Options for safer conception when you're HIV Positive, how to minimise risks of transmission of HIV, risks to your baby.
If you or your partner is HIV positive, deciding to start a family can be a complicated and difficult decision.
The only reliable way of preventing HIV transmission is through using a condom or abstinence from sexual intercourse, both of which are not possible if you want to have a baby.
There are several options available to you for conceiving in a safer way:
- If the female partner is affected, have IVF with donor eggs.
- If both partners are affected, have IVF with donor eggs and sperm.
- If the male partner is affected, either use donor sperm or his own sperm, using a technique called sperm washing.
What is Sperm Washing?
Sperm Washing is a technique by where a sample of sperm is taken and the sperm is removed from the seminal fluid and then tested for HIV. The unaffected sperm are then used to fertilise the egg, which is then implanted into the womb. Over 500 healthy children have been born this way, worldwide, and there have been no reported cases of HIV transmission through this method.
What About the Risk To My Baby?
Current recommendations are that a HIV positive, pregnant mother be treated with AZT, that she deliver by caesarean, not breast feed her baby and that the baby also be treated with AZT. Official figures for HIV infection after this has been followed, are thought to be 1%.
This is controversial, though, and there is little evidence to support not breast feeding a baby, indeed, mothers in less affluent countries are advised to carry on breast feeding as the benefits of breast feeding outweigh any potential risk of HIV.
Little research has been done into breast feeding and HIV Positive mothers. It is known that breast milk contains immune cells that are not present in formula milk, something I imagine would be vital to the baby of a HIV Positive mother. There are also numerous studies showing that breast fed babies don't die of cot death very often and that most of those affected by SIDS were bottle fed, that they don't surcumb to chest infections, pneumonia and meningitis as often as their bottle fed counterparts. Indeed, the American Academy of Pediatrics is so convinced of the benefits of breast feeding that they advise mothers in third world countries who are HIV positive, to breast feed. (The American Academy of Pediatrics, policy statement on breast feeding, 1997).
I will be discussing this in further detail in my blog, as well as discussing the pitfalls of the current HIV test and it's use in pregnancy.
