SPAR Fertility Procedures
Methods
Specimens collected through SPAR are prepared for use in two methods of conception: in vitro fertilization (IVF) and insemination procedures.
Follow-Up Testing
SPAR was designed as a clinical trial. The protocol for each pregnancy attempt calls for sperm cryopreserved from at least two specimens with an undetectable viral burden and for the female partner to be tested for HIV-antibody at 3 weeks, 3 months, and 6 months following each pregnancy attempt, whether or not pregnancy is achieved. SPAR will mail test kits.
In Vitro Fertilization
Because IVF does not involve direct contact between the mother and the sperm, it is considered by some to be the safest approach to conception, although this is not known with certainty.
As with all IVF procedures, the collaborating clinic will give the woman medication to regulate her cycle and cause her ovaries to mature more than one egg. While on medication, she will be monitored with blood tests and ultrasound exams. Just prior to ovulation, an egg collection will be performed under anesthesia as a day surgery procedure. The eggs are removed from her ovaries and combined with tested sperm in a culture dish in the laboratory. For this process, many clinics prefer to use a method called intra-cytoplasmic sperm injection (ICSI). This method involves selecting a single sperm with a small glass needle and then inserting the sperm into the egg. In this way, each egg is exposed to only one sperm.
If the eggs are successfully fertilized, they will be returned to the woman’s uterus within the next several days.
Additional patient information is available from the American Society for Reproductive Medicine at: www.asrm.org .
Intrauterine Insemination (IUI)
Some fertility clinics prefer IUI (Intrauterine Insemination) for women with normal fallopian tubes. IUI deposits the tested, washed sperm directly into the uterus with a thin tube and is a standard fertility treatment for couples with a relatively low sperm count.
The Centers for Disease Control published an opinion in 1992 that “IUI with sperm from an HIV infected male has not been proven safe,” but this is no longer their position. Fertility specialists will advise the most suitable treatment option for each couple.