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off-label prep with donor for pregnancy - 2nd opinion!
Oct 22, 2012

Hi Doc Young,

I've asked in here before -- single lesbian gonna-be mom, poz gay super-uncle donor.

Instead of the sperm-washing route, I just now went to my PCP who also happens to be a nurse practitioner in a reputable HIV-focused practice in a major US city, though again, I'm negative (and gonna stay that way). Considering what I've been reading about PrEP, I asked if he had recommendations for our situation and doing home "turkey baster" insemination. He prescribed Truvada once a day from day 7 of my cycle, through insemination (two tries while I'm fertile, which I know now through charting) out to about 3 days after last insemination to assure blood levels are maintained. So it amounts to about 12 days to two weeks of Truvada per month, till it works and I'm pregnant, fingers and toes crossed. What do you think of this approach? Would you do something different in a donor-only (no sex together!) situation?

I've been reading your responses and really trust your opinion. Looking forward to it.

Response from Dr. Young

Hi and thanks for posting.

Sorry for the delayed reply.

Yours is an interesting question- one without a definitive, evidence-based answer. Having said that, I'd view your situation as a hybrid of pre- and post-exposure prophylaxis. (I've clinically treated similar patients)

I'd agree with the general approach, though I'd be inclined to treat you for a full 4 weeks post insemination (like a post-exposure situation). Probably a small difference, but a somewhat more conservative treatment.

I hope that helps, and hope to hear about a healthy, happy baby in the future. BY



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