If a person is a carrier of HIV infection, this does not mean that he should give up his life. Modern medicine has studied the virus enough to help someone infected with HIV live a fairly long life and still feel good. Men and women with HIV can create families in which sooner or later the question of having a child arises. In this case, it is not necessary for both partners to be carriers of the virus; either only the man or only the woman can be infected. In each of the possible situations, there are options for the spouses to give birth to a healthy child without a virus in the blood.
The fact that an HIV-infected woman can give birth to an uninfected child is not fiction. To do this, it is enough to plan your pregnancy together with a specialist, as well as undergo special treatment throughout your pregnancy. Statistics provided by WHO indicate that taking preventive measures before and during pregnancy reduces the risk of transmission of the immunodeficiency virus from mother to child to 2-3%. Moreover, if you do not interfere with the pregnancy process in order to protect the fetus from infection, the risk of infection is 20-45%.
As you know, women are the most vulnerable to HIV. Unfortunately, despite the widespread promotion of protected sex and personal hygiene rules, every year in Russia there are more and more women of reproductive age who are forced to face HIV. Most often, women are infected between the ages of 18 and 30 – the most favorable age for the birth of offspring. But HIV has ceased to be a reason for refusing to have children. To date, more than 6,000 babies have been born to HIV-infected women. However, cases cannot be ruled out when women prefer to have an abortion rather than risk it. Such situations, as a rule, are caused by the lack of necessary up-to-date information, professional psychological assistance and lack of support from family and friends.
Often, women find out that they are HIV-infected already during pregnancy, when they register at the antenatal clinic and begin to undergo mandatory examinations. To prevent this, both partners should undergo examinations and tests at the stage of planning a child. But if there are no test results, but you are pregnant, you should go to an appointment with an obstetrician-gynecologist and register for pregnancy as early as possible.
Conceiving a child in a couple with HIV infection
There are a lot of questions surrounding the topic of conceiving a child in families where both or one of the spouses is infected with the immunodeficiency virus. People are interested not only in the health of the unborn child, but also in when is the best time to take this serious step, how to get pregnant and protect a partner who is not an HIV carrier.
Not everyone knows that the egg and sperm do not carry a virus; they only contain the DNA of the future parents. However, HIV cells are present in both vaginal secretions and ejaculate. It is also dangerous for spouses infected with various types of HIV or a drug-resistant virus to have unprotected sex in order to have a child, as there is a risk of re-infection of partners. If a woman is infected, she can transmit the virus to her child in the following ways:
- during pregnancy;
- during delivery;
- when breastfeeding.
The risk of a child contracting HIV through one of the first two routes can be minimized with the help of special treatment that prevents transmission of the virus to the fetus. But infection will be inevitable if a woman carrying HIV breastfeeds her baby, since virus cells are contained in large quantities in breast milk. In addition, infection is also possible through careless handling of a child after he or she has passed infancy. Therefore, you need to get used to being extremely attentive to your actions and his healthy future from the very beginning - even before the baby is born.
Safety of future parents
As mentioned earlier, if a couple in which one or both partners are diagnosed with HIV wants to give birth to a child, it is necessary to take care not only of the unborn child, but also of the spouses themselves. To prevent an infected man and woman from becoming carriers of various types of viruses, as well as from infecting healthy members of a couple, there are various assisted reproductive technologies.
Alternative methods of conception in families with HIV
1. If only a woman is HIV-infected
If only the woman is a carrier of HIV, then to protect the man from the virus, conception can be achieved through artificial insemination. To do this, you need to find a clinic that practices this particular ART method. The woman determines the period during which ovulation should approximately occur; as a rule, with a 28-day cycle, ovulation occurs on the 14th day. On the day of expected ovulation, an artificial insemination procedure is prescribed. Before this, the man must donate sperm, which will be injected into the patient’s vagina.
2. If only a man is infected with HIV
- In such a situation, the safest method of conception, according to many doctors, would be artificial insemination. The HIV-infected partner provides a semen sample, which is subsequently cleared of the virus in the laboratory. With the help of a specialist, the woman determines the day of ovulation and it is at this time that purified seminal fluid is injected into her vagina. This method is not only safe for the expectant mother and child, but also quite effective against ART. However, before artificial insemination is carried out, the partner must undergo tests to determine how fertile he is, that is, whether he has the ability to fertilize.
