Genesis Fertility Clinic Blog
searching: “hiv”
May 4, 2009
HIV and us
I was recently asked to be a part of a committee whose goal is to develop pregnancy guidelines for people living with HIV/AIDS. The reason why a few of us fertility doctors were asked to participate is because these guidelines are also going to outline how patients with HIV can or should get access to fertility services and they wanted our advice about this.
With current treatments, people who are HIV positive are living much longer and healthier lives. Also, with current obstetric practices in Canada, the chance of a baby of an HIV positive mother having the disease after birth is extremely small. So people are looking to start families and they want not only information, but in some cases they want access to fertility treatments.
Some people may wonder why fertility clinics are needed since patients with HIV aren’t necessarily having trouble conceiving. The issue is that for a heterosexual couple where one partner is HIV positive and the other is negative, it is possible for the virus to be transmitted during intercourse. An option for this couple then is to do artificial inseminations with washed sperm as reduces the chance of transmission. It is thought that the “safest” way to prevent transmission to the partner is actually to do an IVF cycle with ICSI (intracytoplasmic sperm injection) where one sperm is directly injected into each egg.
I have to admit that currently at Genesis we don’t offer treatment to patients who are HIV positive. In fact, a recent survey looking at nationwide access to fertility treatments demonstrated how few places there are to seek treatment in Canada.
There are several reasons why fertility clinics have been slow and sometimes reluctant to offer treatment to patients who are HIV positive. These include:
- one needs the services and cooperation of an infectious disease specialist
- the concerns of the staff of the clinic need to be addressed
- the public perceptions have to managed so that patients who are not HIV positive feel that their sperm and eggs and embryo are safe
- some duplication of expensive laboratory equipment would be needed
- issues around counseling and making sure that patients understand the consent process
All of this is surmountable but takes some oomph on the part of fertility clinics. This is really the purpose of the guidelines, to outline what should be available for people living with HIV/AIDS so that we as fertility clinics can aim higher.
Dr. Jason Hitkari, MD, FRCSC
Reproductive Endocrinology & Infertility