making babies ...

[pozcanuk]

not sure if this is where i should be posting ... but i have so many questions about being possitive and having children.  i am so heart broken at the thought of not being a dad.  i live vicariously through my sisters children and thought it would be enough.  it is clearly not.  i love spending time with them but when i leave, i  find myself in tears.  i would love to hear from women who are poz that have had children and men that are poz that have fathered children.  i have read studies about sperm washing and adherience to drugs making the chances of passing on the disease exceptionally minute .. but i would REALLY love to speak with someone or hear other's experiences with this. 

if i am posting in the wrong section .. please tell me where to go.  i am new to this and any information would be greatly appreciated. 

[27years]

I havent got the experience on this one but from what i have read you are still capable of having children if you are poz.  Bear in mind that they can be other problems which are have nothing to do with hiv which can stop people from having kids, considered adopting as an alternative if you really love kids.     

[beaubrent]

I think any of us with the means should at least try adoption, if only because there are so many kids in the world with no home. I'll be a dad one day.

In the meantime, the cat is still alive and the herb garden isn't dead yet...

[aztecan]

There is a technique called sperm washing that will enable you to have children.

HIV lives in semen, but not sperm, hence the washing. From what I have heard, its expensive, but it would make it possible for you to procreate should you desire to do so.

Of course, you will need a female to go along with this.

HUGS,

Mark

[Snowangel]

Hi Pozcanuk-
I have had 2 healthy pregnancies and 4 healthy children since becoming poz.  I was lucky enough to be followed in a study here in Massachusetts.  There are certain meds that you(sorry-when I say you I mean the mother   ) can't be on during pregnancy, adherance is very important, you can not breast feed, the child has to be on meds for like 6 weeks after birth.  I can't remember if you have to have a c-section or not?  With my first son, he came a month early and I barely made it in the delivery room and I had trip  lets the second pregnancy so that was an automatic c-section.  I could find out for you though.  Send me a pm, if you have any questions.
Take care,
Snow

[Oceanbeach]

The year I joined the Sonoma County Commission on AIDS, there was some discussion about sperm washing and a study similar to the one in Massachusetts like Snow has been part of.  In the first year, 9 HIV+ families gave birth to 9 HIV- babies, knowing they would be there for their childrens high school graduation.  That was two years ago and I do not have any more recent information.  Have the best day
Michael

[pozcanuk]

Thank you all so much for you responses. 

Beaubrent ... I absolutely intend on adopting.  I want to have two ... one that is biologically mine and one that is not.  I agree that there are too many little lives out there that need a loving and safe home to call their own.  I believe that if I can feel like a father to my little cat .. a little human version should be a walk in the park .. so to speak!

Aztecan ... I have heard and read about sperm washing ... and yes there is a great expense involved ... uggg.  No matter what road I take to get a child ... it is going to be an expensive one.  Dam the fact I was not born with a womb!!!  Think I might need another couple of jobs!  I will be speaking with my doc about this one in the next couple of weeks!

Snowangel ... thank you so much for your posting.  It is so reassuring for me to hear that there are people like myself who want and find the means to having children.   It is such an integral part of what I want from my life.  Congrats on 4 healthy children!!!  People will ask if i want a boy or girl .. and i respond .. I just want a healthy baby, however, it would be very easy for me to adopt an HIV baby here .. so that is one thing I am looking into.  I am trying to read up on infant HIV issues and concerns.  I have heard about children becoming infected at birth and then converting back to negative.  So much to learn .. I dont no where to begin!  Thank you also for your offer to PM with questions .. I am sure as time goes by I will have many.  It is a gracious offer!!

Sonomabeach ... that is wonderful information.  I am going to see if there have been any such studies done here.  The more I read and the more info I get from kind people like yourselves, the better and more informed decisions i am able to make! 

Thanks again everyone.  Becoming a parent without this issue is difficult enough and I do appreciate all responses.  I do look forward to the day when my questions will be guided to parental forums and I am asking what one does when teething starts!!!!