- IVF – in vitro fertilization. In order to carry out IVF, germ cells are taken from both the man and the woman. The husband donates sperm, and mature eggs are collected from the wife using a low-traumatic endoscopic procedure - laparoscopy. Then two sterile germ cells are combined “in vitro”, the egg is fertilized by a sperm, and a healthy, viable embryo is placed in the woman’s uterus. It is advisable to use IVF only if the couple has problems conceiving.
- Using donor sperm. If a man is infected, a woman can use a sperm bank and undergo artificial insemination using sperm from an HIV-negative donor. With this method of conception, the risk of infecting the woman and child with the human immunodeficiency virus is zero, but not all couples are ready to decide on this due to the ethical side of the issue.
Where to start planning for pregnancy with HIV?
Knowing her family situation, a woman should consult an obstetrician-gynecologist several months before the expected date of conception. As practice shows, the more attention is paid to pregnancy planning and preparation for it, the better for the mother and her unborn child.
You need to know that a woman’s risk of infection increases if she has sexually transmitted diseases in acute or chronic form, chronic diseases of the reproductive system in the acute phase, as well as diseases of other organs that lead to a deterioration in her condition and well-being. Therefore, before a planned pregnancy, it is necessary to undergo the necessary treatment and get rid of the largest number of diagnosed diseases. For an HIV-infected woman, it is important to know the stage of development of her disease, indicators of immune status, viral load, and the presence of opportunistic infections.
Feel free to contact HIV and AIDS counselors to ask all your questions, ask for advice, learn about the experiences of couples with a similar diagnosis and what options are available to you.
You can become the mother of a healthy child with HIV. To do this, you just need to contact a specialist in time, prevent the transmission of HIV to the fetus, and also take yourself and your unborn child seriously from the very beginning.
Even those who have had personal experience with HIV infection want to become parents to a cheeky toddler. Couples in which one or both partners are infected with this virus experience some difficulties in conceiving a child. Here we need even more thorough preparation for pregnancy. Therefore, put aside all your affairs, no matter how important they are (whether you are currently delivering crushed stone or graduating from a university), and deal with this issue. But the main thing is to eliminate all risks associated with infection of the embryo (fetus) with a terrible virus. To do this, you need to use one of the alternative methods of conception.
If only the woman is infected
In this case, you can use the method of artificial insemination, for example, vaginal insemination. That is, sperm is taken from a healthy partner and injected into the vagina during ovulation. It is at this time that a mature egg leaves the ovary and is ready for fertilization.
If a man is infected
- Some HIV-positive couples take the risk and try to conceive a child through unprotected intercourse during ovulation. But why risk it if you can use one of the following methods:
- Artificial insemination of a woman with purified sperm of a man infected with HIV. However, a small number of clinics offer such a medical service, and the cost of the procedure can scare off a couple.
- In vitro fertilization (IVF). The term itself refers to fertilization outside the woman’s body. There are many subtypes of IVF, but the principle is that the best (active, healthy) sperm are isolated from the sperm of men, and eggs are collected from women using laparoscopy. Fertilization itself occurs in a “test tube”. And already 3-5 days old embryos are placed in the uterine cavity. This procedure costs a lot of money, and for some women even such minimally invasive surgery may be contraindicated.
- Artificial insemination of a healthy woman by another (HIV-negative) male donor. However, the ethical and legal aspects of this method of conceiving a child may force a couple to refuse such a procedure.
I would also like to remind you that before trying to conceive a child, the body of both partners should be prepared. This is especially true for the expectant mother. Get a full examination. Get tested for STIs, TORCH complex, blood sugar tests. It is important to check the kidneys (whether there is sand or infection in them). A couple in which one or both partners are HIV-positive needs the help of family planning specialists.
For many women, deciding to become pregnant is a real difficulty. She faces a difficult task, because she needs to think about whether she can risk her own health and the health of her unconceived unborn child. The desire to give birth is intertwined with fear and doubt if a man or woman is HIV positive.
