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Dr. John Jain:
Hello, I’m Dr. John Jain from Santa Monica Fertility, and today I’m with Dr. Panagiotis Vagenas, an international expert on HIV, and today we’re going to talk about sperm washing and how this technique can further prevent transmission of HIV to women carrying the baby and the baby itself. So for men preparing to have children, what can they do themselves to help prevent the transmission of HIV to the woman carrying the baby and the baby itself?
Dr. Panagiotis Vagenas:
So the most important thing that men with HIV can do is take their antiretroviral medications daily as prescribed. When one takes their medications daily, it is possible to achieve what we call undetectable status, which means that the virus cannot be detected in their fluids.
Dr. John Jain:
And in the world of fertility, we can go one step further. We can do what’s called sperm washing. What is sperm washing? How has it performed?
Dr. Panagiotis Vagenas:
So sperm washing involves putting semen in a test tube and centrifuging it at high speeds. What that does is it separates the sperm cells from the seminal fluid.
Dr. John Jain:
And why is that effective?
Dr. Panagiotis Vagenas:
Well, that is effective because HIV cannot enter sperm cells. It can only enter cells that have specific receptors on their exterior, which sperm cells do not have. So by removing the seminal fluid from the sperm cells, you remove any virus from the sample.
Dr. John Jain:
And is there a way of further assuring that no HIV virus remains after washing?
Dr. Panagiotis Vagenas:
Yes, we can use a technique called polymerase chain reaction or PCR, which can detect minute levels of the virus in the sample. We can use that before and after the sperm washing step to confirm the absence of HIV from the sample.
Dr. John Jain:
And in the IVF lab then we can take the sperm that’s devoid of HIV virus and use it for a procedure called intracytoplasmic injection. In this procedure, under the microscope, taking a needle, we pick up one motile sperm and inject it directly into the egg in order to create an embryo. So the methods of sperm washing can be useful for both heterosexual and gay men with HIV who want to have children. For heterosexual men, sperm is washed and then can be used for artificial insemination of their female partner or IVF to create embryos. For gay men, they need an egg donor, typically a woman in her 20s who donates eggs in order to create embryos, and then a surrogate, someone to carry the baby. Of course we will wash the sperm prior to making the embryos thus assuring that the surrogate and the baby are not at risk for HIV.
We’ve come a long way in 40 years with the treatment of HIV. Men are living longer with a normal lifespan and now can contemplate having children and seeing those children grow to adulthood. Santa Monica Fertility is one of only a few clinics in the United States offering sperm washing for men with HIV. But in addition, we have our own in-house egg donors and surrogates providing a comprehensive solution for gay men with HIV. Dr. Vagenas, thank you for coming today and thank you for listening.
