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sperm washing-hiv discordant couples
Jan 15, 1998

Dear Mr. Sowadsky,

I can't believe that I have found someone willing to address my concern of sperm washing in the possible elimination of the virus in sperm. I have read all of your articles regarding this and will bookmark this page. My question for you, as of January, 1998, has there been any progress in the U.S. concerning this issue and if so, could you provide the name of the program/clinic?

Thank you so much for providing this service.

Response from Mr. Sowadsky

Hi,

Thank you for your question. Your interest in this procedure is actually more common than you may realize. I have personally been surprised how many couples have come to me wishing to learn more about "sperm washing", and artificial insemination, in HIV discordant couples. Through this procedure, the amount of the virus in semen is reduced (but not necessarily eliminated), thereby reducing the chance a woman would become infected during artificial insemination. This procedure is NOT a drug or a medication. It is a series of procedures done on the semen itself, to reduce the amount of HIV in semen. It is being used with discordant couples, where the man is HIV positive, and the woman is HIV negative, and they want to have a child of their own. As of today (January 1998), I am still unaware of this procedure being done anywhere in the USA.

Sperm washing is currently not an option for most discordant couples, due to the high costs involved, and the difficulty in getting access to this procedure. This is why it is important to not limit yourself to this one option, if you want to have a child. There are other options as well. For example, discordant couples may want to consider adoption as one possible option. Adoption removes all the risks for HIV transmission, and at the same time, allows the couple to have a child. It also allows a child to have a new family. There are many children out there in need of a caring family. Adoption therefore solves two issues at the same time.

I have seen some couples choose "chance/luck" as their option to have a child of their own. In other words, they choose to have unprotected vaginal sex to impregnate the woman, despite the fact that this puts the woman at significant risk of infection. They then take their chances that the woman will not get infected. This is the riskiest and least desirable of your options, since this is the riskiest option, in terms of the woman and her baby becoming infected. Remember, there is a significant chance of infection during unprotected intercourse, even if the viral load of the man is low.

For more information on the topic of sperm washing, please go to the posting ART Procedures and HIV+ Fathers. Also go to the posting, WHY HAVE CHILDREN? for another perspective on this and related issues.

If you are interested in sperm washing as a realistic option for you, I have a listing of research reports that have been published on this very topic. I can send it to you via e-mail. This file is quite technical in nature, but will give you an idea who has performed this procedure, and how it is done.

When planning a family, regardless of a couples HIV status, the most important thing to remember is to put the needs of the child first. Look at the issue from the child's perspective. You have to ask yourself whether or not you will have the ability (physical, emotional, financial etc.) to take care of a child (from baby to adult). It is important to think about these things when planning a family. The comments I'm making here apply to ALL couples planning a family (not just those with HIV).

The decision on which option is best for you (sperm washing vs. adoption vs. not having a child, etc.) is a deeply personal one. My position here is to give you some of your options. Once you know your options, it is important to make an educated decision as to which will be the best option for you. Whatever you do, do not rush in making your decision. Remember, the life of a child is literally in your hands.

If you have any further questions, or if you would like me to send you additional information about sperm washing, please feel free to e-mail me at "nvhotline@aol.com" or call me at (Nationwide). I'm glad to help!



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