[Ann]

I have heard about children becoming infected at birth and then converting back to negative. 

Any baby born to an hiv positive mother will have her antibodies, so the baby will test positive on the antibody test at birth. It takes a few months for the baby's body to clear the mother's antibodies. If the baby has not been infected in the womb, it will test antibody negative after a while. However, if the baby becomes infected in the womb, it will always test positive because once infected, always infected.

You might be interested in the following threads:

http://forums.poz.com/index.php?topic=18704.msg238315#msg238315

http://forums.poz.com/index.php?topic=17683.0

http://forums.poz.com/index.php?topic=18746.0

Good luck!

Ann

[pozcanuk]

Thanks for the heads up Ann.  I have read the other links you suggested.  Very informative and very touching.  I feel like I am growing in leaps and bounds with the knowledge I am accumulating.  To add to everything, we have to find a woman that wants to co parent with us, minor details. 

[butterfly]

We are pregnant via donor sperm & ivf.  We had considered the sperm washing but our clinic locally could not do it; if we had made that choice, we would have needed to go to Columbia University and we decided we really wanted to use our doctor we were comfortable with...also, the bio connection wasn't the important factor to us --- we just wanted to have children together.

We did attempt adoption.  All was GREAT...until they found out about the hiv.  We were suddenly called in & it was explained to us that we were denied the completion of our home study based on 'various factors' (all factors that we had previously been told would be no problem).  HIV was not mentioned but we found that quite interesting due to the timing - this occurred just one week after we informed our worker that my husband was HIV positive.  At this point we had already completed everything but one week of the required parenting class and all but one home study visit.

Also, due to several comments by our worker - she asked about my health and when I replied that I was healthy, she responded "Oh, good, we would like at least one of the parents to live for at least 20 years."  (and, trust me, we did try to educate her as did my husband's ID doctor)  Also when we were denied, I asked her about domestic adoption of a baby through a private agency, and she said that would be a good plan "because they do not look so much at health."

I really hope this is not the way it is all over the country, that every social worker is not so prejudiced against someone who has HIV adopting.  It was a devastating blow to us, and very sad that somewhere there is a child who was denied a great home because of ignorance.

I am happy that we found another way to add to our family, but I did have to add my two cents here...sometimes it is not so easy as saying "You can always adopt."  Sometimes, you can't.

[WorriedWife]

I looked into doing the sperm washing because my husband is pos and I am not. We learned that it costs about 10,000 not including travel expences, insurance will not pay for it and it is a 1/3 chance that it actually works. So we kind of threw that one out the window and I am now debating on wether or not to concieve naturally. We have talked to my husbands doctor about the swiss study that was done and to see if I could get on some type of ARV to help prevent transmission so we are still waiting on that responce. The article says pretty much if you follow certain guidelines that it is unlikely that the HIV will be passed during intercourse. Some of the conditions include being undectectable for 6 months, being on a HIV regime and having regular check-ups. I hope this helps you and good luck.

[pozcanuk]

Thanks butterfly and worriedwife.  I understand that adoption is not always a possibility although living in Canada, I believe it would be an easier although costly option compared to our good neighbors to the south.  Ultimately I would love to have one of my own and one adopted.  I have been watching and reading about the swiss study with very keen interest.  I am very fortunate to have been undetectable for a few years now and with luck on my side plan on keeping it that way.  I will definately be waiting to see what happens with sero discordant couples having children the natural way.  I am excited beyond belief that this could now be possible when once I thought my chances were slim to none.   Thank you both for sharing your experience and advice and I truly wish you both all the best.  Be sure to post baby pics!!!!!!

[Tempeboy]

Went to a Medical forum in Sydney a couple of weeks ago that addressed some of these issues.  An Australian perspective but might be useful.


The forum was presented by Dr Michelle Giles of the Alfred Hospital in Melbourne - a great speaker who is passionate about this subject.  A number of topics were discussed and they are summarised below.

