HIV and Sperm Washing

In this age of effective HIV medications and near normal life expectancies, having a family while living with HIV is a real possibility; as real as it is for any couple. HIV and pregnancy is no longer impossible. In couples whose partners are both HIV positive or couples with a negative man and a positive woman, conception and holds relatively few risks when compared to the reward of being a parent. But what of those couples with an HIV positive man and a negative woman? This type of serodiscordant couple presents a very substantial risk to the negative partner; the woman. There is one option that is beginning to show promise in preventing HIV transmission to an HIV negative woman. Sperm washing is becoming a viable option in those serodiscordant couples wanting to conceive a child and start a family. Let's learn a little more about this procedure, its effectiveness and its availability.

Family Planning for the HIV+ Woman

The Challenges Faced By Serodiscordant Couples

What is Sperm Washing?

Sperm washing is a technique that was first developed in Milan. The concept of sperm washing rests on the premise that HIV resides mainly in the seminal fluid of an HIV positive male. Sperm washing concentrates and separates the fertilizing sperm from the infectious seminal fluid. During ovulation, the woman is then artificially inseminated with the concentrated sperm. Without the infectious seminal fluid, the theory is that the risk of the woman being infected with HIV is greatly reduced, thereby reducing the risk of vertical transmission (transmission from mother to child) as well.

Methods to Prevent Vertical Transmission

Does Sperm Washing Work?

Experts disagree with regard to how well sperm washing protects the female. One 2005 study from Italy showed encouraging results. Of the 567 serodiscordant couples treated with sperm washing, 298 pregnancies resulted (26.2% with artificial insemination and 37.2% with conventional in vitro fertilization or with intracytoplasmic sperm injection) and 224 children were born. The study showed that semen washing in HIV-positive men in the study has not produced any horizontal (in woman) or vertical (to the child) HIV seroconversion. However, there is no 100% guarantee that the virus is eliminated in motile sperm.

Will Medical Insurance Cover the Procedure?

Unfortunately, most often insurances do not pay for sperm washing. In addition, the procedure is a costly one; some put the cost at more than $10,000 US. However, the fertility specialist performing the procedure may have ways for you to finance and pay for the procedure. Exact costs and insurance coverage can vary so check with your insurance provider and your physician for more information.

Insurance Benefits Fact Sheets

Where Is The Procedure Done?

Currently, there are relatively few places that perform this procedure. To find a facility that performs sperm washing, start by looking at major university-based health systems and fertility specialists at large medical institutions.

_Source

Oliva G, Pons JM; "Sperm washing in HIV-serodiscordant couples wishing to have children."; Health Technology Assessment International. Meeting (2nd : 2005 : Rome, Italy). Ital J Public Health. 2005; 2: 300.