HIV-positive men father children through ICSI. (Sperm Washing Cuts Transmission Risk).

WASHINGTON -- Intracytoplasmic sperm injection with washed sperm in a Columbia University study has allowed 23 HIV-1 seropositive men to father healthy infants while maintaining the HIV-negative status of the infants' mothers.

"HIV-1 infection occurs primarily in young men who might normally desire to have children," said Dr. Mark V. Sauer during the Third World Congress on Controversies in Obstetrics, Gynecology, and Infertility. "For those who desire a family, it's usually been the end of the road.

"But HIV infection is now considered a chronic disease rather than a death sentence, with [highly active antiretroviral treatment] slowing progression and decreasing deaths. Today, the emphasis is on maintaining a healthy, normal, productive life, and for many, 'normal' means having kids."

The HIV-1 Cost and Services Utilization Study conducted last year demonstrated that 29% of 2,864 HJV-1-infected adults desired to have children, said Dr. Sauer, professor of obstetrics and gynecology and director of reproductive, endocrinology at Columbia University, New York.

Until recently, only a few European centers offered assisted reproductive therapy to HIV-1 serodiscordant couples. Preliminary reports from those centers, which primarily performed intrauterine insemination with washed sperm, showed no seroconversions in the mothers or babies.

However, Dr. Sauer said, it is difficult to ensure that washing removes all viral particles; the risk of infecting the woman remains, especially since with intrauterine insemination, millions of sperm are placed above the immunologic barrier of the cervix.

In 1997, Columbia University initiated a study ...