How available is sperm washing?

The disadvantages of sperm washing are that:

  • The treatment is expensive and patient-funded in over 50% of cases.
  • It is currently only provided by a limited number of fertility centres in the UK, Europe and Northern America. In the UK, sperm washing is currently available at the Chelsea and Westminster Hospital in London.

National Institute of Clinical Excellence guidelines published in February 2004 on fertility have recommended sperm washing in serodiscordant couples as a risk-reduction process.1 This has led to a significant increase in the number of primary care trusts willing to fund up to three cycles of sperm-washing treatment on the basis of risk reduction.2 The costs involved depend largely on whether other fertility treatment is needed, with insemination the cheapest and ICSI the most expensive.

A letter of recommendation from the GUM physician to the relevant health authority is usually required.

To be eligible, couples need to be in a heterosexual relationship that has lasted over a year, and HIV serodiscordant or both HIV-positive. They are expected to be on treatment and for their HIV to be stable. They will need a referral letter from a GP or HIV clinician, and current details of CD4 count and viral load.

They will receive counselling individually and together, be screened for sexually transmitted infections and undergo fertility tests. They will also be assessed to check that the welfare of any child conceived is not at risk. (Previous injecting drug use will not necessarily exclude couples if it is felt the behaviour is no longer an issue.) The couple will be asked to sign consent forms stating that they understand the procedure. This initial process can take two to three months.

References

  1. National Institute for Health and Clinical Excellence Management of couples with viral infections. Fertility assessment and treatment for people with fertility problems www.nice.org.uk/guidance/ index.jsp?action=byID&o=10936, 2004
  2. de Ruiter A et al. British HIV Association and Children's HIV Association guidelines for the management of HIV infection in pregnant women 2008. HIV Med 9: 452-502. Available online at www.bhiva.org, 2008
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.