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Pregnancy and conception
Because of successful anti-HIV treatments, and the availability of effective means of reducing the risk of mother-to-baby transmission of HIV, many HIV-positive women have reconsidered their decisions about sex, relationships and having children.
If you would like support to think through these issues, it may be helpful to see a counsellor, or to talk to other HIV-positive women. One option is Positively Women, a national organisation providing peer support to HIV-positive women. Their telephone number is 020 7713 0222. Another organisation is Body and Soul, a self-help organisation which supports women, heterosexual men, children and families living with or affected by HIV. You can telephone them on 020 7383 768.
In the UK, HIV treatment centres provide condoms free of charge. The NHS also provides free access to contraceptives. Contraception is available from GPs and family planning clinics. Details of family planning clinics are available from NHS Direct on 0845 46 47.
If you are thinking of becoming pregnant, it’s very important that you tell your doctor so they can, with you, reduce the risks of your baby being infected with HIV. The use of anti-HIV drugs during pregnancy, choosing a caesarian delivery and not breastfeeding can mean that an HIV-positive mother can have an HIV-negative baby. For more information on preventing mother-to-baby transmission of HIV see the chapter Mother-to-baby transmission of HIV .
If you are an HIV-negative woman with an HIV-positive male partner and wish to become pregnant, one option you may want to consider is sperm washing. Using this technique, semen can be `washed' by separating sperm and seminal fluid; the sperm sample is then incubated to allow live sperm to separate from dead sperm, and this sample can then be used for insemination.
So far there have been no cases of HIV transmission to the female partner using this method. Unfortunately, few centres in the UK offer this service and NHS funding remains limited. This method has been under investigation at the Chelsea and Westminster Hospital in London since 1999.
A woman wishing to conceive by this method will be monitored to determine when she is due to ovulate, and then her partner will be asked to provide a sperm sample which is washed before testing it for HIV. If the sample is negative, the insemination can proceed. The Chelsea and Westminster Hospital warns couples wanting to undertake the process that even after washing, around 5-6% of samples have tested HIV-positive.
So far, dozens of HIV-1 positive men with HIV-negative partners have been treated at the Chelsea and Westminster Hospital. Following a sexual health and fertility screen on each partner, sperm washing was performed with intrauterine insemination (IUI). If a fertility problem is diagnosed, the couples receive IVF treatment.
Ongoing pregnancy/live birth rates per cycle were 10.6% (10/94) for IUI and 23.8% (10/42) for IVF. Many healthy children have been born, with no cases of HIV infection in either the women or their infants. However, there is little NHS funding available for sperm washing and one cycle of IUI costs several hundred pounds.