Sperm washing in HIV-positive men

By BSc, MSc (embryologist), BSc, MSc (embryologist), BSc, MSC, PhD (gynecologist) and BA, MA (fertility counselor).
Last Update: 09/22/2014

The high prevalence of HIV virus in men of reproductive age, and the advance of retroviral treatments, which improve the life quality of HIV patients, make that serodiscordant couples (only one member affected by the disease) wish to become parents more and more often.

HIV virus

For men who are HIV virus carriers, there is the option of a sperm washing, which ensures that there's no risk, for the mother and the future baby during the pregnancy, that the man spreads the disease.

HIV virus is a retrovirus transmitted through blood, sexual fluids, and through vertical transmission (from the mother to the children). AIDS (acquired immunodeficiency syndrome) is the most serious manifestation of HIV-positive people: their immune system is affected by the virus and the body remains with no defenses.

Sperm washing result

In order to carry out a washing, it is necessary the man leaves a sperm sample in an andrology laboratory; through different techniques, sperm with better motility are separated from the rest of the components (seminal plasma, epidermic cells, weak sperm...)

HIV-negative

Once isolated the fastest sperm, the presence of the virus is analyzed through PCR; if the result is negative (no virus found), this sample is adequate to be used in an assisted reproduction treatment. The sample is normally virus-free between 95 and 97% of the times. If the virus is present, the process of washing is carried out again with the same sample, in order to completely eliminate the virus and leave the sample HIV-negative.

A part from HIV-positive men, this technique is used also in case of other illnesses, such as Hepatitis C: it allows patients to have their own children, without turning to sperm donation. There is a very high guarantee of success, and no transmission case after the washing has been described so far.

FAQs from users

Is seminal washing in men with HIV effective in achieving a pregnancy without risks for the mother and the foetus?

By Dr. Marita Espejo Catena BSc, MSC, PhD (gynecologist).

One of the ways of transmission of the human immunodeficiency virus is sexual and, indeed, the seminal sample of an HIV+ male may contain a viral load that allows infection of his partner.
Seminal washing is a laboratory technique that is applied to couples in which the male may be affected by an HIV infection and also by hepatitis B or C virus. It is based on the fact that viruses are located in seminal plasma and non-sperm cells, but not in sperm.
When the spermatozoa are separated from both seminal components, we are sure that the risk of viral transmission has been reduced to the maximum and this is confirmed by the determination of the negative viral load in the treated sample in the laboratory, which shall be used for assisted reproduction.

Which one do you recommend in patients with HIV? IUI or IVF?

By Aitziber Domingo Bilbao BSc, MSc (embryologist).

When a man is affected by HIV, the first thing we would do is washing the semen sample, which removes the seminal plasma, so that the sample contains spermatozoa only. Thanks to this technique, we are able to remove the virus from semen samples. After the washing, we examine the sample to detect copies of the virus using the PCR (Polymerase Chain Reaction) test. If the PCR is negative or the number of copies is low, the sample can be used for a fertility treatment. In this cases, we recommend patients to choose ICSI, as a sperm washing affects the sperm count and motility.

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References

Authors and contributors

 Aitziber Domingo Bilbao
Aitziber Domingo Bilbao
BSc, MSc
Embryologist
Bachelor's Degree in Biology from the University of the Basque Country. Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid, and Master's Degree in Biomedical Research from the University of the Basque Country. Wide experience as an Embryologist specialized in Assisted Procreation. More information about Aitziber Domingo Bilbao
 Cristina Mestre Ferrer
Cristina Mestre Ferrer
BSc, MSc
Embryologist
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information about Cristina Mestre Ferrer
Dr. Marita Espejo Catena
Dr. Marita Espejo Catena
BSc, MSC, PhD
Gynecologist
Graduated in Medicine and Surgery from the University of Valencia in 1992. Specialist in Gynaecology and Obstetrics. Doctor in Medicine from the University of Valencia in 2000. Master in Assisted Human Reproduction by the Rey Juan Carlos University and IVI in 2008. Currently, she is the director of Instituto FIVIR. More information about Dr. Marita Espejo Catena
License: 464616497
Adapted into english by:
 Sandra Fernández
Sandra Fernández
BA, MA
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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