August 24, 2003, Updated September 13, 2012

“Sperm washing” is a simple laboratory procedure that uses centrifugal force to separate out the different cellular components of the semen.HIV positive men are now able to father children without risking the health of their baby or their partners, doctors have announced.

A joint Israeli-European medical team called the ‘sperm-washing’ treatment a life-transforming breakthrough for men infected with the virus.

The success of the treatment has prompted American doctors to urge for FDA approval for the procedure to be administered in the U.S. According to statistics, there are thousands of couples in the U.S. in which the husband is an HIV carrier.

Haifa’s Rambam Hospital’s Immunology, Allergy and AIDS Institute said that the new technology, which was developed by the Haifa hospital in conjunction with medical centers across Europe, allows the infected semen to be “washed clean,” leaving behind only HIV-free semen.

Use of the procedure began in Europe in July last year, and in Israel at the start of
this year. Out of 53 couples who took part in a Chelsea and Westminster Hospital study in England, a third were able to conceive a child using the method.

It is believed that there are over 100 couples in Israel where the male partner carries the virus. Doctors have so far recorded two pregnancies in couples where the man is an HIV carrier. One of the women is in her first trimester, and the second is due in December.
Over 30 Israeli couples are currently undergoing treatment at Rambam, the only medical center in Israel offering the treatment.

Dr. Margalit Lorver, deputy director of the Rambam institute, who headed the project in Israel, said that while a carrier’s semen is heavily infected, the HIV virus cannot
penetrate the semen itself.

According to Lorver, semen contains seminal fluid, sperm cells and at times white blood cells, any of which could contain or transmit HIV. Semen also comes into contact with other tissue as it leaves the body, making seminal HIV transmission a very complex and poorly understood process.

Sperm washing is a procedure for separating sperm from seminal fluid. Sperm washing has been used for years in fertility clinics and sperm banks to increase the odds of fertilization by selecting the healthiest, most active sperm for artificial insemination. However, the use of sperm washing to reduce or eliminate transmission of infections like HIV to a mother or baby has only emerged over the last decade.

“Sperm washing” is a simple laboratory procedure that uses centrifugal force to separate out the different cellular components of the semen.
The semen is put into a test tube and spun in a centrifuge to separate the cells. The non-sperm part is removed and the isolated sperm are covered with a new solution.

The healthiest of the motile sperm will swim up to the top of the solution where they are harvested and tested for HIV. The final sample of sperm is free of the fluid and non-sperm cells which can carry the virus. This is then inseminated into the female partner at her most fertile time of the month. This is done either through in vitro fertilization in a laboratory culture dish, or directly injected into a woman’s uterus (intrauterine inseminations).

According to Lorver, the procedure means that such couples do not to have to rely on
anonymous sperm donors as they used to do in the past.

Dr Carol Gilling-Smith, a British gynaecologist who is leading the research team in England recently called for the British Government’s support of the procedure, which she believes will reduce the number of cases of HIV transmission through unprotected sex. She explained that her next step was to make the process more widely available, but one cycle of sperm-washing currently costs $600.

She told the BBC: “Nothing is 100% safe in life. What we try to do is reduce that risk. Until this was available, couples had no option but to risk unprotected sex, or to resort to donor sperm – or to live a life without children.”

One woman who has managed to have a baby with her HIV-positive partner told the BBC how it had transformed her life.

She said: “I had expected to be a widow in my late 20s. “Now I have a happy, long-lasting marriage, and the extra joy of a child. “It helps my husband fight to live longer and stay healthier as well.”

Lorver told ISRAEL21c that the treatment has raised the interest of doctors in the United States, and one in particular, Dr. Deborah Anderson of Brigham and Womens Hospital in Boston, is involved with attempting to attain FDA approval.

In the United States it is illegal to transfer HIV-infected blood or tissue from one person to another, and in this case, the law is interpreted to include methods that assist in reproduction. Infertility clinics in the U.S. are prohibited from using semen from HIV-positive men to impregnate women.

Anderson told a U.S. news show that the U.S. is slower to adopt the procedure because of warnings from the Center for Disease Control and Prevention, but she’s optimistic about the future. “I tell them that the tide is turning here in North America,” she said.

Anderson obtained her doctorate degree in immunology from the Graduate School of Biomedical Sciences at the University of Texas Health Science Center at Houston. She has conducted extensive research on improving sperm washing techniques and has found it to be a highly efficient method for removing HIV contamination.

“I don’t think you can give 100-percent guarantees,” Anderson told Minnesota Public Radio. “But what you can offer is numbers that say that by doing a sperm wash the couple is much better off, much safer, than trying to conceive on their own.”

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Jason Harris

Jason Harris

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