HIV+ sperm washing possible for KD?

[kkearney1982]

So, we asked our first (and only) choice for a KD if he would donate for us, and his response was "I would love to, but I think I'm out of the running: I'm HIV+...not having kids is my only regret." We don't know him extremely well, but only because I respect him so much, and he's such a purely good, good man, that I am awkward around him, and don't have the nerve to get to know him, although several of my friends have been close friends with him for years. Because we don't know him well, we at first chose to find someone else. However, this was the only person we could think of that would love to be involved in our lives and our kids lives that we know.

So, we have a few prospects for KD's who are friends/family of friends of friends who would most likely not be involved at all except for possibly yearly Christmas cards. I'm OK with that, but still attached to the idea of using KD1's sperm. I'm already in the process of doing IVF with ICSI (covered by our insurance for now), but our clinic does not do sperm washing for HIV+ clients. While we're pursuing other options for KDs, I'm still looking for ways for KD1 to work. Does anyone know more on sperm washing for HIV+ men? If so, how much does it cost, and where can it be done? We live in NY, if that helps.

Thanks,
Kate

[AmandaMom]

I'll start off by saying this is solely my opinion, and I am not a health professional... or any other kind of professional.

Unless you are HIV+ already, I would steer clear of using this person as your KD. Sperm washing will not remove the HIV antibodies from the semen, and you and your child could very likely end up HIV+. True, people can live for many, many years with HIV these days, and there's the chance neither of you could contract the virus, but it's not worth the risk to you or your child. You'd end up having to take medications for the rest of your life, and forget about being able to get health insurance. I can't imagine a clinic in NY or anywhere else that would wash HIV+ sperm for you because of the huge liability and likelihood of you and/or your embryo being infected.

Finding a donor is probably the hardest decision to make, so I wish you the best of luck! I'm sure whomever you choose will be the right person for you and your family.

[kkearney1982]

Originally Posted by AmandaMom

Sperm washing will not remove the HIV antibodies from the semen, and you and your child could very likely end up HIV+.

Actually, sperm washing for HIV+ sperm has been happening for about the past 15 years, and the only women to be infected are women who go against doctors' orders and try going au-natural with their man, at least as of a research study in 2007 (over 4,000 IVFs). There are further studies from 2009, but I can't get access to them online. There are special procedures and tests that have to be done both on the man and the sperm, both pre-wash and post-wash, and all kinds of stuff, so you are correct that traditional washing does not clear the HIV antibodies.

This is not any kind of plan, it was just wishful thinking. I know it can be done, but I don't think I could afford it--nor could he. But I appreciate the concern.

[bluenight]

i have not personally undergone this process, but i am a nurse in an HIV clinic who does a lot of reproductive health stuff. there is likely clinics in NY that would be willing to work with you; we have one in manitoba which is like the boondocks compared to where you are. my thoughts about it are: if your donor is on antiretrovirals and you go through sperm washing with the people doing the washing aware of the donors HIV status (they do it a different way) then theoretically it is safe. you could go a step further and take post-exposure prophylaxis but there is not really any evidence to support its use in that situation. in my knowledge there has not ever been a case of seroconversion from IVF with washed sperm. It may be hard o find a doc to work with you but if you contact a local AIDS service organization they would likely be able to steer you in the right direction.

In terms of diffusing misinformation, even if you yourself were HIV+, with proper medical care during pregnancy, labour, delivery and postpartum there is a LESS then 2% risk of your baby contracting HIV from you. It is extremely unlikely in the US for vertical transmission to occur with proper care.

good luck.

[kkearney1982]

Originally Posted by bluenight

we have one in manitoba which is like the boondocks compared to where you are.

Lol, I'm not sure where manitoba is, but we're just barely NOT boondocks here (we're not in NYC, we're upstate NY, just outside a "city"). Thank you for your input. I'm waiting to hear back from Columbia University who has done most of the major studies in seroconversion with IVF, usually using ICSI, so there is no semen involved at all--I don't know much about KD1's status, I didn't feel comfortable asking at that point, it was kind of a bombshell. If Columbia gets back to me, I will recommend that he talk to his specialist as to whether it would be a possibility for him before even thinking about doing it. Thank you for the info!

