Pre-Pregnancy Tests for People with HIV

Healthy couples who want to get pregnant naturally (without assisted reproductive technologies like IVF) should take certain tests before trying to conceive. It goes without saying that if one of the parents has a medical condition such as HIV, extra tests are needed to make sure they can have healthy children.

Thanks to medical advances, people living with HIV can have a successful pregnancy and a healthy baby, as long as they take all the required tests and are monitored by an experienced specialist. In this article by Raadina Health, we explain what tests are necessary for HIV-positive people and how they can prevent virus transmission.

Test to Measure HIV Level

Even if you took a test before and the result shows “positive”, your doctor will order HIV tests again. These tests include CD4 cell count (T-cell test), antigen or antibody tests, and a viral load test. The results help the doctor understand the exact condition of your immune system and how far the infection has progressed, so they can choose the best treatment for you and your partner.

Antiretroviral Therapy and Controlling the Viral Load

Another important step before trying to conceive is antiviral therapy. In this treatment, the patient should take antiviral medications to reduce the amount of virus in the body until it becomes undetectable in the blood tests. When the mother’s viral load is low, the risk of passing the virus to the baby is almost %1. These medications also improve the mother’s immune system and reduce the risk of pregnancy complications. Remember that the doctors usually start the antiretroviral therapy 3 to 6 months before trying to conceive.

Coinfection Tests

The doctors also order blood tests to detect hepatitis B and C, syphilis, and other sexually transmitted infections such as chlamydia, gonorrhea, HPV, etc. These infections can affect both pregnancy and treatments; therefore, they should be diagnosed and treated by a specialist before trying to conceive.

General Checkups

In addition to the above-mentioned tests, doctors also check the following factors to make sure the patient is healthy enough to become a parent:

• Complete blood count (CBC)
• Kidney and liver function tests
• Rh factor test
• Thyroid test
• Vaccination records, such as rubella, varicella (chickenpox), and others
• Blood glucose test
• Blood pressure test
• Cardiac screening

Fertility Counseling for HIV-Positive People

After taking tests, the couple should attend multiple fertility counseling sessions to reduce the risk of passing HIV to the baby and increase the chances of a successful pregnancy. The following topics are discussed in these sessions:

• Assisted reproductive technologies, such as IUI or IVF, are introduced to the couple, and their success rates are measured.
• If the father-to-be has HIV, the sperm is washed before it is used in IVF, ICSI, or IUI. Sperm washing is a medical treatment in which healthy sperm are separated from the infectious semen.
• Couples are taught when and how to have protected sex. In some cycles, the risk of transmitting the virus is lower, and the chance of pregnancy is higher.

Pre-Pregnancy Diet for People Living with HIV

Having a good diet is important in improving the immune system and preparing the body for pregnancy. Women living with HIV usually lack important vitamins and minerals, including vitamin D, B12, and folate. Therefore, they should follow a balanced diet containing healthy protein (like chicken and fish), whole grains, fresh fruits, vegetables, and healthy fats (like olive oil or avocado).

They should also take folic acid supplements for three months before pregnancy. If the doctor orders, they should continue taking it even during pregnancy. Things they must avoid months before pregnancy and during it include:

• Processed foods
• Trans fats
• Refined sugars
• Unpasteurized foods
• Undercooked meat
• Alcohol (even the light ones)

The Best Lifestyle for People with HIV

Couples living with HIV must have a healthy lifestyle if they wish for an easy pregnancy and a healthy baby. If the mother-to-be is overweight or underweight, she should cooperate with a specialist to reach a normal weight. Getting enough rest, avoiding smoking and drinking alcohol, and exercising daily for several months before trying to conceive are also very important.

Pre-Pregnancy Vaccination for HIV Parents

People with HIV cannot get some vaccines during pregnancy, so the mother’s vaccination record, especially for rubella, is checked before trying to conceive. If she didn’t get the hepatitis B vaccination, she must get it before pregnancy. These vaccines increase the level of antibodies that protect both the mother and the baby from infections.

Emotional Support from Family and Friends

Unfortunately, some people do not support pregnancy in women living with HIV because they worry about passing the infection to the baby. Therefore, both parents should attend the counselling sessions to keep their spirits up and learn how to deal with negative opinions. They should know that if they follow all medical advice, the risk of passing the infection to the baby is less than %1. During this time, women need more emotional and psychological support from their partners and families.

The Last Note

Couples living with HIV can have healthy children just like anyone else. Women with HIV should take multiple tests before pregnancy to increase the chances of a successful pregnancy. When all the necessary tests and physical examinations are done successfully, the chance of a healthy pregnancy and delivery is very high, and the risk of passing the infection from mother to baby is less than %1. Of course, the father should also be tested multiple times and undergo necessary treatments if necessary.

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FAQs

1) Can couples with HIV have a safe pregnancy?

Yes. They can become parents and have a healthy child, just like others.

2) What should a woman living with HIV do before pregnancy?

Blood tests, physical examinations, and checking the vaccine records are crucial, but antiretroviral treatment to reduce the viral load is the most important step.

3) What pre-pregnancy tests are necessary for women with HIV?

Tests for hepatitis, HPV, blood pressure, blood glucose, sexually transmitted infections, thyroid function, etc., are necessary.

4) Can HIV-positive people have a healthy baby?

Yes. If they undergo all the required treatments and use assisted reproductive technologies (like IVF and ICSI), it is unlikely that their child will get HIV or related diseases.