Everyone understands perfectly well that HIV is a popular causative agent of AIDS. There are two types of HIV: HIV 1 and 2. HIV 1 is the most common, it is more insidious, because after it 35% of carriers develop AIDS. And for HIV 2 it is only 10%. The average time for AIDS to develop from the moment of infection is about 10 years.
Experts were able to isolate the infection from some fluids of the human body: tear fluid, saliva, urine, semen, blood. Today, infections are registered only through breast milk, sperm, and blood.
Conceiving a child
If a couple with the HIV virus wants to have a baby, they should consult a doctor and seriously think about it. This does not mean that all responsibility should be shifted to the doctor. His role is to conduct a consultation, and the man and woman, taking into account all the risks, make their own decisions.
Until today, it has not been proven that HIV during pregnancy affects health. Therefore, if certain conditions are met, pregnancy is still possible.
There is some difference if, at conception, the carrier of the infection is a woman or a man.
If a woman is infected with HIV:
Today in medicine there are various methods of conception, in which the transmission of infection to the fetus is significantly minimized. Unfortunately, no method provides a 100% guarantee that the child will not become infected.
If a man is HIV negative and a woman is infected, then the man is at risk of becoming infected when he conceives. To prevent this from happening, the expectant mother needs to use insemination. To do this, the man's sperm are collected in a sterile container and the woman is fertilized during a favorable period for conception, in other words, during ovulation.
If a man is infected with HIV:
Then there is a risk of infecting the woman. The baby will not be infected through sperm, but will become infected from the woman. To protect the wife, doctors recommend planning pregnancy on the most favorable days for fertilization, as well as when the husband’s viral load is undetectable.
There may be another option - cleaning sperm from the family fluid. Then the viral load decreases, and as a result the virus is not detected. Italian doctors performed this method on approximately 200 women, and none of them became carriers of the virus.
There is another method of artificial insemination, in which I use the sperm of another man to conceive.
If both spouses are infected with HIV:
Then the risk of infection of the baby is maximum. Also, during unprotected sexual intercourse, partners can become infected with various diseases.
Pregnancy
If a woman is infected and she is pregnant, then in this condition she should be under very strict medical supervision. If during pregnancy the expectant mother stops using antiviral medications, there is a risk of rapid reinfection. And this increases the chances of vertical infection of the baby. In principle, even during pregnancy, the baby can become infected in the womb or during childbirth. There is evidence that infection from woman to baby occurs at the end of pregnancy. The risk of transmitting the virus to a baby from an infected woman is one in seven.
If the virus is first detected in a woman during pregnancy, she is told the truth about the possible risks and then given a personal choice: to plan a pregnancy or not. The pregnancy itself in an HIV-positive woman comes with some complications.
Childbirth period
During childbirth, there is a high risk of infecting the baby, because he is exposed to the vaginal sector and blood. Also, the risk of infection increases in the presence of various wounds and injuries that form as a result of surgical manipulations or the birth process.
If a pregnant woman is taking contraceptive medications, she is unlikely to be recommended for a cesarean section. And all because in her cases the chances of transmitting the infection to the baby are equal in both cases. Therefore, if therapy has not been carried out, then a cesarean section is chosen.
A woman is given the drug Zidovudine - this is a very useful prophylactic agent.
Postpartum period
If a child does not become infected with the virus during conception, pregnancy and childbirth, this does not mean that he will not become infected in the postpartum period. It has been proven that the virus is transmitted when a woman feeds her baby with breast milk. Therefore, after giving birth, a woman is advised not to breastfeed her baby. Also, the mother is taught the rules of caring for the child so that she poses minimal risk to him. If a woman follows all precautions, the risk of infection will decrease many times.
What should you think about?
You need to think about whether you agree to pregnancy and agree to such a risk. You must understand: if a baby is infected in utero or during childbirth, in 80% of cases he will develop AIDS by the age of six. Will anyone raise a child if the parents are not doing well?
The decision regarding pregnancy is made only by the couple. And the doctor should support and help in every possible way.
Every woman dreams of becoming a mother, but often this desire is overshadowed by worries and fears, because deciding to become pregnant with HIV infection is not an easy task and requires a serious approach. In this case, the woman risks not only her health, but also the health of the unborn child.
