Getting Pregnant: HIV-Positive Man and HIV-Negative Woman (Serodiscordant)
There are several different options for reducing the chances of passing on HIV while trying to get pregnant. If you are an HIV+ man and an HIV-negative woman seeking information on getting pregnant, the options below will help you understand what might be the best for you, and to prepare for discussions with your health care provider. (For other options, you can return to the main "Getting Pregnant and HIV" page.)
Sperm washing refers to a process in which sperm is separated from seminal fluid (semen = sperm + seminal fluid). Since HIV exists in seminal fluid but not in sperm, "washing" the sperm clean of the seminal fluid lowers the risk of infection. See "Understanding the Science" for more information. Any of the types of assisted reproduction listed below can be used with washed sperm to get the HIV- woman pregnant.
This means that a sperm fertilizes an egg with the help of a medical technique or therapy. Assisted reproduction (sometimes called "assisted reproductive technology" or ART) is useful when the future parent(s) require help to prevent HIV transmission between partners, are using donor sperm, or are having difficulty getting pregnant at home because of fertility issues. Unfortunately, few facilities offer assisted reproduction to HIV+ patients, and few health insurance plans cover it. There are several types of assisted reproduction that can be used with washed sperm:
- Intra-uterine insemination (IUI): Washed sperm is drawn up into a narrow tube, which is then inserted through the cervix into the uterus (womb). The sperm is deposited in the uterus, where fertilization of the egg can occur.
- In-vitro fertilization (IVF): The woman takes fertility drugs to help her prepare eggs (also called ripening her eggs). When eggs are ready (or ripe), they are removed from the ovary and put in a dish with sperm. Once there is a fertilized egg (embryo), it is put back in the woman's uterus.
- Intra-cytoplasmic sperm injection (ICSI): This is a specific type of IVF in which a sperm is injected directly into an egg using a very thin needle. When a fertilized egg occurs, it is returned to the woman's uterus. This method is used when a man's sperm do not swim well or are not normally shaped.
Donor sperm comes from a sperm bank or from someone you know who does not have HIV. Sperm donors to sperm banks are most often anonymous, and they are tested for fertility and diseases to make sure the sperm is safe and able to result in pregnancy. This involves no risk of HIV transmission to your partner.
Donor sperm is often used in an assisted reproductive technique called intra-vaginal insemination (IVI). In this procedure, sperm are placed deep inside the vagina by a health care provider. This is very similar to home insemination, only done in a clinic. Donor sperm can also be used in any of the other assisted reproductive techniques listed above.
This involves using donor sperm from someone you know who does not have HIV. Depending on the state in which you live, you may be able to use donor sperm from a sperm bank for home insemination. If using donor sperm from a sperm bank for home insemination is possible in your state, ask your sperm bank for instructions on how to use the sperm at home.
If using sperm from someone you know who does not have HIV, have the man ejaculate (cum) into a clean cup or condom. If using a condom, be sure to use a condom without spermicide. Then, using a syringe (without a needle) or baster, you suck up the semen and insert the syringe or baster deep inside the vagina. Once the syringe or baster is deep inside the vagina, you squeeze out and deposit the semen. You can get non-needle syringes at most any pharmacy as they are commonly used to give medicines to babies. Your HIV provider may also have some to give you.
It is more effective to use home insemination when a woman is fertile, or when she is ovulating. Ovulation occurs when an egg is released from the woman's ovary and usually happens about two weeks before a woman starts her menstrual period. Insemination during the "fertile window" -- usually one to two days before ovulation and one day after ovulation -- has a greater chance of success. For more information on understanding and tracking your fertility, visit:
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