Depending on the HIV status of each partner in a couple, getting pregnant safely can be a dilemma. While having an undetectable viral load reduces the risk of sexual transmission, it doesn’t eliminate it entirely. Here are some options.
If You Have HIV And He Doesn't: Artificial insemination may be the way to go. Some couples choose to do this at home by placing the man’s ejaculated semen into the woman’s vagina using a needleless syringe or turkey baster. However, your chances of conceiving are better with professional help, and that’s the safest route. At a clinic, the semen can be inserted directly into the uterus (which is called intrauterine insemination, also known as IUI). It will cost you about $500 (more if you use a sperm bank instead of providing the semen).
If artificial insemination doesn’t work, some people go the full in vitro fertilization (IVF) route. This involves taking fertility drugs and having your eggs removed surgically, then fertilized and reinserted into your uterus. A single IVF attempt can cost about $10,000.
If He Has HIV And You Don't (or you both have HIV and are concerned about reinfecting each other): A procedure called “sperm washing,” which is actually sperm sorting, involves separating uninfected sperm from HIV-infected semen in a test tube. The sample of uninfected sperm is double-checked for HIV, then inserted into the woman’s uterus via artificial insemination.
“Sperm washing is an opportunity to conceive a child without the risk of unprotected sex,” says Dr. Cargill-Swiren. “It is no longer experimental, and more than 100 HIV positive couples have already had healthy children using this method.” The downside: The procedure is expensive ($1,000 or more per specimen, not including the cost of artificial insemination) and not widely available. Try Bedford Research Foundation at 617.623.7447.