In many cases, planning is the only way to give birth to a healthy baby. The process of preparing for conception requires a blood test that will help determine the viral load. At high levels, it is necessary to ensure that the number of lymphocytes returns to normal and viral activity decreases.
If HIV activity is not observed and the woman has been without therapy for some time, then it is not recommended to resume taking medications during planning and in the first trimester of pregnancy.
Conception
To date, it has not been proven that pregnancy negatively affects the health of an infected woman, aggravating the course of the disease. Medicine, using modern techniques, can minimize the risk of infection of the fetus. But no method gives a 100% guarantee.
People who are HIV-positive and dream of having children should take the process of conception very seriously. There are often couples where only one of the spouses is sick.
Several ways to conceive:
- If the carrier of the virus is a woman: in this case, there is a high probability that a man will become infected during the process of conception, so it is worth resorting to a kit designed for self-fertilization. To do this, take a sterile container and place sperm there, which fertilizes the female egg on the fertile days of the cycle.
- The carrier is male: the fetus cannot be directly infected by male sperm, but if the mother becomes infected during unprotected sexual intercourse, he will become infected from her. Therefore, doctors advise starting conception only on fertile days of the cycle, provided that the man’s viral load is kept to a minimum. There is another way - to cleanse the partner's sperm from seminal fluid, which will reduce HIV activity, and then inject it into the woman. You can resort to the procedure of artificial insemination, in which case the biological material is taken from a sperm bank.
- Both partners are carriers of HIV infection: the likelihood of infection of the fetus increases several times. Also, during unprotected sexual intercourse, partners can infect each other with sexually transmitted diseases that complicate the course of the disease, or exchange strains that are resistant to drugs.
Pregnancy
During pregnancy, a woman with HIV infection is registered with two obstetricians and gynecologists:
- The antenatal clinic, where general observation is carried out - the necessary tests and examinations are prescribed;
- AIDS center, where they monitor the viral load and the state of the immune system, develop treatment tactics, and select the drugs necessary for antiretroviral therapy. At the last visit (35–37 weeks), the patient is given a doctor's note and HIV chemoprophylaxis medications, which help reduce the likelihood of transmission of the virus during childbirth. They are accompanied by detailed instructions: for the mother - intravenously, and for the baby in the form of syrup.
A child can be infected by an HIV-positive mother in three ways:
- During intrauterine development;
- During childbirth, infection most often occurs this way - this is the main danger;
- When breastfeeding.
There are a number of factors that increase the likelihood of a child becoming infected:
- decreased immunity of a pregnant woman;
- high HIV activity in the mother;
- discharge of amniotic fluid ahead of schedule;
- uterine bleeding;
- pregnancy with twins;
- breast-feeding;
- drug use during pregnancy.
Risk prevention
Every woman who knows about her HIV-positive status asks the question: “How to avoid infecting a child?”
First of all, it is necessary to follow all the advice and recommendations of specialists, take the necessary tests in a timely manner and regularly come to the antenatal clinic. It is usually recommended to start treatment in the third month of pregnancy, this will reduce the risk of intrauterine infection of the fetus. Experts prescribe medications that are completely harmless for the baby - you cannot refuse to take them.
Particular attention should be paid to the following points.
- Proper diet and giving up all bad habits. The baby must receive the full amount of vitamins and microelements necessary for full development and gain weight - this is the only way his body can resist the virus;
- Preventive actions aimed at preventing premature birth. The immunity of a child born prematurely is reduced, which increases the likelihood of transmitting HIV infection;
- Treatment of chronic diseases;
- Planning for a cesarean section at 37–38 weeks. The doctor, taking into account the state of health of the expectant mother, makes the final decision on the possibility of performing the operation. In the absence of viral activity, natural birth is possible;
- Avoid breastfeeding your baby. The breast milk of a mother with HIV infection contains the virus, so it is better to choose a milk formula for artificial feeding;
- The infant's use of chemoprophylactic drugs for preventive purposes.
