Helping Men With HIV to Have Children is ‘Last Taboo’ in Fertility Industry, New York Times Reports
Helping HIV-positive men have children is the "last tabo[o]" in the fertility industry, the New York Times reports in an article examining clinics that help discordant couples have HIV-free children. Many of the 900,000 HIV-positive men in the United States want to have children, but only a "minuscule" number of the country's approximately 400 fertility clinics will help them, the Times reports. Fertility experts have determined that it is possible to separate the sperm of an HIV-positive man from the seminal fluid, which contains the virus. Such separation techniques "minimize the transmission risk" to both the impregnated woman and the fetus and have been successful in the past, although "too few" procedures have been performed to determine the exact risk, the Times reports. Dr. Mark Sauer, director of a fertility clinic at Columbia University, uses a different technique called intracytoplasmic sperm injection -- the injection of a single sperm into an egg -- to "greatly reduce" the chance of transmitting the virus. Dr. Ann Kiessling, a Boston virologist working at a clinic "wrestl[ing] with treating patients with HIV," promotes the idea of using an HIV-positive man's semen for in vitro fertilization if he is taking antiretroviral therapy and his viral levels are undetectable. "If there is no detectable virus in the semen, it can apparently be safely used for insemination," Kiessling explained. However, clinics providing such services with "wash[ed]" sperm are taking a risk. If a couple undergoing such fertility treatment engages in unprotected sex and either the woman or the fetus contracts HIV, the clinic could be held liable and be shut down, Sauer said. Clinic staff in some fertility clinics have decided to "invoke the same right-of-conscience provision that allowed medical staff members to refuse to assist in abortions," according to a clinic laboratory director, because they are uncomfortable knowing that one or both of the parents may die prematurely. Although the American Society for Reproductive Medicine approved such fertility treatments for HIV-positive men in February, three states -- California, Florida and Illinois -- have banned such procedures (Kolata, New York Times, 4/30).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.