Sperm washing in HIV-positive men

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.

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...)

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?

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?

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.