Compliance with these instructions reduces the likelihood of HIV transmission to the infant, but there is still a small percentage. You need to prepare for this. The main thing is that the child is planned and loved, and everything else will only serve as an incentive to fight the disease and defend one’s rights and interests.
Childbirth
Small children do not have their own antibodies - only the mother’s antibodies are present in the baby’s body. Consequently, after birth the baby will also be HIV positive. Only after 1-1.5 years will maternal antibodies disappear from the child’s body and then it will be possible to find out whether HIV infection has been transmitted or not.
Infection can occur before birth, during intrauterine development. The expectant mother needs to carefully monitor her health and strengthen her immune system. Good immunity has a beneficial effect on the placenta, which protects the fetus from viruses contained in the maternal blood. Damage or inflammation of the placenta is a direct threat of infection to the baby.
In most cases, infection occurs during childbirth. After all, when the baby passes through the birth canal, there is a high probability of contact with blood. This is the fastest and shortest route of infection. Therefore, from the second trimester of pregnancy, the mother needs to take antiviral drugs, this will help reduce the risks.
If the tests taken before childbirth show high HIV activity, then a planned caesarean section is performed.
Risks that should not be forgotten
Modern medicine has many ways to minimize the likelihood of an infant becoming infected, but the risk cannot be completely eliminated. Every woman dreams of giving birth to a healthy baby, so even at the planning stage you need to analyze the situation, weighing all the pros and cons. The main difficulty is that you can find out whether the baby was born healthy or infected only after 1-1.5 years.
People planning a pregnancy with HIV infection should know what awaits the baby if he is unlucky and ends up in that ill-fated 2%.
Reviews from doctors indicate that the most severe course of the disease is observed with intrauterine infection of the fetus. In most cases, such children die before 1 year of age. Only a few of them survive into adolescence. This is the limit - medical practice does not know cases of transition into adulthood.
When infected with HIV during childbirth or breastfeeding, the symptoms of the disease are milder because at the time of infection the immune system has already developed. But still, life expectancy does not exceed 20 years.
HIV infection does not have a negative impact on pregnancy, therefore, it is not a contraindication, but requires a balanced and deliberate approach. Even modern medicine does not guarantee the birth of a completely healthy baby, but the chances increase if all recommendations are followed. Of course, the pregnancy of an HIV-infected mother is associated with difficulties, worries and risks, but the main goal of these actions is the birth of a healthy baby, and it is worth it!
Families where one or both spouses suffer from immunodeficiency often dream of having their own child. But people with such a diagnosis believe that they will definitely “reward” their child with a serious illness. But it is worth remembering: HIV-infected people can give birth to healthy children.
How to give birth to a child from an HIV-positive father and not get infected? Ways to reduce the risk of infection during pregnancy:
- Giving birth with an HIV-positive husband possible through in vitro fertilization. Thorough sperm purification or the use of donor material completely eliminates the risk of infection for the woman and baby.
- How to give birth to a healthy child from an HIV-infected man? Using sperm cleansing. Spermatozoa lack CD-4 and CCR-5 receptors, which are activators of immunodeficiency. But the CXCR4 receptor is sometimes found among germ cells. It is capable of inactivating the pathogen. To get rid of the receptor described above, sperm is secreted: living sperm are separated from dead ones. The procedure reduces the load of the virus, which leads to the conception of a healthy child without infecting the spouse.
Is it possible to give birth to an HIV-infected man? Yes, but many married couples resort to artificial insemination. IVF is a method that allows a woman to give birth to a child without unpleasant consequences. All sperm donors are screened for infectious diseases.
How to conceive a healthy baby if both partners are infected? The main one is that a woman and a man can get new strains of retrovirus, as well as other infectious diseases, through unprotected sex. This will lead to complications of the underlying disease and problems with bearing the fetus. Therefore, a natural method of conception should not be considered. In such a situation, whether it is possible to give birth to a child is determined by a specialist. In this case, the pregnant woman’s husband does not have to take an HIV test.
After the baby is born, you should stop breastfeeding. Milk contains many leukocyte cells. Among them is the unpleasant CD4 receptor, which causes immunodeficiency. In addition, the baby absorbs albumins well, complex compounds that are harmful to his natural immunity.
