HIV positive men can now father children

[Guest guest]

HIV positive men can now father children

Aditya Ghosh,

August 09, 2008: It was the prick of a needle that changed life irrevocably for

Chandigarh-based medical practitioner Amogh Singh (name changed on request). The

needle passed on the Human Immunodeficiency Virus (or HIV) to the 32-year-old

doctor. Among his many concerns was his despair at believing he would never be

able to have a child.

But that changed a few months ago. Singh can now father a child

because of a unique in-vitro fertilisation process that was developed

in the west and has now become available in India. He and his wife

have begun packing their bags and will soon arrive in Mumbai to try

out the new procedure. The treatment will help the couple have a child

without passing on the infection either to the mother or the newborn,

by separating uninfected sperm cells in Singh's sperm sample.

" The procedure, called the Density Gradient Centrifugation, separates

the sperm cell and eliminates the virus effectively from the seminal

fluid where the virus is generally found, " says Anirudh Malpani, a

Mumbai-based IVF practitioner. The process involves high-speed

rotation of the patient's sperm sample in a test tube. This causes the

uninfected cells to rise to the top of the tube, while the infected

cells settle at the bottom.

Recent research shows encouraging results in the separation of

infected sperms from non-infected ones for IVF. " We have established a

very simple and effective method to isolate sperm cells from even

poor quality infected semen. It's called tilted-tube rotation method

and with it, we have been successful in recovering motile sperm from

positive males with heavy viral loads, " says Naoaki Kuji of the

Department of Obstetrics and Gynaecology, Keio University School of

Medicine. Kuji has developed the Density Gradient Centrifugation

process.

" A cluster of negative sperm cells can be obtained by this method

which then can be used in any process of IVF, " explains noted IVF

expert Indira Hinduja.

The method was first developed by SPAR — the Special Program of

Assisted Reproduction, a renowned programme under the Bedford Research

Foundation Clinical Laboratory in Massachusetts, USA. One of the

earliest methods used to separate the uninfected sperm cells involved

sperm washing.

The process was based on research findings that indicated that

approximately two-thirds of the semen produced by all HIV-infected men

has no detectable virus. Hence, the washed sperm from such samples

produces semen that is safe to use for an IVF treatment, resulting in

an uninfected baby and mother.

The Bedford Research Foundation also offers this service to clinics

worldwide. One has to collect a sperm sample and send it to the

foundation preserved in liquid nitrogen. After treating the samples

and separating the negative sperm cells, the Bedford clinical lab

sends cryo-preserved sperm with an undetectable amount of virus to

infertility centres worldwide.

According to Malpani, most of the requests he receives for such IVF

treatments come from people like Singh — positive males who don't

indulge in high-risk behaviour and who have been infected due to

professional hazards. " All this while, they lived a condemned life.

But now they have the option of starting a family without hurting

anyone, " Malpani says.

Most HIV/AIDS care agencies in the country advocate against HIV

positives either getting married or having children. However, some

like Shabana Kapur of the Maharashtra Network of Positive People

(NMP+) disagree. " The decision to get married or have children, and

particularly the latter, should be left to individuals.

With anti-retroviral therapy increasingly improving the quality of life and life

spans, one should look at life positively. A person who gets infected at 30 can

easily live a good life for the next 30 years. Why should he compromise? " she

asks.

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Nookaraju