Current picture

More women than ever in Australia are living with HIV and these numbers are increasing.  The majority of these women are heterosexual and of child bearing age.  Many of these women have emigrated and are Medicare Ineligible with limited access to information and support compared to their urban gay brothers.  Some of these women choose to seek out positive partners who may be from a different part of the world making superinfection a real issue.  Women living with HIV should have a pap smear every 6 months as HIV is associated with an increased incidence of cervical dysplasia.

Contraception

There is no such thing as 100% reliable contraception for sexually active heterosexual women and many pregnancies are unplanned.  Many women have limited ability to negotiate sex with their partner, let allow safe sex – making consistent condom use almost impossible.  This increases the risk of unplanned pregnancy and transmission of HIV.  Positive women do not have access to free female condoms.

Conception

Current care and technology allows couples living with HIV to conceive without passing on the virus to their negative partner or baby.  There are a number of techniques available including home or in-hospital insemination.  Many couples take treatments to allow them to conceive naturally.  Sperm washing is also used to prevent transmission from positive male to their negative partner.  The technique does not involve washing at all - but spinning.  A 'sample' is collected into a test tube and spun in a centrifuge.  As most of the sample is 'rubbish' (speakers words not mine) the quality stuff goes to the bottom of the tube, the top layers are discarded and the good stuff used to inseminate an egg under a microscope.  This technique is used widely in infertility care and not limited to couples living with HIV.

Even before conception men are categorised according to their usefulness.   

Pregnancy

All pregnant women in Australia are screened for HIV allowing appropriate monitoring and care during pregnancy.  Not all women tested receive pre or post test counselling.

Sexually active heterosexual women of child bearing age should take folate whether or not a pregnancy is planned.  Folate deficiency is one of the leading causes of preventable birth defects in the world.  Supplementation should commence 6 months prior to the planned date of conception.  This is also true for positive women.

Women can take treatments before, during and after pregnancy with few complications EXCEPT if taking Efavirenz.  Efavirenz is associated with birth defects BUT is still recommended to women as first line therapy.  These women suffer greatly when they learn that their HIV medication has harmed their baby - totally avoidable if alternative medication is used. Some clinics have a total ban on prescribing Efavirenz to women - but the scripts keep coming.

Link to picture of baby with Efavirenz Myelomeningocele - http://www.medscape.com/content/2004/00/47/06/470600/art-nf470600.fig2.jpg

Childbirth

Treatments can prevent mother to child transmission (MTCT) of HIV.  If a woman is not taking treatments at the time of birth there are a choice of treatment based interventions that can be given during birth to prevent transmission.  Many women elect for Caesarian Section to reduce the risk of MTCT.

Breastfeeding

Even though HIV can be passed on through breast milk, women can pasturise their breast milk and bottle-feed their milk to their baby without passing on HIV.  Many women also choose to bottle feed.

Summary

Our current levels of care and knowledge allow women living with HIV entry at all levels of health care, and there is a growing number of Women Doctors with a special interest in this area.  It goes without saying that women better understand the health needs of women. 

[Coffeechick88]

I am a poz woman and my due date is exactly in one week.  I will be having a boy and the father and I haven't yet decided on a name.  I will be going through labor.  They don't require C-sections.  I think they used to, but after finding out that labor is finewith  following certian guidelines, they don't make you have a C-section.  People think I am crazy for choosing labor, but given that a C-section is an invasive procedure with longer hospital stay and longer recovery time, I am trying to avoid that unless absolutely necessary.  Of course, now that I chose labor, of course I am in a position where I still haven't progressed and I really want this baby out STAT.  Hopefully my Thursday appointment will have good news in that department--even better if I don't make it to Thursday still pregnant.  But I have no worries--I know my baby will be healthy.  It can be hurtful, because there are many people out there who think that poz women should automatically go and have an abortion and are cruel for having children, but I know it is mainly ignorance talking and try not to get down about it.

Other people have outlined options for the guys--there are many ways poz men and women can have healthy babies.  I do know of an HIV+ guy, who I met through the father of my child, who conceived with his wife (HIV-) through intercourse.  The wife doesn't have HIV after 9 years of marriage and they have 2 healthy children.  So I know it will be very possible for you to get your baby, no matter how you choose to go about it.

