Sperm Washing and HIV
There was a time when being an HIV-positive man meant you couldn't biologically father a child without putting your female partner's health or the health of a surrogate at risk. Thanks to modern technology, this isn't always the case.
A serodiscordant couple, meaning a couple where the man is HIV positive and the woman is HIV negative, can take advantage of an assisted reproductive technology called sperm washing to have a biological child of their own with minimal HIV-related risks to the woman.
Having sex without protection is not an option for couples who have one HIV-positive partner even if it meant the chance of conceiving. The only way to have a biological child is to collect the sperm, clean it of the virus and then inject the sperm back into the woman in a GIFT procedure or ZIFT procedure. The cleaned sperm can also be used to fertilize an egg in a laboratory setting and then the developing embryo can be implanted into the woman in a procedure known as in vitro fertilization.
The Basics of Sperm Washing
Sperm washing is a procedure where the collected sperm is washed and separated from the seminal fluid. It's the belief that the HIV resides mostly in the seminal fluid of an HIV positive man. Sperm washing removes the infectious fluid which is meant to reduce the chance of the mother-to-be becoming infected with HIV. Some researchers also say that sperm washing reduces the risk of vertical transmission as well. Vertical transmission is the process of transmitting the virus from mother to child.
Doubts About the Procedure
BBC News reports that there are still doubts among researchers about the effectiveness and safety of using sperm washing as a way to protect against HIV. One British researcher told the BBC that sperm washing can't be considered 100 percent safe, but acknowledges that the process gives hopes of parenthood to couples who may have never thought it could be biologically possible.
The studies that have been done to analyze the effectiveness of removing the HIV virus from sperm are promising. In 2005 Italian researchers treated 567 serodiscordant couples with sperm washing. Two hundred and ninety eight pregnancies resulted which led to the birth of 224 children. The sperm from all the HIV positive men was treated with sperm washing. The study shows there was no horizontal (in woman) or vertical (in child) HIV seroconversion.
Not every reproductive center offers sperm washing or sperm washing specifically for HIV positive men. If you're considering going this route to have a child, you should first do some research to find out which centers are willing to do this procedure. Then contact the center.
In most cases you will then be required to see a counselor. You and your partner will be seen together and individually. You will be made aware that the risk of the woman getting an HIV infection is minimal, but it's not impossible. Issues will be discussed concerning any challenges you may experience raising a child when one parent is HIV positive.
You will be required to provide a full sexual health screen and both partners will need to get an HIV test. After test results are received, you will meet with staff at the reproductive center again to have you and your partner's fertility tested. This can take weeks and testing could include x-rays, semen analysis, ultrasound scans and various blood tests.
Expect to pay a significant amount for the procedure. Costs can go above $10,000 USD. Most insurance companies will not pay for the cost of sperm washing. You may be required to get a loan or some other type of personal financing. Often the fertility center will be able to offer you options on how you can pay for the procedure.