Sperm Washing: a Safe Way for HIV-Positive Men to Become Fathers

One of the main concerns for HIV-positive men is whether they can have children without passing the virus to their partner or their baby or not. In the past, many of them had to give up the dream of becoming fathers because of this fear, but today, they can have healthy children just like anyone else. Fortunately, modern medicines and assisted reproductive technologies (ARTs) can help HIV-positive men have children of their own (same DNA, same genetics). One of the best methods used to prevent father-to-child transmission is sperm washing.

In this article by Raadina Health, we have explained what sperm washing is, its procedure, challenges, benefits, and more.

What Is Sperm Washing?

Sperm washing is a lab procedure that extracts healthy sperm from seminal fluid, mucus, and other virus-carrying materials. During this treatment, the sperm are separated from the semen, and healthy ones are selected. The chosen sperm should be totally healthy, motile, and able to fertilize an egg. After that, they are used in different fertility treatments such as IVF, IUI, or ICSI.

In IVF, the sperm fertilizes the egg in the lab, and when an embryo forms, it is transferred to the woman’s uterus. In IUI, the sperm is directly placed in the uterus, and fertilization happens inside the body. In ICSI, only one healthy, motile sperm is injected into an egg in the lab, and the resulting embryo is then transferred to the uterus.



Sperm Washing Steps

Sperm washing is done under the supervision of a specialist and has 4 steps:

1. The male partner provides a semen sample through masturbation. The sample is taken in the lab because the room should be free of any contamination, and its temperature must be controlled.
2. The sperm is washed in the lab using a density gradient solution. These solutions separate the sperm from the semen, dead cells, and white blood cells.
3. The doctor examines the semen under a microscope to find healthy sperm. In this step, any sperm carrying the virus is taken out of the sample.
4. When healthy sperm are detected, they are either frozen or used in fertility treatments (IVF, ICSI …).

Why Is Sperm Washing Important?

In general, there are three reasons why sperm washing can be helpful.

1)It reduces the risk of father-to-child transmission.

The main reason for using sperm washing is to reduce the risk of transmitting HIV to the baby. Without this technique, the HIV-carrying sperm can fertilize the egg and infect the fetus. When sperm washing is combined with fertility treatments such as IVF or IUI, it increases the chance of a safe and successful pregnancy.

2)It detects sperm-related problems.

Another reason for having sperm washing is that if the sperm are not motile and healthy, medication can resolve these issues before IVF or other ARTs start.

3)The embryos can be checked before being transferred.

Also, the embryologists can genetically monitor the embryos before they are transferred to the uterus. In most cases, only the top-quality embryos are transferred, and the rest are left to perish.



Challenges and Limits of Sperm Washing

Although sperm washing has a high success rate, it has some challenges and limits that cannot be ignored. Here are the most important ones:

• The cost of sperm washing (and other lab work), IVF, and IUI is very high. So, some people cannot afford it and take the risk of transmitting the virus. If freezing cycles are repeated, the total cost can increase even more.
• Sperm washing needs advanced laboratory equipment and trained specialists. That’s why it’s important to find a reputable medical center with experienced staff.
• The sperm count and quality in HIV-positive men are usually low. Because of the virus, some men only have a few low-quality sperm. In these cases, sperm washing may not give the desired results. If medicines don’t increase the sperm’s quality, the couple must use donor sperm.

What to Do Before and After Sperm Washing

To make pregnancy as safe as possible, men should do the following before and after the sperm washing:



• Before trying to conceive, they should take antiviral medication. After a few months, the viral load gets so low that it cannot be detected in the blood. When the level of virus is at its minimum, it is easier to find healthy sperm in the semen.
• They should take several medical tests and be regularly checked during the treatment. Therefore, being patient and determined is an important factor.
• Getting emotional and psychological support is also important. The decision to have a child and go through treatment can make them feel fear, worry, or doubt. That’s why counseling and social support are very helpful.
• Maintaining a healthy lifestyle during treatment is also important. Regular exercise, avoiding drugs and alcohol, getting enough sleep, and eating healthy are all important factors.

The Last Note

Sperm washing is one best techniques that helps HIV-positive men have healthy children of their own. In this method, healthy sperm are separated from the infected semen in a laboratory and are used in assisted reproductive technologies, such as IVF and ICSI. In these treatments, the healthy sperm fertilizes the egg in a controlled lab environment, so the risk of passing the virus to the baby is almost zero. As soon as an embryo forms, it is transferred to the mother’s uterus to develop for 38 weeks.

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FAQs

1) How likely is it to pass HIV to the child after sperm washing?

If the male partner takes the treatments seriously, the risk of passing the virus to the baby is near zero. The most important medical procedures for him are antiviral medications, regular checkups, and STI tests.

2) Does sperm washing work for all men living with HIV?

No, but it works for most men with HIV. In other words, if their sperm count or quality is very low, the results may be satisfactory.

3) Does sperm washing have any side effects?

If it is done by trained specialists and in a well-equipped lab, it is safe and does not usually cause serious complications.

4) What are the benefits of sperm washing?

In this treatment, only healthy sperm are selected, so the risk of passing the virus to the baby is zero. Also, because doctors can choose high-quality sperm, the chance of a successful conception is very high.