[Victory101]

Am interested in the pastururizing of breast milk, how is this done? And if done, does it still have some of the good stuff breast milk is meant to have eg pro biotics etc

[deniur efil]

there was an article recently on an other site where doctors in Europe believe that is a male is reacting well to meds VL UD that there is very little risk if any passing the virus through sperm, this news article was only recently realeased.

[butterfly]

Congratulations Coffee Chick! 

I did want to add one note...I don't have tubes, so conceiving naturally wasn't an option for us, either.  With IVF, they do have certain requirements which led us to only 2 choices:  sperm washing or donor sperm.  If we had the option of conceiving naturally, and my husband was on meds and undetectable (he's not yet) then we would have likely gone that route.  I am really happy that is an option for couples after the swiss study. 

And I am so happy that it worked out well for you!

Butterfly

[Tempeboy]

Breast feeding.

Breast milk contains many nutrients and antibodies that can stimulate the babies immune system - how cool is that!  The first feed is the most important as is contains colostrum - a rich supply.  This first feed also helps the uterus to contract down.  There are a couple of options for poz mothers who want to breast feed.

Pasteurising breast milk entails boiling expressed breast milk to 'kill' HIV.  There are special devices and I am told that you can do it at home with a jar and a saucepan of water.  You would obviously need to consult an expert for instructions (equipment, time of boiling etc).

Medication taken my mum (or you say mom I think) can reduce levels of HIV in breast milk.  Some penetrate better than others.

Babies can take PrEP - low doses of one or more HIV meds whilst they are breast feeding to prevent transmission.

Link to previous article - http://www.poz.com/articles/1_10902.shtml

PS I am by no means an expert in this area but I am so amazed at what women are doing as researchers, clinician and people living with HIV.  Last year I met a young man that was born with HIV who's wife had recently given birth to their first baby - mum and bub both neg - truly amazing.

[MarcoPoz]

My wife and I began this process eight years ago.  I'm positive, she's negative.  We dealt with the roller coaster of emotions surrounding our desire to have children and if we were putting her at risk.  The science said then and now that we weren't doing anything that lead to a reasonable risk of infection, but it still did a major mind-f***k to me.

First there was that voice in my head yelling that I was crazy to do this--then the other voice saying that she wanted our child so bad.  It didn't work and we were crushed.

I remember holding her hand in the exam room during the insemination.  It was incredibly emotional and emasculating to be in such a sterile environment with medical staff doing for me, what I could not do romantically, lustfully and lovingly with my wife.

Flash forward to a year ago when we decided to pull out all the stops and go in vitro.  For us. in vitro was a no-go. Before we started we agreed that no matter the outcome, we would get to the end of a year and stop.  No matter the outcome, we would still have eachother and either share our lives with our child--or share our lives with one another.

My heart still aches when I see a couple holding a new born.

-Marco

[butterfly]

Marco,

I am so sorry that having a baby did not work out for you & your wife.  I have felt that heartache for many years and I understand that feeling of seeing a couple with a newborn.  I went for over a decade unable to have a child and feeling I was 'defective' (nothing related to HIV, but very painful to me).  When we found out that my husband was HIV positive, it just added another layer of that 'this is impossible' feeling to the mix.  We took some time off to let it all sink in and make a decision. 

Especially after our attempt to adopt was shattered, we got to a place where I had to feel ok no matter what.  I had to get to that spot where you guys are of accepting the future no matter what it held for us.  We made the decision to try in vitro 4 times...it worked the first time.  I am still in shock about that, after my past history. 

I know it has been hard for my husband.  There have been times in our journey that he has felt that he hasn't contributed anything.  That is not true!  He has been the most supportive & wonderful husband, ever...and I would feel that way no matter what our outcome. 

I really wish that things had worked out differently for you & your wife, but I am glad to hear that you have the type of relationship that you are able to work through this. 

Butterfly

[MarcoPoz]

Thank you and good luck!   It's great to hear your story.