HIV+ Men And HIV- Women Having Babies

SPAR – The Special Program of Assisted Reproduction

The Special Program of Assisted Reproduction (SPAR) is for couples trying to conceive when the father is HIV positive. Yes, pregnancy is possible while significantly lowering the risk of transmitting the father’s HIV infection to the mother and to the baby. By using sperm with no detectable virus infection, the mother avoids many of the risks associated with other types of fertility treatments. (learn more)

As of fall 2014, 150 babies have been born using SPAR, including 22 sets of twins; the rest are singlets. IVF procedures have resulted in 176 pregnancies, and 7 pregnancies and 7 births have been achieved through the Oligospermia Cup procedure. (learn more)

How is this accomplished?

Research has shown that an HIV blood test does not reliably predict the presence of virus in semen. The reason is that the organs that produce semen are affected separately for HIV infection. A man may show no HIV in his blood, but his semen may have viral load, even for men on therapy. Approximately two thirds of semen specimens from healthy HIV infected men show undetectable amounts of the virus. (learn more)

Here’s how it works:

After a couple has been counseled and medically evaluated, semen is tested for the presence of the HIV virus. SPAR is the only program that uses the highly sensitive PCR tests for the presence of HIV in semen. The PCR array detects free virus particles (HIV RNA) and virus infected cells (HIV proviral DNA). (learn more)

In 2006, research data from Bedford Research Foundation showed that 24% of the semen specimens from 262 men entering SPAR were positive for HIV, even when the blood samples showed no detectable HIV particles. All of the men eventually produced at least two semen specimens with no virus detected. This is why it is so important to actually test the semen, and not just rely on blood tests. (learn more)

Semen specimens that do not contain any detectable HIV virus are then “washed.” This means the sperm is separated from the semen using a centrifuge and placed in a solution, then cryogenically preserved. The HIV virus has not been found to be present in sperm cells, only in semen. Only sperm from specimens that show no virus detected in the semen are used at SPAR. This is much safer than using washed sperm from untested specimens. (learn more)

Specimens are then preserved for shipping to a collaborating clinic for use in a Cervical Cup Insemination (Oligospermia Cup) or In Vitro Fertilization (IVF). The center does not prepare the sperm for use in an intrauterine insemination, due to the very slight risk of placing undetected virus directly in the uterus. Women are tested for the presence of the HIV virus at regular intervals after each pregnancy attempt. (learn more)

Couples have an initial consultation with Dr. Kiessling. The HIV infected male is evaluated for current health status, duration of disease, current antiviral therapy, and other infections. The entire process is fully explained and couples have the opportunity to share their concerns and ask questions. Couples are guided to find a fertility center in their area. During the initial consultation, couples are advised which centers in their area are a good choice, or how to work with their doctor. Cooperating clinics are located worldwide. (learn more)

In addition to emphasis on research proven practices, SPAR couples find that we are their advocates with all professionals involved, including fertility clinics and infectious disease physicians. If the medical evaluation indicates potential problems, we can guide you to fertility specialists, urologists, and other medical professionals who can help you. (learn more)