KD2 is looking like a bust--he hasn't gotten back to me at all after the initial "yes, that'd be awesome" to a mutual friend. *sigh* off to find a KD3.

[FtMPapa]

Originally Posted by kkearney1982

Lol, I'm not sure where manitoba is, but we're just barely NOT boondocks here (we're not in NYC, we're upstate NY, just outside a "city"). Thank you for your input. I'm waiting to hear back from Columbia University who has done most of the major studies in seroconversion with IVF, usually using ICSI, so there is no semen involved at all--I don't know much about KD1's status, I didn't feel comfortable asking at that point, it was kind of a bombshell. If Columbia gets back to me, I will recommend that he talk to his specialist as to whether it would be a possibility for him before even thinking about doing it. Thank you for the info!

KD2 is looking like a bust--he hasn't gotten back to me at all after the initial "yes, that'd be awesome" to a mutual friend. *sigh* off to find a KD3.

Manitoba is a Canadian province, think Canada's version of, say, Montana? South Dakota? Not urban, not hip, not exactly cutting edge.


Bluenight - that's awesome info and great advice! Great to know! I personally know several HIV+ men who would like to be known donors or dads some day. Do you know any of the specifics of how the process of "washing" is different? I wasn't aware that it was.

I was JUST saying to my students last week (I teach an Intro to Women Gender Sexuality Studies course) that the reproductive rights of people who are HIV+ are at the bleeding edge of the reproductive justice movement at the moment. Unfortunately, even without medical knowledge, and even when confronted with medical knowledge, doctors and others are all to willing to deny HIV+ folk their right to parent.

[kkearney1982]

OMG, I heard back from one of the clinics in NYC that apparently is covered by our insurance (Columbia)...they can do it. His portion of the program would not be covered (so, say, ~$700)--the testing and bloodwork, but theoretically, aside from travel expenses, they would work the same as my current IVF clinic.

Now the question is, how to bring it up to him to see if he'd be willing to foot that bill. And then, if so, trying to talk DW into traveling to NYC for this will be interesting.

We're still waiting to hear from KD3, and it would be easier for us to use him (we wanted to switch to plain AI), but wouldn't help out a friend.

I'll have to talk to KD1 on Monday.

Thanks all, and please, if you have any other advice, continue discussing!

PS--I knew Manitoba was Canada, I just don't know my provinces as well as my US States. And generally Canada tends to be a bit more cutting edge than the US in a lot of ways, eh?

In terms of the process, from what my friend Brenda (the biologist who brought this up) said, with HIV- men, they just rinse & freeze (to put it very simply). With HIV+ men, they have to test first his blood for viral count, and if that is low enough, they test the semen (the lower the count in the blood, chances are it is very low or nonexistant in the semen a lot of the time). If that is low enough or negative, then they wash it, then they have to test it again. They may even wash it twice, I'm not sure. They also require ICSI, even after all that washing, which is where they take one single sperm and inject it into the egg, therefore taking the semen out of the equation entirely.

That's all I know. Without insurance, at Columbia it costs about the same as a conventional IVF: $10,000-$15,000, although they do have payment plans. Even if KD1 isn't comfortable doing that, I hope it becomes more available to more people. There's already a lot of resources for HIV+ women who want to get pregnant, I hope our culture can get over its homophobia soon and realize that hiv+ men want kids too.

Thanks again,
Kate

[AmandaMom]

Wow, I had no idea this was being done. My fertility knowledge honestly only extends to IUI, and though I have a few HIV+ friends, I obviously know nothing about HIV and reproduction. I think this is fantastic. Your first choice for a KD should have just as much of a right to children as anyone else out there... Maybe more, because he wants it so bad. It's amazing your insurance might cover everything. I don't see why he wouldn't want to foot the $700 bill, unless he couldn't afford it for some reason. I really hope this works out for you, Kate! Best of luck to you and DW!

