Answer from: Raúl Olivares, MD
In this case, it depends on whether it’s the man or the woman who is HIV-positive. However, in both cases, what we need is that the viral count should be negative, so the virus must be undetectable before starting any kind of treatment, and of course, we need the doctor in charge permission of those patients. We can start the treatment and help them get pregnant.
Second, it’s true that in some cases, the assisted reproduction techniques in this particular case are used because what we want is to reduce the risk of transmission of this infection especially, in regard to the fact that the man may transmit the disease to the woman. Then, depending on each case, we may need different tests, for example, let’s say that the woman is HIV- positive, as long as the count of the virus is close to zero, there are no restrictions. You can have any treatment regardless of the HIV problem. You can have IUI, IVF, or egg donation because, in women, the only real risk is the vertical transmission of the virus and the infection to the fetus. If you are negative, we can start with the simple IUI to avoid having unprotected sex between the couple, and that’s it.
Regarding the man, it’s slightly more complicated because we know that the sperm may transmit the infection, so we need to wash the sperm before doing any treatment, and this is something that is done despite having a low viral count in the blood. The main problem is that this sperm washing damages the sperm, and it makes it worse. So that the spermogram must be good if you want to do an IUI. This is why nowadays, most of the time, we perform IVF in these patients, we first perform this washing, we reduce the low count of viruses that could be in the semen sample, and then we proceed with the ICSI to reduce the risk of transmitting the infection to the woman. The only strict criteria that we need to fulfil before starting is having a negative viral count in the blood.
Are there any options to treat HIV-positive patients via IVF to make sure the baby will not inherit the virus?
Is fertility treatment possible for HIV-positive patients? How does it work? What should I first do if I would like to start such a treatment?