New Delhi: To HIV-positive individuals, IVF offers a safe and effective path to conceiving a healthy baby. During the IVF process, sperm washing methods ensure only virus-free sperm are used for fertilisation while in the case of women, egg retrieval and avoiding direct sexual intercourse safeguards the male partner from the infection. Advanced IVF technique like Preimplantation Genetic Testing (PGT) also screens embryos to ensure they are unaffected before implantation.
In an interaction with News9Live, Dr. Kalpana Jain, Infertility Specialist, at Birla Fertility and IVF, Guwahati, answered FAQs on HIV and its impact on IVF success rates.
How does HIV affect fertility in both men and women and how can IVF help?
In men, there are several ways HIV may affect your fertility, primarily sperm count, motility, and morphology. HIV weakens the immune system, which can negatively affect semen quality and lower the chances of natural conception. HIV also increases the risk of infections, including sexually transmitted infections (STIs), which can further contribute to male infertility. Antiretroviral therapy (ART), which is used to manage HIV, has also shown detrimental effects on sperm quality, further complicating reproduction efforts.
Among women, HIV and its treatment ART impairs oocyte (egg) quality, alters hormonal balance and causes menstrual abnormalities that contribute to reduced fertility. The virus can induce secondary infections, such as pelvic inflammatory disease (PID), which can cause tubal blockages and infertility.
What precautions are taken when a person with HIV undergoes IVF treatment to protect the health of the egg or sperm?
When an HIV-positive individual undergoes IVF, strict precautions are taken to ensure the safety and health of both the egg or sperm and the recipient. Universal precautions like the use of personal protective equipment (PPE) and proper sterilisation of all medical instruments are followed rigorously by all medical staff involved, to prevent cross-contamination.
For men, the sperm washing technique separates sperm from seminal fluid, where the HIV predominantly resides, significantly reducing the risk of HIV transmission to the embryo. For women undergoing IVF, there is a medical evaluation in place, where a written letter from a physician is required confirming a stable viral load (typically undetectable), safe antibody titers, and healthy immune status, often assessed through CD4 counts. This is to ensure the patient’s health is stable enough to undergo the IVF process and minimise the risk of maternal-to-fetal transmission. Furthermore, preimplantation genetic testing (PGT) may be recommended to screen embryos and ensure they are infection-free.
What are the potential risks involved in freezing and thawing eggs or sperm for HIV-positive individuals?
Both freezing and thawing eggs or sperm involve inherent risks, especially for HIV-positive individuals. The primary concern is of course the potential risk of HIV transmission through blood or seminal fluids. To mitigate this risk, there are specialised protocols followed like sperm washing (to remove the virus from seminal fluid) and separate cryogenic storage (using dedicated cryocans for the gametes of HIV-positive individuals). These measures significantly minimise the chance of HIV transmission during the freezing and thawing procedures.
How does HIV affect the chances of successful fertilization or embryo development during IVF?
HIV can have a significant impact on successful fertilisation and embryo development in IVF. Infected sperm has low motility and deteriorated morphology, which contributes to the low probability of fertilisation. HIV can also affect oocyte quality leading to a lower probability of embryo development and implantation.
Are there any risks to the child born from IVF using frozen sperm or eggs from an HIV-positive individual?
The main issue while performing IVF for HIV-positive patients is avoiding maternal-fetal transmission. With appropriate treatment and care, including the use of ART, the risk of transmission can be greatly minimised. In such cases, PGT is also highly advised as it allows for embryo screening and selection, increasing the chances of a virus-free embryo being implanted. HIV-positive individuals need to collaborate closely with a healthcare team to oversee and address these risks.
HIV patients are more prone to catching infections and diseases easily because of a compromised immune system. In a Q/A, expert talks about its impact on fertility and IVF results. Health News Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
