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Sperm washing in the UK: evidence of safety and efficacy
  At the 9th Annual Conference of the British HIV Association held in London April 25-26, researchers presented that sperm washing was successful in safe and effective birth of newborns in HIV-infected women.
HIV-discordant couples where the male partner is HIV-positive have an option to reproduce safely through the technique of sperm washing. Unfortunately, few centres in the UK offer this service and health authority funding remains limited. Doctors at the Chesea and Westminster Hospital in London have provided a sperm-washing programme since 1999 and report on the safety and efficacy of this service. Dr Gilling-Smith presented these findings at the conference.
53 HIV-1 positive men with seronegative partners have been treated. Following a sexual health and fertility screen on each partner, sperm washing was performed with intrauterine insemination (IUI) if there were no fertility factors or in vitro fertilisation (IVF)/ICSI if a fertility factor was diagnosed.
38 couples had 94 cycles of IUI and 30 couples had 42 cycles of IVF or ICSI. All sperm samples were verified HIV-1 negative with NASBA assay before treatment. Ongoing pregnancy/live-birth rates per cycle were 10.6% (10/94) for IUI and 23.8% (10/42) for IVF/ICSI. 15 healthy children have been born with no seroconversions in either female partner or child on rigorous follow-up. Eight couples had satellite arrangements for investigations and scanning. Only five couples received NHS funding and over 40% of patients referred did not proceed to treatment for financial reasons.
The researchers concluded that sperm washing in a specialist centre is safe and effective as a risk-reduction treatment. Lack of NHS funding for this service may force couples to consider unprotected intercourse. Health Authorities must address this issue.
Reference: 9th Annual Conference of the British HIV Association. C Gilling-Smith, B Tamberlin, A Cox, G Rozis, JR Smith, S Barton and PA Almeida. Chelsea and Westminster Hospital, London, UK
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