HIV positive men can now father children

HIV positive men can now father children

It was the prick of a needle that changed life irrevocably for Chandigarh-based medical practitioner Amogh Singh (name changed on request). The needle passed on the Human Immunodeficiency Virus (or HIV) to the 32-year-old doctor. Among his many concerns was his despair at believing he would never be able to have a child.
But that changed a few months ago. Singh can now father a child because of a unique in-vitro fertilisation process that was developed in the west and has now become available in India. He and his wife have begun packing their bags and will soon arrive in Mumbai to try out the new procedure. The treatment will help the couple have a child without passing on the infection either to the mother or the newborn, by separating uninfected sperm cells in Singh’s sperm sample.
“The procedure, called the Density Gradient Centrifugation, separates the sperm cell and eliminates the virus effectively from the seminal fluid where the virus is generally found,” says Anirudh Malpani, a Mumbai-based IVF practitioner. The process involves high-speed rotation of the patient’s sperm sample in a test tube. This causes the uninfected cells to rise to the top of the tube, while the infected cells settle at the bottom.
Recent research shows encouraging results in the separation of infected sperms from non-infected ones for IVF. “We have established a very simple and effective method to isolate sperm cells from even poor quality infected semen. It’s called tilted-tube rotation method and with it, we have been successful in recovering motile sperm from positive males with heavy viral loads,” says Naoaki Kuji of the Department of Obstetrics and Gynaecology, Keio University School of Medicine. Kuji has developed the Density Gradient Centrifugation process.
“A cluster of negative sperm cells can be obtained by this method which then can be used in any process of IVF,” explains noted IVF expert Indira Hinduja.
The method was first developed by SPAR — the Special Program of Assisted Reproduction, a renowned programme under the Bedford Research Foundation Clinical Laboratory in Massachusetts, USA. One of the earliest methods used to separate the uninfected sperm cells involved sperm washing.
The process was based on research findings that indicated that approximately two-thirds of the semen produced by all HIV-infected men has no detectable virus. Hence, the washed sperm from such samples produces semen that is safe to use for an IVF treatment, resulting in an uninfected baby and mother.
The Bedford Research Foundation also offers this service to clinics worldwide. One has to collect a sperm sample and send it to the foundation preserved in liquid nitrogen. After treating the samples and separating the negative sperm cells, the Bedford clinical lab sends cryo-preserved sperm with an undetectable amount of virus to infertility centres worldwide.
According to Malpani, most of the requests he receives for such IVF treatments come from people like Singh — positive males who don’t indulge in high-risk behaviour and who have been infected due to professional hazards. “All this while, they lived a condemned life. But now they have the option of starting a family without hurting anyone,” Malpani says.
Most HIV/AIDS care agencies in the country advocate against HIV positives either getting married or having children. However, some like Shabana Kapur of the Maharashtra Network of Positive People (NMP+) disagree. “The decision to get married or have children, and particularly the latter, should be left to individuals. With anti-retroviral therapy increasingly improving the quality of life and life spans, one should look at life positively. A person who gets infected at 30 can easily live a good life for the next 30 years. Why should he compromise?” she asks.
Diabetes ‘decreases male fertility’

SOURCE: TIMES ONLINE


Experts have suspected as much for years and now it has been confirmed: diabetes is a threat to male fertility, according to new research by Queen’s University Belfast.
The study found the impact was strongest in people with type 1 diabetes, which is usually present from childhood, but was also apparent in men who developed the condition later.
Fertility experts at the university have been studying sperm samples from 60 diabetic men for several years, comparing them with thousands of other men without the condition. The latest study, involving examination of the semen of eight men with diabetes, found that it had disrupted the DNA in their sperm.
The researchers concluded that high blood sugar levels meant men with the condition “have a significant decrease in their ability to repair sperm DNA, and once this is damaged it cannot be restored”.
Neil McClure, professor of obstetrics and gynaecology at the university, said the possibility of a link between the condition and reduced fertility had been mooted before but adequate research had never been carried out.
“Male fertility has always been looked at in diabetics in a haphazard way,” he said. “Under a light microscope there’s no difference, but in DNA analysis, you see a lot more damage. Diabetes affects virtually every part of the body. It sticks little sugar molecules onto everything, so when we looked at the sperm we found a lot of these molecules. The whole way the DNA functions in the diabetic man is upset.”
Corresponding research at the university’s In Vitro Fertilisation (IVF) unit found that where the father had diabetes, the treatment’s success rate decreased. McClure said they had also used research from Australia. It showed that the percentage of men with diabetes enrolling for IVF treatment was three times higher than average.
“Diabetes poses a threat to their fertility. It’s not an absolute barrier but it does make it more difficult,” said McClure. “We wouldn’t say diabetic men don’t need to use contraception but we would say if they and their partner are looking to get pregnant, it could take a lot longer.”
The team presented their findings at the European Society of Human Reproduction and Embryology conference in Barcelona this month. They said that the research was important because the age at which people are getting diabetes is decreasing and that the men affected are increasingly of reproductive age.
An Institute of Public Health report in 2006 estimated that there were 143,000 people living with diabetes in Ireland, of which 58,807 were men. One in 10 had type 1 diabetes, while the remaining 129,000 had late-onset type 2 diabetes. This often develops during adulthood as a result of obesity, high blood sugar, old age or genetics.
The Diabetes Federation of Ireland believes there are a further 200,000 people who are unaware that they have the condition and 250,000 people who have impaired glucose tolerance, or “pre-diabetes” — half of whom will go on to develop diabetes unless they make lifestyle changes.
Anna Clarke, spokeswoman for the Diabetes Federation, said the Queen’s University research needed more analysis. But McClure said that “meticulous control of blood sugar” was mandatory for men looking to have children.