A lot of people have asked us through our several channels about the relationship between HIV and fertility treatments. So, we have decided to talk with Dr. Marta Zermiani, one of our fertility specialists in order to provide some clarity about the subject. Continue reading!
Our followers seem to be confused about the concepts relating to the topic…Is being HIV-positive or a HIV-carrier the same as suffering AIDS?
No, it is not the same. Being a HIV-Carrier or HIV-positive signifies the presence of the virus has been detected but it hasn’t developed yet (it can take years to develop whilst showing no symptoms). Suffering from AIDS (Acquired Immune Deficiency Syndrome), on the other hand, signifies that the illness has developed.
Does HIV affect fertility?
There are different mechanisms that engage HIV with fertility problems. The infected man can develop hormonal disorders which can decrease sperm motility, sperm concentration or alter sperm shape. At the functional level it can decrease libido and/or increase the chances of impotence, erectile dysfunction and ejaculatory dysfunction in 60% of the patients.
In HIV-positive women there is a reduction of fertility (26%) associated with systemic disease, stress and weight loss that affects ovarian function.
Is the viral charge detected an important factor at the fertility treatments? And for eggs vitrification?
The HIV-Positive viral charge test detects HIV genetic material and measures the number of copies (viral charge) which is in the blood. It allows a follow-up of the fluctuations of the HIV viral charge, and along with the CD4 lymphocytes recounted, it is useful for assessing the effectiveness of treatments.
In fertility treatments, including eggs vitrification, we are allowed to see the risk of transmission. Although there are no limiting values for access to the techniques, the recommendations are that it should not be high.
Could it influence the medication that women are taking during treatments?
In terms of antiretroviral therapy, there are some drugs that could negatively affect gamete production, these effects are more acute in eggs rather than sperm. Other influences that can affect fertility in patients undergoing antiretroviral therapy include a reduction in the capacity of embryos to implant and the increased chances of miscarriage.
Do HIV-carrier patients or those suffering AIDS need specific protocols, follow-ups, tests, visit to the clinics?
No. The only difference is that the initial health screening process is more comprehensive in order to identify any kind of alteration in the partners health in relation to the HIV infection. We usually ask for an infectious diseases specialist report which allows us to formulate and manage treatment.
Are any special techniques required in the laboratory?
The technique that is usually carried out for HIV positive couples in the laboratory (if both are HIV positive or if only the male is) is sperm washing.
Sperm washing is a laboratory technique where a semen sample is sent to virology to be checked. If this indicates a negative viral charge the washed sperm can be used for either a IVF or ICSI procedure.
Is a woman with HIV or AIDS more likely to experience complications during pregnancy or childbirth? Do they need to take any special measures?
A pregnancy for someone who is HIV positive or has AIDS is considered more high risk due to the danger of transmission to the baby at different stages which are,
– During pregnancy
– At the childbirth, especially with vaginal birth.
– During breastfeeding
During pregnancy it is necessary to keep taking antiretroviral treatment (majority of them are safe during pregnancy) and possibly administering vaccines and other preventives treatments. It is necessary to do blood tests periodically to control HIV levels. HIV must be fully controlled or be “non detectable”. This will help to reduce the risk of mother-to-child transmission.
Vaginal birth can expose the baby to HIV, especially if it is detectable. If that is the case, a caesarean section is recommended. After birth, drugs can be administered to protect the baby from HIV and they will need to be examined and have blood tests regularly. In the majority of cases, diagnosis of HIV infection can be done when a baby is three months old. As HIV can be transmitted through breast milk, formula feeding is recommended.