[bluenight]

Papa the only real difference is they wash twice instead of once. due to general hang-ups and insurance/liability issues they generally use a dedicated sort of 'infectious disease' centrifuge, tho that may be different in the states.

also we are incredibly hip and cutting edge up here. in a prairie pride sort of way

kate, it is amazing to here you may have found an option. if you were planning on coparenting in some way with your KD, it seems like he would likely be happy to foot the bill for the chance at being a parent, if he can afford it. we cant test viral load in semen up here (only for research purposes). its so cool you can down there. likely your donor would have a recent plasma viral load that could be submitted to columbia. good luck!!!!!!!

[FtMPapa]

Kate - thanks for the extra info, that all totally makes sense.


Incidentally, I've footed the bill for all of my donor's stuff that wasn't covered. We had his STD tests and as much as we possibly could covered through our student health at school which is all covered, and then all the infertility stuff went through my insurance, so I had to meet my deductible, which is only $200, and pay co-pays on my meds, which was probably another $200. I also paid for his semen analysis, which was peanuts, like $60ish. But if anything else had come up, I would have paid for it.

It just seemed like the right way to do it. I also have often bought him lunch and things like that, mostly because I have more money than he does, and being my donor has been a series of small inconveniences for him, so I want to make up for that in whatever small ways I can.

If your KD has health insurance, he might be able to get it covered, but chances are he'd have to look into himself, they won't tell you anything.

[kkearney1982]

Papa,
We would cover a large portion of his bills, but I'm not sure how much his insurance would cover. Our original plans included "regular" testing and analysis, which would have rounded out to ~$300 for him. $700 (or more) plus travel expenses to Manhattan ($200/night hotel rooms, or staying in NJ about an hour away and paying for commuter rail transportation) is a bit out of our budget. We are trying to figure out other KDs that would be easier, both financially, emotionally, and physically, at least at this stage of the game, but yes, we were hoping to coparent with him, and going through this would be his call. Which would entail him taking up part of the bill, as much as we hate to do it to him. Unfortunately, I've started "priming" for another IVF already, so really he's got 3 weeks to decide and get our butts down there for a consult! Although I could stay on the "priming" drugs for another week or two if necessary to hold things off.

You guys rock my socks, and please, if you have anything else in support of this decision, keep posting, especially if you are working with HIV+ patients, or in the area of reproductive rights. I have to talk with DW about this--she knows I've done some research, but still doesn't want to talk about it because it would be too much work and stress, mostly for someone else and not us. And it doesn't help that she really doesn't know him well at all--I'm the one who sees him 2-3 times a week every week. We were hoping, originally, to move away from highly medicalized IVF, and this is taking us in the opposite direction. Not to mention, if we're going to be paying all this extra money, what if I only make 1-2 eggs in a cycle, like I normally do? We'd have to discuss that with the doctors to see if they'd do a retrieval and freeze the eggs for 3 months at a stretch, and then do one ICSI round and transfer on a month I'm not highly medicated.

Wish me luck with DW. Maybe I'll send her to this thread. So post advice to her as well, if you want!

[kkearney1982]

x

[kkearney1982]

Sorry, bad hormones on both sides here last night. I shouldn't "fight-post" (like drunk-dialing, except worse).

We talked more last night and came to the compromise that if we could find somewhere around here that would help us, we'd approach KD1 again, and if not, we'd take it as a sign that it's not meant to be.

Miracle of miracles, my clinic told me today that they'd do it. So, back to the awkward hemming and hawing, although now that the topic has been broached it will be easier (and can be done via email).

[AmandaHope]

Originally Posted by kkearney1982

Sorry, bad hormones on both sides here last night. I shouldn't "fight-post" (like drunk-dialing, except worse).

We talked more last night and came to the compromise that if we could find somewhere around here that would help us, we'd approach KD1 again, and if not, we'd take it as a sign that it's not meant to be.

Miracle of miracles, my clinic told me today that they'd do it. So, back to the awkward hemming and hawing, although now that the topic has been broached it will be easier (and can be done via email).

