HIV+ person wants children
Mar 13, 2006
Hey Dr. Bob I have a client who found out recently that his boyfriend is HIV+. He asked me a question about the possibility of his boyfriend having children in the future. I told him that because it would probably be in vitro fertilization and a surrogate mother I couldn't see much risk of the child being +. Then I realized that I didn't really know what I was talking about so I decided to ask you. Can you clear this up for us? Health Educator in DC
Response from Dr. Frascino
Hi DC Health Educator,
The issue of HIV+ men wanting to conceive children safely and decrease the likelihood their mate or offspring will acquire the virus is a complex topic. I'll repeat a question from the archives that summarizes our current recommendations.
HIV + male HIV - female Feb 12, 2006
Dr. I have a question concerning having children. I have asked my HIV specialist and I am getting mixed answers. I am HIV pos and my wife is HIV neg. we really want to have a child, is it really possible to have a child without endangering her life and the child life. We decided against adoption and artificial reproduction (sperm banks). These were options to us. Is it really safe? Please give a yes or no answer if possible. I haven't received a answer.
Response from Dr. Frascino
I'll repost a response form Dr. Sharon Lee below that addresses this problem.
Resources for Positive Men & Negative Women Who Want a Baby Oct 16, 2004 Response from Dr. Lee
Several people have written recently asking for information about sperm washing and their hopes about having a baby when the man is positive and the woman is negative. There are a growing number of places that provide information and that provide these services. Here is a comment and list of general resources:
Studies have suggested that HIV is not present in the sperm themselves but it is in the fluid which surrounds them (Semen). Sperm washing consists of removing the semen (and presumably the HIV) from the sperm and then using the "washed" sperm for insemination. There are currently three ways to attempt pregnancy using washed sperm. A common method used for years is intravaginal insemination, which involves holding a cervical cap full of live sperm near a woman's cervix and allowing them to swim into the uterus. Another is to directly insert the washed sperm into the uterus through a cannula (or plastic tube) placed through the cervix into the uterus. The safest method is in vitro fertilization, which only exposes the woman to fertilized eggs, and not to live sperm cells. In this technique the sperm cells and the egg are brought together in a laboratory and the fertilized eggs are implanted directly into the woman's uterus.
Sperm-washing combined was reported to be the source of one man passing the virus to his partner, though it remains unclear whether her infection was caused by the procedure. (A lawsuit is underway.) Health care professionals willing to undertake the sperm-washing venture are quick to remind their patients that it is only a risk-reduction method, and that no procedure is entirely risk-free. There are several places in the United States that utilize sperm washing. However, due to quite variable policies, you will need to contact fertility specialists in your individual area to find a doctor or to be referred.
Resources 1. American Society for Reproductive Medicine. Visit www.asrm.org.
2. Bay Area Perinatal AIDS Center (BAPAC), at the University of California, San Francisco's (UCSF) Positive Health Program in San Francisco General Hospital. Offers pre-conception counseling and infertility work-up to seroconcordant and discordant couples (both partners positive or one partner is positive). Also conducts prenatal care to HIV-positive women. Call (415) 206-8919. Visit http://php.ucsf.edu/bapac.
3. Center for Women's Reproductive Care, at Columbia University in New York City. Conducts IVF for serodiscordant couples. Call (646) 756-8282.
4. Duncan Holly Biomedical. Operates the Special Program of Assisted Reproduction (SPAR), started in 1994 as a support group for couples living with incurable sexually transmitted virus diseases such as HIV. Developed a mail-in product for shipping sperm-washed samples to fertility clinics around the country, as well as an HIV testing kit for sperm that can be mailed to you at home. Complete details and in-depth articles available on its Web site, including the story of Baby Ryan, the first baby conceived through SPAR. Call (781) 665-0750 or (617) 623-7447, or visit www.duncanholly.com/idi/spar/spar_main.html
5. Reproductive Lab Service, 233 East Erie St. Suite 309, Chicago, IL 60611. Call toll-free: (877) REPROLAB (737-7652). Visit www.reprolab.org
6. SMART (Sisterhood Mobilized for AIDS/HIV Research & Treatment), New York City, provides treatment and prevention education and support for women impacted by HIV/AIDS. Call (917) 593-8797, write firstname.lastname@example.org or visit www.smartuniversity.org.
7. "Sperm Washing: Reducing the Risk of Father-to-Mother Transmission." Comprehensive article, although written in 2001. Visit http://hivinsite.ucsf.edu.
8. Women Organized in Response to Life-Threatening Diseases (WORLD), 414 13th Street, 2nd floor, Oakland, CA 94612. Call (510) 986-0340. Visit www.womenhiv.org. Unfortunately, not all copies of their excellent newsletter and articles are available on-line. However, an abbreviated version of their article "Reducing the Risks of Conception: Getting Pregnant When One or Both Partners is HIV positive," is available at www.PositiveWords.com. The article is very easy to understand and extremely detailed.
To each of the couples who are concerned about this issue: our best wishes for wellness for you and your families!
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