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HIV and Sperm Washing

Serodiscordant (sero-discordant) is a term used to describe a couple in which one partner is HIV positive and the other is HIV negative

Sperm Washing - Hope For Serodiscordant Couples Wanting a Family

By Mark Cichocki, R.N., Guide:
Updated December 18, 2009
Seroconcordant is the term used to describe a couple in which both partners are of the same HIV status (ie both are HIV positive or both are HIV negative).

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. 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. 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. 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.

Serology is the scientific study of blood serum and other bodily fluids

Preventing HIV Transmission During Pregnancy?

By Mark Cichocki, R.N., Guide Updated December 21, 2009

Question: How Do Doctors Prevent HIV Transmission During Pregnancy? HIV transmission from mother to unborn child is relatively easy if steps aren't taken to decrease that risk. In fact, without proper prenatal and postnatal care of mother and baby, the infection rate is about 1 in 4. Luckily, there are steps that can be taken to reduce the risk of HIV transmission during pregnancy to about 2 percent. Answer: As was stated about, the risk of HIV transmission from mother to unborn child is about 26% without any treatment or intervention. But fortunately, there is a way to dramatically reduce the risk of HIV transmission during pregnancy.

Treating the HIV+ mother with a Retrovir (AZT, zidovudine) containing regimen during pregnancy. Guidelines state the treatment of the pregnant woman may start as early as 14 weeks into the pregnancy. Giving the mother a dose of intravenous (IV) Retrovir during delivery. Treating the newborn with oral Retrovir for six weeks after birth.

Keep in mind that other regimens can be used during pregnancy, depending on the mother's HIV resistance profile. Important Warning! The HIV medication Sustiva can cause birth defects and therefore can never be used during pregnancy. Important Information! Currently there are medication trials looking at single dose of the HIV medication Viramune as a prevention method for vertical transmission. A single dose treatment that prevents HIV in newborn children would greatly assist those countries that do not have the financial resources available for multidrug regimens containing Retrovir.