So glad that you have a local option! I've been following this thread with interest and am learning alot. I also sympathize with being on a different page than your partner. My DP and I already have an 8-yr-old DD, and she really doesn't want to expand our family further. We've gone back and forth about it for about five years, with considerable pain and anguish on both sides. She has good reasons for her reluctance (chronic fatigue, among other things), and we really can't afford it. BUT I feel so strongly about this, as does our DD, and I know that I'll regret it (and possibly resent her--hate to say) if we don't do it. So she agreed last fall, though she is not happy about it in the least. Yesterday, when it was time for this cycle's insemination, she got stuff out for me and then went downstairs to do dishes! She wasn't trying to be mean--just didn't feel like helping out, didn't realize I expected her to, wasn't feeling very good, etc. I was so hurt. We got through it without a big fight and acknowledged eachother's feelings last night, but I'm still bummed. It sucks to feel so differently about something so important. In our nearly 15 yrs together, we've never faced a conflict like this before. I'm sure (and so is she) that she'll love the kid once he/she comes along, but I am grateful for MDC and my friends who can provide the support I need right now. Sigh. Hang in there!

[kkearney1982]

I know most of our issues are stress related right now. Once we get all our crying and yelling and snarkiness out of the way, we generally calm down and see each others' points. Last night was one of the worse fights we've gotten into. I know we need to address some of the resentment issues if/when I cannot get pregnant, but weekly counseling is financially not do-able right now. Copays have gone up, and with the fertility process sucking the lifeblood of my paycheck out of me, I keep telling myself that we can get counseling after I get pregnant, lol.

And, of course, they cannot bill his insurance for all the testing. *sigh*...$700 in one shot! (no pun intended). Oh well, we would have to do it for any guy we're using for an IVF/IUI donor, and it only needs to be done once for any donations made within 7 days. No additional cost because he's HIV+ (wow!). I guess, if he agrees, $700 up front for ~6 samples is way cheaper than bank sperm, and cheaper than spending $200 in gas/hotels to travel to Toronto or Ohio each month for our other donor prospects. Regardless, it's going to be expensive. We're OK with that. We'll just know where our tax return is going! (go figure, I'm getting about $700 back...hmmm)

[kkearney1982]

KD1 is going to talk with his doctor...I honestly cannot gauge his reaction, it could have been "oh crap, how do I get out of this while not being rude", it could have been "oh crap, this could actually work..." All I know is there was a lot of giggling. Like the blind leading the blind here in terms of shy, awkward people in awkward conversations, lol. I even read through the section on using HIV+ donors in the Stephanie Brill book, and let him know that this has been done since 1987 with NO seroconversion!

Let's hope his doctor is knowledgeable, or at least willing to do some research, and maybe gets in contact with my clinic about this.

K

[heathergirl67]

How exciting! Please keep us updated. Is DW feeling better about the whole situation?

[kkearney1982]

Originally Posted by heathergirl67

How exciting! Please keep us updated. Is DW feeling better about the whole situation?

Yes, we've talked about it, and especially since we'd be sticking with our same clinic which is 3 miles from us and 1 mile from KD1, if he says yes our procedures won't change at all, except that maybe we'd have enough donations to do some IUIs (we'll be discussing that and the risks with our doctors--from what I can find, the risk is still only theoretical with IUI and IVF, as either way no one has been infected) if I cannot get enough follicles for IVF.

Here's hoping he says yes...AND has decent swimmers! Too much to hope for?

[erthe_mama]

Originally Posted by bluenight

also we are incredibly hip and cutting edge up here. in a prairie pride sort of way

Here, here!! The 'peg city rocks, yo. lol We have tons of amazing things going on here.



kkearney1982, that's fantastic news!! I sure hope it all works out for you guys.

[Bestbirths]

This is amazing stuff. We are being tested for XMRV the new retrovirus and the possibility of sperm washing is really cool.....cause of course, everyone wants to have children, lots and lots of children, and we have the right to!!!!