Their draft guidance on fertility treatments — an update to a document previously issued in — was issued today and is open for consultation. The writing group reviewed in detail the scientific evidence for different methods that a couple could use to become pregnant, where the man has HIV and the woman does not. Previous guidance recommended sperm washing, but the experts also looked at the evidence for effective antiretroviral treatment and for pre-exposure prophylaxis. On the other hand, sperm washing has the disadvantage of reducing the likelihood of pregnancy occurring. All the following conditions should be met: Unprotected intercourse is limited to the time of ovulation.
NICE says sperm washing is no safer than effective treatment and timed intercourse
HIV & AIDS Information :: Sperm washing - How effective is sperm washing?
Conclusion s Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized, controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. A cornerstone of successful HIV prevention campaigns has included the promotion of consistent condom use 3. However, many heterosexual HIV-discordant couples desire pregnancy 4 , 5 and consistent condom usage impedes this desire. Couples may risk sexual HIV transmission in order to achieve pregnancy if they do not have access to safer reproductive methods 4 , 6 , 7.
The new report marks the first time the agency has backed sperm washing as a viable and safe conception technique for these HIV-discordant couples. The approval represents a reversal on a recommendation that has stood for more than two decades. Previously, the agency had endorsed conception among couples with HIV-positive men and HIV-negative women when both parties used antiretroviral drugs to prevent viral transmission. Sperm washing has been in practice for more than 20 years and has been endorsed by other medical associations, according to a report from ABC News. The process involves the isolation of sperm from semen and the separation of the sperm from lymphocytes, which serve as a reservoir for viruses in semen.
How effective and safe is semen washing for HIV-serodiscordant couples? The issue The prevalence of the human immunodeficiency virus HIV in people of reproductive age, together with improvements in life expectancy and quality of life in HIV-positive people receiving highly active antiretroviral treatment HAART , have meant that more serodiscordant couples are considering having children. Adoption and donor insemination are alternative, safe options, but due to legal restrictions they are only offered in a few centres and countries.
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