Today, a diagnosis of HIV does not always mean the “end”. Life undoubtedly changes but after the first avalanche of stress comes the understanding that it continues. And thanks to the science of antiretroviral therapy people with such a diagnosis live a full life for several decades. And it is clear that HIV-infected men and women are thinking about the possibility of procreation. These days, the wonders of artificial insemination give couples where one or even both partners have a positive HIV status an opportunity to have healthy children.
First of all, it is necessary to determine the features of the IVF program for HIV-infected couples.
In case only a man has HIV positive status at first sight only the use of donor sperm is the safest way to conceive a child. It can be both intrauterine (artificial) insemination of sperm and the use of IVF procedure for HIV-infected people, more often with ICSI depending on reproductive health followed by transfer of the embryo to the woman’s uterus.
But not all men are ready to bring up genetically alien children. If it is necessary to carry out the IVF program for HIV-infected couples the reproductive technology uses “washing of sperm” purifying it of the virus and then using it for fertilization of eggs with clean spermatozoa. Indeed this method gives a 100% guarantee to prevent the risk of transferring a dangerous virus to the embryo and as a result the couple has a healthy child.
For couples where carrier of the virus is a woman intrauterine insemination with the sperm of a healthy partner or a full fertilization procedure in vitro is also possible. IVF for HIV-infected women is mandatory together with the use of HAART (highly active antiretroviral therapy) drugs – both during the stimulation of superovulation and during pregnancy. Further monitoring of the course of pregnancy and prevention of HIV transmission to a child from the mother are conducted accordingly with the established requirements for prenatal care and delivery.
Implementation of the IVF program for HIV-infected couples is significantly different from the standard IVF program!
At transferring embryo only one should be transferred to a woman due to the increased load on immunity. During the period of gestation invasive interventions with the pregnant woman such as taking chorionic villi, amniocentesis at week 16 of pregnancy, cordocentesis and others which in a certain way increase the risk of fetus infection are not recommended.
In case one partner is infected with HIV ART is used to exclude the infection of the second partner when trying to conceive children. But basically all manipulations and activities are aimed at protecting the future child from the virus. According to the WHO, with consistent and strict observance of recommendations the risk of infection of the child with a virus will be only 2 to 8%.
If HIV-infected people need IVF or VMI for conception, in other words, they plan a pregnancy this provides a high degree excluding infection of a partner in a discordant couple. And for safety of the future child one should take some more precautions. A woman risks transferring the human immunodeficiency virus to her child through placenta, during natural childbirth and breastfeeding.
Therefore, when choosing the method of delivery the standard practice is the planned cesarean section. The special conditions for taking care of a newborn and feeding it with artificial mixtures, abandoning bad habits, antiretroviral therapy of mother and child right after delivery will ensure a normal life and complete absence of virus in the body.
In reality, the most basic problem is that in Ukraine not all clinics are ready to provide these services to this category of people, first of all due to risks for employees. And although the combination of such concepts as IVF and HIV is not prohibited by the law, except for the donation of gametes, there is no transparent regulation on the procedure for the use of ART for those infected with the virus, unlike the Russian Federation where the law regulating the use of assisted reproductive technologies states about IVF that it is possible for patients with HIV.
When couples address the clinic for artificial insemination a common package of documents must necessarily be accompanied by a certificate from the infectious disease specialist about the situation with the viral load and the possibility of carrying pregnancy. For obvious reasons, the concordant couple has more chances of getting refuse to perform the procedure. By the way, the artificial insemination center for HIV-infected persons (but only for those couples where a man is infected) officially operates in Ukraine.
IVF and HIV remain an urgent issue in Ukraine yet as in the whole world. The right to have children is the sacred right of every person. Definitely, in case of HIV it is better if the pregnancy comes under the control of a specialist which will provide high chances for avoiding child contamination. And as a consequence, it will give an opportunity to control the epidemic to some extent.
It should be added that these technologies make it possible to provide the services of IVF program for HIV infected and HIV-positive couples when the couple is discordant and when both partners are infected with HIV, maternity is successfully applied and there are no cases of infecting a surrogate mother or virus transmission to fetal in the world. Therefore, technology can overcome what was previously thought impossible. Address the experts to make your dreams come true!