Semen Washing To Prevent HIV Transmission In HIV-Discordant Couples: Is It Effective?

The most comprehensive systematic review to date evaluated the effect of semen washing on HIV transmission among HIV-serodiscordant couples and showed there is practically no risk of HIV transmission if the procedure was carried out correctly.

Sperm washing removes spermatozoa, which do not take HIV particles, from the surrounding seminal fluid, and the HIV-negative sperm fractions are used in assisted reproduction. The first study, from 1989, of semen washing for HIV-discordant couples, with the use of intrauterine insemination (IUI), found no HIV transmission to 29 uninfected female partners.

Recently a collaboration of scientists from the University of California and University of Michigan School of Medicine conducted a systematic review of the studies of HIV transmission prevention among serodiscordant couples in which the male is infected to estimate the safety and effectiveness of semen washing procedure.

There were no cases of HIV transmission after exposure to washed sperm among 3,994 women undergoing 11,585 cycles of assisted reproduction. Also, there were no HIV seroconversions among 1,023 couples in which the HIV-infected man was not virally suppressed. Furthermore, there were no cases of mother-to-child HIV transmission among 1,026 newborns, either at birth or the follow-up evaluations.

"We found that semen washing provides a safe and efficient method for HIV-serodiscordant couples to become pregnant. There were no instances of HIV seroconversion among HIV-uninfected women inseminated with washed semen from their HIV-infected partners. More than one-half of the couples in this review achieved a clinical pregnancy, and the rate of spontaneous abortions reported was similar to general population estimates," the study report says.

"Integration of semen washing into HIV prevention protocols may help to restrain the incidence of sexual HIV transmission," Maryam Zafer, a research collaborator from Global Health Sciences, University of California concludes.