News Briefs: Group advocates HIV-positive fertility assistance
News Briefs: Group advocates HIV-positive fertility assistance
A person’s HIV status should not necessarily preclude them from receiving assisted reproductive technologies to have children, according to new ethical guidelines developed by the Birmingham, AL-based American Society for Reproductive Medicine (ASRM).
The standards issued in February by ASRM say therapies now exist that can greatly reduce the risk of passing HIV, the virus that causes AIDS, to the baby.
However, they do not encourage HIV-infected couples to have children and caution that physicians should ensure that parents understand their baby could be infected, regardless of what precautions are taken.
Since 1994, the group’s ethics guidelines have discouraged fertility treatment if a potential parent has HIV. The risks of infecting the unborn child were too great.
Special care can reduce risks
Today’s therapies allow many HIV patients to live longer, healthier lives, and most patients are in their prime childbearing years. Special prenatal care can greatly reduce — although not eliminate — the risk of infecting a baby, the society’s ethics committee concluded.
According to the Centers for Disease Control and Prevention, an estimated 200-300 infants are born with HIV each year, most thought to have been born to mothers improperly tested or treated for HIV.
The fertility society’s new guidelines, available on-line (www.asrm.org) state:
- Appropriate drug therapy, a cesarean section, and no breast-feeding drops an HIV-positive pregnant woman’s chances of infecting her baby from 20% down to about 2% — but the risk isn’t zero.
- If only the potential father has HIV, both mother and fetus could be infected. Unprotected intercourse is not safe. Special sperm washing and testing before artificial insemination appears to greatly reduce risk, but more proof is needed. Couples should be counseled about considering donor sperm, adoption, or not having children.
- If both potential parents have HIV, they must be counseled about the risk of infecting and orphaning a baby.
Treatment ethically acceptable
Many couples at risk for genetic diseases such as cystic fibrosis attempt conception despite a 25% chance of having an ill child, the guidelines note. Fertility specialists who treat those couples also "should find it ethically acceptable to treat HIV-positive individuals or couples who are willing to take reasonable steps to minimize the risks of transmission."
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