HIV/AIDS transmission prevention

1. Sperm washing
Presented by:
Swornim Bajracharya
067/BPH/19

2. Introduction
• In this age of effective HIV medications and near
normal life expectancies, having a family while
living with HIV is a real possibility; as real as it is
for any couple.
• HIV and pregnancy is no longer impossible.
• In couples whose partners are both HIV positive
or couples with a negative man and a positive
woman, conception and holds relatively few risks
when compared to the reward of being a parent.

3. But what of those couples with an
HIV positive man and a negative
woman?
• This type of sero discordant couple presents a
very substantial risk to the negative partner;
the woman. There is one option that is
beginning to show promise in preventing HIV
transmission to an HIV negative woman.

4. Sperm washing is
becoming a viable
option in those
serodiscordant
couples wanting to
conceive a child and
start a family.

5. Introduction
• Sperm washing is the process in which individual
sperms are separated from the seminal fluid. The
sperms are then used in intrauterine insemination
(IUI) or in vitro fertilization (IVF).
• Sperm washing is a standard procedure used in
infertility treatment.
• The concept of sperm washing rests on the premise
that HIV resides mainly in the seminal fluid of an
HIV positive male.

6. • Sperm washing is a process in which a man’s
sperm are washed free of HIV before being
inserted into a woman.
• It is a way to help HIV discordant, or mixed
status, couples conceive a baby without
passing the virus from the father to the
mother or child.

7. Method of sperm washing

8. Methods
• Sperm washing concentrates and separates
the fertilizing sperm from the infectious
seminal fluid. During ovulation, the woman is
then artificially inseminated with the
concentrated sperm.
• The risk of the woman being infected with HIV
is greatly reduced, thereby reducing the risk
of vertical transmission (transmission from
mother to child) as well.

9. Sperm may be "washed" by density gradient
centrifugation or by a "direct swim-up"
technique that doesn't involve centrifugation.
In normal semen samples, centrifugation
causes no more DNA damage to spermatozoa
than a direct swim-up technique

10. Evidences
• Sperm washing was first used in Milan, Italy.
• The oldest child conceived using this method is now about 11 and is
HIV negative.
• The first known American baby conceived this way, Baby Ryan, was
born in 1999 through the Special Program of Assisted Reproduction
started by Dr. Ann Kiessling.
• Starting in the mid-1990s it was adopted to help HIV discordant
couples conceive without passing the virus from the father to the
mother or child.
• The idea is that when the male is HIV positive the technique will
reduce the risk of transmission to the female. For years there were
lingering doubts about the safety of the procedure, and many
couples had to travel to locales that would do the procedure, such
as Italy.
• Today, hundreds of babies have been born through this process.

11. • One Italian study from 2005 of 567
serodiscordant couples treated with sperm
washing resulted in no horizontal (to the woman)
or vertical (to the child) HIV seroconversion.
However, there is no 100% guarantee that
washed sperm is free from virus.
example: partner HIV negative having HIV negative
mother and two daughter: Mauro, Italy,011

12. • A retrospective study at eight centres involving 1036 serodiscordant
couples wishing to procreate.
• Sperm washing was used to obtain motile spermatozoa for 3390
assisted reproduction cycles (2840 intrauterine inseminations, 107
in-vitro fertilizations, 394 intra-cytoplasmic sperm injections and 49
frozen embryo transfers).
• An HIV test was performed in female partners at least 6 months
after assisted reproduction attempt. The outcome measures
recorded were number of assisted reproduction cycles, pregnancy
outcome and HIV test on women post-treatment.
RESULTS:
• A total of 580 pregnancies were obtained from 3315 cycles.
• All tests recorded were negative.
• The calculated probability of contamination was equal to zero (95%
confidence interval, 0-0.09%).

13. Advantages and disadvantages

14. advantages
• higher hopes for hiv positive men to be father
• one of the method to treat infertility
disadvantages
• Expensive: The sum takes upto $10,000 US.
• no 100% guarantee
• Currently, there are relatively few places that
perform this procedure.

15. References
• aids.gov. (n.d.). Having Children. Retrieved august 22, 2014, from
http://www.aids.gov/hiv-aids-basics/staying-healthy-with-hiv-aids/
friends-and-family/having-children/
• Cichocki.R.N, M. (n.d.). HIV and Sperm washing-hope for serodiscordant
couples wanting a family. Retrieved august 22, 2014, from
http://aids.about.com/cs/womensresources/a/washing.html
• how effective and safe is semen washing fot HIV-serodiscordant couples.
(n.d.). Retrieved august 22, 2014, from http://www.euro.who.int/en/data-and-
evidence/evidence-informed-policy-making/publications/hen-summaries-
of-network-members-reports/how-effective-and-safe-is-semen-
washing-for-hiv-serodiscordant-couples
• Shared Journey, y. p. (n.d.). Sperm washing and HIV. Retrieved august 22,
2014, from http://www.sharedjourney.com/sperm-washing-and-hiv.html

16. • sperm washing. (n.d.). Retrieved august 22, 2014, from
http://sementesting.org/index.php/hiv-semen/hiv-sperm-washing.
html
• when the man is HIV positive and woman HIV negative.
(n.d.). Retrieved from • http://i-base.
info/guides/pregnancy/man-hiv-positive
• wikepedia. (n.d.). Retrieved august 22, 2014, from
http://en.wikipedia.org/wiki/Sperm_washing
• Cichocki.R.N, M. (n.d.). HIV and Sperm washing-hope for
serodiscordant couples wanting a family. Retrieved august
22, 2014, from
http://aids.about.com/cs/womensresources/a/washing.ht
ml

17. THANK YOU