Test tube babies offer hope to HIV-discordant couples

[Guest guest]

Test tube babies offer hope to HIV-discordant couples

4 Dec 2007, 0202 hrs IST ,Malathy Iyer , TNN

MUMBAI: After six years of marriage, Reema and Nagesh wanted a child. Only,

their wish isn't as simple as it sounds. Nagesh is HIV-positive and didn't want

Reema to get infected ever.

The couple, who only want to be identified as residents of a big southern city,

began visiting doctors and, of course, countless websites. They soon found an

answer - assisted reproductive techniques (ART) better known as infertility

treatment. " I found out after an intensive Google search that we could have a

healthy baby using an ART procedure called ICSI, " reveals Nagesh.

After some infertility experts refused to take up their case, they flew down to

Mumbai to meet Anjali and Aniruddha Malpani who had agreed on email to help

them.

" Many people don't know that it is possible and extremely safe for

HIV-discordant couples (one person is HIV positive but the other is not) to have

HIV-negative babies using ART, " says Anjali Malpani, who has helped four

discordant couples conceive in the last one year.

Her husband, Aniruddha, points out that ART for HIV discordant couples is an

established medical protocol. " Two medical journals, Lancet and New England

Journal of Medicine , carried exhaustive studies highlighting this over five

years back establishing a treatment protocol for HIV-discordant couples, " says

Aniruddha.

Rahul and Sapna are another HIV-discordant couple who approached the Malpanis

for medical assistance. The 26-year-old husband and 24-year-old wife are now

proud parents of a baby girl.

" A baby is one of the natural urges in human beings, " says Rahul, who got

infected while trying to help an accident victim. " I and my wife always loved

babies and so we also wanted one for ourselves. More importantly, we wanted the

child to be a part of both of us, " he says in an email interview.

In medical terms, the HIV-affected man's sperms are put through a " wash " for the

IVF treatment. The density gradient sperm wash, which is conducted in a

centrifuge machine, continues for almost 60 minutes and separates the sperms and

other cells and waste in the semen. The live sperms are once again tested for

HIV before being transferred to the woman in a procedure called the

intra-uterine transfer.

" However, to be extra cautious, we use a technique called ICSI or an

intracytoplasmic sperm injection to ensure that both the child and mother won't

be exposed to HIV, " says Aniruddha. ICSI involves injecting the sperm into the

inner part (or cytoplasm) of the woman's egg in a laboratory, explains Anjali.

According to Lilavati Hospital's infertility expert Nandita Palshetkar, " Given

the improved treatment and medications for HIV as well as IVF technologies,

healthy pregnancy and babies can be a reality for HIV-discordant couples. "

While the US bans transfers of any tissues or organs from HIV-positive persons

and puts a question mark on such pregnancies, it is carried out in Europe. In

fact, a peer-reviewed medical journal, AIDS 2007, recently advocated the wider

use of IVF techniques for HIV-discordant couples.

The article, submitted by scientists from the University of Toulouse, France,

states, " It is neither ethically nor legally justifiable to exclude individuals

from infertility services on the basis of male HIV-infection. For many countries

in the world, the first priority of the policy against HIV is to improve

education, to allow access to HIV screening, to encourage condom use and to

offer antiretroviral therapy where appropriate. In countries where these

approaches are now in place we recommended that assisted reproductive

programmes, such as IUI with sperm washing, should be integrated into a global

public health initiative against HIV. "

Rahul and Sapna, who began enjoying the joys of parenthood a few months back,

couldn't agree more.

http://timesofindia.indiatimes.com/India/Test_tube_babies_offer_hope_to_HIV-disc\

ordant_couples/articleshow/2593269.cms

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Sonal Singh Wadhwa

MAITRI

J-92 A.R.D. Complex

R.K. Puram, Sector 13

New Delhi 110066, India

Tele: +91-11-2412-2692

Cellphone: +91-98182-23494

email: Sonal.Singh@...

Website: www.maitri.org.in

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