Can You Have Fertility Treatment If You Have HIV?

Even if you – or your partner – has HIV, and require fertility treatment, it is possible for you as a couple to have world-class fertility treatment, a healthy pregnancy, and a healthy and HIV-negative baby.

At Medfem Fertility Clinic, we believe in making world-class fertility treatments available for everyone, and we have the purpose-built facilities, extensive medical expertise and decades of experience in helping couples reach their family dream, even if one of the partners have HIV.

In this article we explain what you need to know about safe fertility treatment for HIV-positive people.

HIV is a serious but manageable chronic disease that affects people of all ages. Fortunately, thanks to medical advances, HIV-infected persons have the potential to live long and healthy lives.

Sadly, the largest groups affected are people of reproductive age, many of whom still want to experience the joy of having their own biological children. Of course, a major concern is the transmission of the disease to a partner or to the couple’s offspring.

Fortunately, today’s advanced treatments can now limit the risk of viral transmission to the uninfected partner and baby. The possibility of not transmitting the virus to a partner, while also having uninfected children, is prompting many individuals who have HIV, or an HIV-positive partner, to start or grow their biological families.

Keeping your partner safe

For people who have HIV, or have an HIV-positive partner, it is very important to minimise the risk of passing HIV on to their partner.

This is possible during fertility treatment. For example, where the female partner is HIV-positive and the male partner an HIV-negative, it is possible to become pregnant without risking HIV transmission through intrauterine insemination (IUI) or artificial insemination (AI).

Intrauterine Insemination (IUI) – which is also known as Artificial Insemination (AI) – is a relatively low-tech solution to a range of infertility problems. During normal intercourse, only a small amount of sperm makes it to the woman’s uterus and into the fallopian tubes where fertilisation takes place. The IUI procedure inserts large amounts of the best performing sperm directly into a woman’s uterus around the time the woman is ovulating, significantly increasing the chance of fertilisation.

So, the answer to the question if a HIV-positive woman can receive fertility treatment such as IUI is emphatically ‘Yes!’. We do it regularly at Medfem Fertility Clinic.

For safe fertility treatment for HIV-positive patients, there are three requisites. The first is a medical clinic with specialised facilities, such as a separate, dedicated laboratory. The second is that the patient must be on antiretroviral (ARV) medication at the time of the treatment and throughout the pregnancy. The third is that the HIV viral count must be non-detectable.

Where the male partner is HIV-positive and the female partner an HIV-negative, sperm washing is the safest way for the HIV-positive male partner to biologically father a child with his HIV-negative partner.

Sperm washing is used to separate the seminal fluid, which contains HIV, from the sperm, which do not contain HIV. Although it can’t be guaranteed that no HIV remains, sperm washing is considered very safe.

The likelihood of a pregnancy after sperm washing depends on many factors (including age, overall fertility and the technique used to implant the sperm), but the sperm washing itself does not reduce the chance of any treatment working.

Once the sperm sample has been ‘washed’, it can be used in a range of fertility treatments. This means it is possible – without risking HIV transmission – to become pregnant through treatments such as IUI or AI. If the woman has any difficulty in conceiving, or if her partner has a low sperm count, other treatments can be recommended, such as In Vitro Fertilisation (IVF), a treatment where the eggs are inseminated with washed sperm in a laboratory; or Intracytoplasmic Sperm Injection (ICSI), a treatment in which the sperm are injected directly into the eggs.

HIV and antiretroviral therapy can cause some males to have sperm abnormalities, including low sperm count, low motility, and low volume, and in these cases IVF or ICSI are more suitable options.

Keeping your baby safe

Without any treatment or care, the chance of a woman with HIV passing it on to her baby is between 35% and 40%. However, with the right treatment and care, this risk can be much reduced to a substantially lower number, and in some cases to less than 2%.

To reduce the risk of transmission to the baby, an HIV-infected woman must be actively treated with antiretroviral drugs. This treatment reduces the viral load, which means that the baby is exposed to less of the virus while in the womb and during birth. Some anti-HIV drugs can also cross the placenta and enter your baby’s body where they can prevent the virus from taking hold.

Because there is an increased risk of you or your baby developing an infection after your waters have broken, a pre-labour caesarean section may be required to prevent HIV transmission during childbirth.

Newborn babies whose mothers are HIV positive are also given a short course of anti-HIV drugs – called infant post-exposure prophylaxis, or infant PEP – after they have been born. What sort of treatment your baby has will depend on the HIV treatment you have taken during your pregnancy. To avoid passing HIV to your baby, it is safest to formula feed because breast milk can contain the virus.

The baby will also be tested for HIV several times during the first 18 months – first at a few hours after birth, and then again at six weeks old and at 12 weeks old to see if the virus is present in the baby’s blood. If all these tests are negative, and the baby is not breastfed, you may already have confirmation at 12 weeks that the baby is HIV negative.

The baby will also have an antibody test at 18 to 24 months, as the final confirmation that it does not have HIV.

If your baby is diagnosed with HIV, your baby will be referred to a specialist clinic for children with HIV.

Are you, your partner and your baby safe from HIV at a fertility clinic?

A question often asked by HIV-positive and HIV-negative patients at Medfem Fertility Clinic is whether it is possible to have HIV-positive embryos in a sophisticated IVF clinical and laboratory setup?

The answer is a definite ‘no’. It would not be possible to create HIV positive embryos (eggs fertilised with sperm) in a sophisticated, purpose-built laboratory like the one at Medfem Fertility Clinic. The reason for this is that all patients at Medfem are required to undergo HIV testing. The criteria for using eggs or sperm or both eggs and sperm from patients who are HIV positive requires strict adherence to certain guidelines and protocols.

The HIV patient must be treated with antiretroviral medication and have an undetectable blood viral load. In the case of the male, the sperm is pre-prepared by a sophisticated sperm washer and the sample is tested to make sure it is viral load negative. The sperm is then frozen and used to fertilize the eggs during the IVF process. Given this attention to detail an embryo cannot be HIV positive.

Medfem also works with select external specialised laboratory facilities that deal specifically with infertility treatments for HIV patients and adhere to international best practises.

Your next step

If you or your partner are HIV-positive and require assistance to start or grow your family, we would like to invite you to meet one of our fertility specialists at Medfem Fertility Clinic.

It’s as simple as clicking here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

We look forward to meeting you!


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