Afternoon Symposium - MHPG Symposium -Controversies and Cutting Edge in Third-party ART: Helping HIV Positive and Serodiscordant Couples Become Pregnant

Date:October 22, 2014

Time:11:15 am - 1:00 pm

Location:HCC312 - Hawaii Convention Center


Kim Bergman, Ph.D (Chair), Growing Generations

Bradford A. Kolb, M.D., HRC Fertility - Pasadena

Daniel Bowers, M.D., Callen-Lorde Community Health Center

Richard B.Vaughn, J.D., International Fertility Law Group

Needs Assessment and Description
While assisted reproductive technology (ART) practitioners now routinely offer services to patients with advanced cancer, lesbians and gay men, transgendered people, single men or women, women well past menopause, and celebrities who choose not to carry their own babies, helping HIV-positive men and serodiscordant couples have their own biological children is one of the last taboos for the ART practitioner. Advances in treatment have made HIV a long-term manageable disease, creating a growing pool of HIV-positive men who see themselves as healthy fathers who can raise children. Advances in science and medical technology coupled with growing public acceptance and legal recognition of same-sex marriage and decreased discrimination and stigma for HIV-positive individuals are all generating more role models and opportunities for HIV-positive men to think about having children. The literature continues to show that HIV-positive men with undetectable viral loads are essentially noninfectious. Through gestational surrogacy, men who are HIV-positive and serodiscordant couples can now safely have their own biological children. Despite all of these legal, social, and medical advances, many practitioners continue to have concerns about serving this population. By exploring the history, science, medical procedures, psychological issues, legal status, and ethics of helping HIV-positive and serodiscordant couples have their own biological children through third-party ART, this course will increase the cultural competency of psychologists, lawyers, and medical doctors working with this newest population of prospective parents. 

Learning Objectives
At the conclusion of this session, participants should be able to: 

  1. Conclude that HIV is a long-term manageable disease. 
  2. Increase their sensitivity to the psychological issues of gestational surrogates carrying for HIV-positive men as well as the psychological issues faced by the HIV-positive parents and their children. 
  3. Describe how the HIV virus affects reproductive risk and how to provide safe and ethically sound treatment options to those who are HIV-positive. 
  4. Discuss the ethical and legal ramifications and special factors that need attending to when working with HIV-positive and serodiscordant couples. 
  5. Explore the historical, cultural, and political drivers in the field of ART, using sperm from HIV-positive donors. 
ACGME Competency
Patient Care 

After participating in this session, in my practice I will use the following as an accepted method to minimize the risk of transmission of the HIV virus in procedures for reproductive purposes:
a. Stopping antiviral therapy only a month prior to treatment
b. Separating the sperm from leukocytes and seminal plasma by gradient separation followed by a swim-up technique
c. Treating a heterosexual couple with ovulation induction with timed intercourse
d. Maintaining a strict policy prohibiting the treatment of HIV-affected patients
e. Prescribing prophylactic interferon therapy for the recipient at the time of treatment
f. Not applicable to my area of practice


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