HIV-Positive Men Can Father Children Through Ivf

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Saturday, August 11, 2001
(Reuters)

By Melissa Schorr

NEW YORK, Aug 10 (Reuters Health) - Fertility specialists at Columbia University report that they have used in vitro fertilization (IVF) and sperm injection techniques to allow an HIV-infected man and his uninfected wife to conceive a child. The technique greatly reduces the risk of passing on the virus to mother or child than if they had conceived naturally.

"The dogma has been if you had HIV, the risk of infection in your partner and newborn is such that it is not wise to have children," lead author Dr. Mark V. Sauer, chair of the department of obstetrics and gynecology at Columbia University in New York City, told Reuters Health.

Several medical groups, such as the American Society of Reproductive Medicine and the Centers for Disease Control and Prevention, have discouraged couples where one member is infected with HIV from attempting to conceive, Sauer said.

However, Sauer said that his lab is one of the few spots in the country that is offering this technique, which greatly reduces that risk and gives HIV "discordant" couples the chance to conceive more safely.

"In the days these proclamations were produced, HIV was uniformly fatal," he notes. "It was a different era of HIV than we see today." Today, he said, many young couples are living with one HIV-infected partner. "The reproductive drive is high," Sauer said. "People are going to have a baby one way or another."

According to Sauer, the technique used--IVF and intracytoplasmic sperm injection--greatly reduces the risk of infection.

HIV is thought to exist either in white blood cells or in the semen, but not within the sperm cell itself. Isolating the sperm cells and injecting only a few directly into the eggs makes the chances of infection far less likely.

"This is not...absolutely safe, but it reduces the risk of infection to a few cells in a million, which may be negligible," Sauer said.

Since Sauer began offering this technique in 1998, about 100 couples have elected to try it. Around 20 babies have been born, and none were infected with HIV, he said. Sauer plans to present some of this data next month at the American Gynecological and Obstetrical Society's annual meeting.

In a case report, published in the July issue of the American Journal of Obstetrics and Gynecology, Sauer and his colleague Dr. Peter L. Chang report on one HIV-infected man and his uninfected wife who attempted to conceive through the IVF technique while the man was living with AIDS.

Despite his subsequent death, his wife went on to have a successful pregnancy and give birth to a healthy, uninfected boy.

"Not everybody is going to agree with the ethics of that, but there was no ethical reason to deny care," Sauer said. "What if you don't offer it?" he added. "They'll still have a child, and the probability is they'll have it in a way that's not as safe."

SOURCE: American Journal of Obstetrics and Gynecology 2001;185:252-253.