If you have HIV but your partner is HIV negative, you can become pregnant without risking HIV transmission to him through self-insemination. This is a simple process you can do at home. You will need to make sure that neither you nor your partner has a sexually transmitted infection before trying it.
This is best done when you are ovulating (your fertile period; see below). It’s best to try the technique several times during your fertile period.
- Your partner will need to ejaculate into a container. The container doesn’t need to be sterile, but it should be clean and dry.
- Next you’ll need a plastic syringe. Your HIV clinic can provide them, or you can buy the kind used to give medicine to babies at a chemist.
- Wait up to 30 minutes for the semen to become more liquid.
- Draw back on the syringe once with nothing but air, then push the air out again. Now point the syringe into the liquid and slowly draw it back to suck in the semen.
- Get into a comfortable position lying on the bed with your bottom raised on a cushion.
- Either you or your partner can now slowly insert the syringe as far into the vagina as possible. The area to aim for is high up in the vagina, towards the cervix.
- Slowly squirt out the contents of the syringe. Gently remove the syringe.
- Try to remain lying down for the next 30 minutes while the sperm makes its way through the cervix. Some semen may leak out but this is normal, and doesn’t mean it won’t have worked.
An alternative method is for you and your partner to have sex together, using a male condom. After sex, withdraw the penis from the vagina with the condom still on. Then take it off, and use a syringe to transfer the semen to your vagina. If you use this technique, make sure that the condom doesn’t contain a spermicide.
The healthcare team at your clinic will be able to provide syringes and other equipment, and information on how to calculate and recognize when you are ovulating.
For an HIV-positive man and an HIV-negative woman
Where you and your partner can’t meet all the conditions that make having unprotected sex a safe option, a technique called sperm washing is the safest way for an HIV-positive man to biologically father a child with his HIV-negative partner.
Bear in mind that, where you can meet all the conditions, sperm washing is unlikely to reduce the risk of infection further. You may also be less likely to conceive through the insemination processes used in sperm washing than you are through unprotected sex.
Sperm washing is used to separate the seminal fluid, which contains HIV, from the sperm, which do not contain HIV. Once the sperm sample has been ‘washed’, it can be used in a range of fertility treatments. The simplest of these is called intra-uterine insemination (IUI). The washed sperm is placed into your uterus (womb) around the time you are ovulating.
If you have difficulty in conceiving or if your partner has a low sperm count, you may want to investigate sperm washing combined with other fertility treatments. These include in vitro fertilization (IVF, where the eggs are inseminated with washed sperm in a laboratory) or cytoplasmic sperm injection.
You can ask your doctor for a referral to an assisted conception unit where you should receive the same service as couples who are not HIV positive.
The likelihood that you will become pregnant after sperm washing depends on many factors (including your age, your overall fertility and the technique used to implant the sperm), but the sperm washing itself does not reduce the chance of any technique working.
Although it can’t be absolutely guaranteed that no HIV remains, sperm washing is considered very safe.
Sperm washing is not widely available and you may have to pay for this service, which is expensive. To be eligible for sperm washing you will need a referral from your partner’s doctor with details of his viral load and CD4 count. There may be other eligibility criteria, depending on where you are having the treatment.