping people access the education and care they need.
Conclusion
There is a lot of loss and despair associated with infertility, with long COVID, and with having to adjust your hopes and dreams because you feel too sick to care for the child you desperately want. In Gleason’s article, she speaks with a woman whose parenting has been drastically impacted by her symptoms. The woman has no regrets, and says that pregnancy with long COVID felt like the most difficult and rewarding thing she’s ever done. Still, it’s unfortunate so many like her are struggling, and more resources need to be directed to the pursuit of better understanding this illness—how it works, how it can be helped or cured, and how family planning fits into the equation.