- In HIV infected
couples, where the female partner is HIV positive and the male partner is
uninfected, timed vaginal insemination (TVI) is a safe and effective
method to achieve pregnancy with low risk of HIV transmission to the male
- With advances in
treatment, HIV infected persons live normal productive lives and long to
have kids and a family and TVI is a safe and inexpensive method to aid
conception in low-income countries.
antiretroviral (ART) therapy controls viral load to low levels in infected
persons, it does not guarantee that HIV transmission will not occur.
Moreover, viral load is not assessed routinely in many cases. Thus timed
vaginal insemination is a safer option
Timed vaginal insemination is a safe, inexpensive and
effective procedure to help HIV couples, where say only one partner (in this
case the woman alone) is HIV positive to conceive and have children. This was
published in a recent study by Okeoma Mmeje, M.D., assistant professor of
Obstetrics and Gynecology at Michigan Medicine.
"HIV does not change an individual's desire to have
the lead author of the study "Our study describes a
feasible, safe and effective method for women living with HIV
to achieve pregnancy" she added.
‘Timed vaginal insemination is a safe effective method to achieve pregnancy when the female partner is HIV positive and the male partner is HIV negative (i.e they are sero-discordant) with low risk of HIV transmission to the male.’
The findings of the study appear in the journal PLOS ONE.
What is Timed
Vaginal Insemination (TVI)?
to the deposition of collected semen by means of a syringe into a woman's
vagina during her most fertile period and is done about 24-48 hours before the
expected day of ovulation, in order to achieve a pregnancy.
- For timed vaginal
insemination, the woman closely monitors her menstrual cycle and during
her most fertile period (1-2 days prior to ovulation).
- The male
partner's semen is collected either into a water-based lubricated condom
(which does not kill sperms) or by ejaculation into a clean cup.
- The semen is then
drawn into a needleless syringe or into a bulb pipette.
- While the woman
lies on her back with hips elevated the semen is slowly introduced deep
into the vagina either by herself or her partner.
Timed Vaginal Insemination in HIV Infected Couples
Participants in the study were enlisted from eight HIV treatment
clinics in the Kisumu area of
Western Kenya. The women were aged between 18 to 34 years. The participants
underwent counseling sessions and teaching aids were used to educate them about
study included 23 couples, in whom the
woman was HIV infected and her partner
couples were initially monitored for two months when they were tested and
treated for sexually transmitted diseases before the timed vaginal insemination
vaginal insemination was done for up to six menstrual cycles.
the 23 couples, Timed Vaginal
Insemination or TVI resulted in six live deliveries without HIV
the end of the study, fertility evaluation was offered to couples who did not
The findings of the study suggest that timed vaginal
insemination is a safe and effective method to help HIV infected couples conceive
Myths About Pregnancy in HIV Infected Couples
Pre-conception counseling is particularly important to
dispel many wrongly held notions about pregnancy prevalent among HIV couples
It is not possible to have a baby if you use a condom.
personnel discouraged pregnancy in HIV infected couples deeming it unsafe
for the baby.
- During pregnancy the immune system becomes even more weak.
Cons of Timed Vaginal Insemination
insemination is a safe and effective way of achieving pregnancy and can be
easily integrated into HIV programs in low-income countries across the world.
- The procedure can
be done at home without the need to feel embarrassed about going to a
clinic to provide a semen sample.
- The TVI procedure
can be easily integrated into HIV control programs and made readily
- It is safe,
inexpensive and effective.
- Timing of the
woman's fertile period may not always be accurate; however, the occurrence
of thin, clear, cervical mucus that can be stretched (spinnbarkeit) is a
reliable indicator of ovulation and correlates best with the timing of
ovulation by ultrasound imaging.
- Couples may
technically find it difficult to collect the semen correctly and/or deposit
the semen into the vagina properly.
- They may feel
uncomfortable touching the genitalia while doing the insemination
initial discomfort with the technique and the socio-cultural barriers
surrounding the procedure are overcome TVI can become be an affordable and
easily accessible reproductive option in these couples.
- Empowering HIV-infected women in low-resource settings: A pilot study evaluating a patient-centered HIV prevention strategy for reproduction in Kisumu, Kenya - (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212656)
- Achieving Pregnancy Safely: Perspectives on Timed Vaginal Insemination among HIV-Serodiscordant Couples and their Healthcare Providers in Kisumu, Kenya - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221525/)
- Evaluating Safer Conception Options for HIV-Serodiscordant Couples (HIV-Infected Female/HIV-Uninfected Male): A Closer Look at Vaginal Insemination - (https://www.hindawi.com/journals/idog/2012/587651/)