Sero- discordant couple would like to have baby.

[Guest guest]

[Moderators review of 'sperm washing' follows the posting]

Dear all,

Could you please advise me if there are any 'Sperm washing centers' in India.?

The reason why I need the information is that, we are mixed status couple (Sero-

Sero- discordant couple) and we would like to have baby and I understand thet

this is possible with some method that involves cleaning of sperms, that makes

it free of HIV virus and through artificial insemenation, female can concieve

the baby.

Any information provided in this regard would be very helpful for me.

Kind Regards

Sunny

E-mail: <trust_my_god@...>

______________________________________________

Sperm Washing

Joe

Sperm washing is a technique that aims to remove the HIV virus from the sperm of

HIV+ve men prior to its use in the assisted fertilisation of HIV-ve women. This

experimental procedure is expected to enable couples with two HIV positive

partners or couples with only an HIV positive woman to conceive a child without

being the mother or the child getting infected.

Life expectancy among patients infected with HIV has increased since combination

anti-HIV therapies were introduced. This has led to calls for infertility in

people with HIV to be treated in an identical way to those in patients who are

not with HIV infection.

Conceiving presents a very substantial risk to the negative partner. Sperm

washing is becoming a viable option in many countries in those sero-discordant

couples wanting to conceive a child.

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 is greatly reduced, thereby reducing the risk of vertical transmission

to the child as well.

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 clinical procedures done on the semen itself, to

reduce the amount of HIV in semen. It is being often used with discordant

couples, where the man is HIV positive, the woman is HIV negative, and they want

to have a child of their own. However, many experts disagree with regard to how

well sperm washing protects the female.

The sperm washing procedure also has implications in infertility treatment as

well. Many health care providers believe that AIDS infection should not limit

infertility treatment. Infection with HIV should no longer be deemed an absolute

contraindication for infertility treatments, say new guidelines from the

American Society for Reproductive Medicine. The society says that sperm from HIV

infected men should undergo a special washing procedure that can decrease the

risk of passing on the infection (BMJ 2002;324:442 ( 23 February ,News)

Currently, ‘the sperm wahing’ procedure in no viable for many people living with

HIV and AIDS as the procedure is a costly one. Currently, there are relatively

few experts who are skilful to perform this procedure.

To get more information about this procedure you may contact a fertility

specialist

However, according to a BMJ article, infertility clinics are generally biased

against patients infected with HIV, with under half of units in UK saying that

they would treat a couple when only the man was infected with HIV.

No established guidelines exist for defining access to fertility care for

individuals infected with HIV. Although many in vitro fertilisation units in the

United Kingdom screen patients for HIV, only a handful are prepared to treat

couples if one or other partner tests positive.

References:

http://aids.about.com/cs/womensresources/a/washing.htm

Ade Apoola, Judith tenHof, and P S Allan, Access to infertility investigations

and treatment in couples infected with HIV: questionnaire survey

BMJ, Dec 2001; 323: 1285.

Infertility clinics may be biased against patients infected with HIV

BMJ, Dec 2001; 323: 0.

Marina S, Marina F, Alcolea R et al Human immunodeficiency virus type 1 -

serodiscordant couples can bear healthy children after undergoing intrauterine

insemination. Fertility and Sterility 1998; 70(1) ; 35-39

Semprini AE, Levi-Setti P, Bozzo M et al Insemination of HIV-negative women with

processed semen of HIV-positive partners. The Lancet 1992; 340(28): 1317-1319

Marina S, Marina F, Alsolea et al Pregnancy following intracytoplasmic sperm

injection from an HIV-1-seropositive man. Human Reproduction 1998; 13(11)

:3247-3249

Semprini AE, Fiore S, Pardi G Reproductive counselling for HIV-discordant

couples (letter). The Lancet 1997; 349:1401-1402

Gilling- C, JR, Semprini AE HIV and infertility: time to treat

(editorial). BMJ 2001 ; 322: 566-567

Infertility clinics may be biased against patients infected with HIV

BMJ, Dec 2001; 323: 0.