Special Program of Assisted Reproduction

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The Special Program of Assisted Reproduction (SPAR) is a program offered to HIV discordant couples (serodiscordant) at the Bedford Research Foundation's clinical laboratory. The program takes advantage of ART (assisted reproduction technology) procedures (including "sperm washing" [1] ) to assist couples achieve a pregnancy who would otherwise risk transmitting the father's HIV infection to the mother and the child through intercourse.

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SPAR employs extremely stringent safety standards; samples will only be submitted for "sperm washing" and cryopreservation that have first been screened for HIV virus particles and infected cells by specialized molecular biology tests. Only samples that have been determined to have an undetectable HIV viral burden will be submitted for infertility procedures.

Assisted reproductive technologies (ART), such as in vitro fertilization (IVF), treat many disorders of the female, but until recent years, treatment options for male factor infertility were limited, and donor sperm was routinely recommended to achieve a pregnancy. Advances in ART, however, have created new possibilities for men with male factor infertility, including those whose sperm counts have been decreased by cancer treatment and other diseases, and men with incurable, sexually transmissible virus diseases.

Infectious diseases transmissible by semen for which there is no cure include:

History

SPAR began in 1994 at the New England Deaconess Hospital (now Beth Israel Deaconess Medical Center) as a support group for couples wishing to parent when one of them had an incurable sexually transmitted disease. The patient couples began raising money to fund the research needed to develop the methods to improve the safety of attempting pregnancy. By 1996 sufficient funds were available to begin, but a merger between the Beth Israel Hospital and the New England Deaconess Hospital (now Beth Israel Deaconess Medical Center) necessitated the creation of an independent Massachusetts public charity, the Assisted Reproduction Foundation (now the Bedford Stem Cell Research Foundation directed by Dr. Ann Kiessling), to continue the work. Within two years, the methods for reducing, and perhaps eliminating, the risks of infection to the mother and the child were developed and Baby Ryan [2] was born in 1999.

The goal of SPAR was to provide semen testing by experts that would ensure improved safety of sperm that could then be shipped to infertility clinics near the couple's home. In this way, couples could be cared for in the same manner as other couples in their community. Fortunately, a few clinics were willing to help with this effort, and by 2002, seven collaborating clinics around the country were caring for couples living with HIV disease.

In the Spring of 2000 a ground breaking study was completed, giving significant insight to the role of semen producing organs in HIV anti-viral therapy. [3]

Related Research Articles

In vitro fertilisation Assisted reproductive technology procedure

In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro. The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova from their ovaries and letting sperm fertilise them in a culture medium in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in a uterus, with the intention of establishing a successful pregnancy.

Reproductive technology encompasses all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology, contraception and others. It is also termed Assisted Reproductive Technology, where it entails an array of appliances and procedures that enable the realization of safe, improved and healthier reproduction. While this is not true of all men and women, for an array of married couples, the ability to have children is vital. But through the technology, infertile couples have been provided with options that would allow them to conceive children.

Intracytoplasmic sperm injection In vitro fertilization procedure

Intracytoplasmic sperm injection is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus. With this method, the acrosome reaction is skipped.

Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species. It is however the healthy state of a human child or other young offspring, for they have not yet undergone puberty, the body's start of reproductive capacity.

Artificial insemination Pregnancy through in vivo fertilization

Artificial insemination (AI) is the deliberate introduction of sperm into a female's cervix or uterine cavity for the purpose of achieving a pregnancy through in vivo fertilization by means other than sexual intercourse or in vitro fertilisation. It is a fertility treatment for humans, and is common practice in animal breeding, including dairy cattle and pigs.

Assisted reproductive technology Methods to achieve pregnancy by artificial or partially artificial means

Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes or embryos, and/or the use of fertility medication. When used to address infertility, ART may also be referred to as fertility treatment. ART mainly belongs to the field of reproductive endocrinology and infertility. Some forms of ART may be used with regard to fertile couples for genetic purpose. ART may also be used in surrogacy arrangements, although not all surrogacy arrangements involve ART. The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits.

Sperm bank

A sperm bank, semen bank, or cryobank is a facility or enterprise which purchases, stores and sells human semen. The semen is produced and sold by men who are known as sperm donors. The sperm is purchased by or for other persons for the purpose of achieving a pregnancy or pregnancies other than by a sexual partner. Sperm sold by a sperm donor is known as donor sperm.

Sperm washing is the process in which individual sperms are separated from the semen. Washed sperm is used in artificial insemination using the intrauterine insemination (IUI) technique and in in vitro fertilization (IVF). It may also be used to decrease the risk of HIV transmission by an HIV-positive male, in which case the washed sperm is injected into a female using an artificial insemination technique.

Male infertility refers to a sexually mature male's inability to impregnate a fertile female. In humans it accounts for 40–50% of infertility. It affects approximately 7% of all men. Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity. More recently, advance sperm analyses that examine intracellular sperm components are being developed.

Human reproduction Procreative biological processes of humanity

Human reproduction is any form of sexual reproduction resulting in human fertilization. It typically involves sexual intercourse between a sexually mature male and female. During sexual intercourse, the interaction between the male and female reproductive systems results in fertilization of the woman's ovum by the man's sperm. These are specialized reproductive cells called gametes, created in a process called meiosis. While normal cells contain 46 chromosomes, 23 pairs, gamete cells only contain 23 chromosomes, and it is when these two cells merge into one zygote cell that genetic recombination occurs and the new zygote contains 23 chromosomes from each parent, giving them 23 pairs. A typical 9-month gestation period is followed by childbirth. The fertilization of the ovum may be achieved by artificial insemination methods, which do not involve sexual intercourse. Assisted reproductive technology also exists.

Reproductive medicine Gynaecology

Reproductive medicine is a branch of medicine concerning the male and female reproductive systems. It encompasses a variety of reproductive conditions, their prevention and assessment, as well as their subsequent treatment and prognosis.

A serodiscordant relationship, also known as mixed-status, is one where one partner is infected by HIV and the other is not. This contrasts with seroconcordant relationships, in which both partners are of the same HIV status. Serodiscordancy contributes to the spread of HIV/AIDS, particularly in Sub-Saharan nations such as Lesotho.

Fertility clinic

Fertility clinics are medical clinics that assist couples, and sometimes individuals, who want to become parents but for medical reasons have been unable to achieve this goal via the natural course. Clinics apply a number of diagnosis tests and sometimes very advanced medical treatments to achieve conceptions and pregnancies.

Semen analysis

A semen analysis, also called seminogram, or spermiogram evaluates certain characteristics of a male's semen and the sperm contained therein. It is done to help evaluate male fertility, whether for those seeking pregnancy or verifying the success of vasectomy. Depending on the measurement method, just a few characteristics may be evaluated or many characteristics may be evaluated. Collection techniques and precise measurement method may influence results.

Ann Kiessling American reproductive biologist involved in stem cell research

Ann A. Kiessling is an American reproductive biologist and a researcher in human parthenogenic stem cell research at The Bedford Research Foundation. She was an associate professor in teaching hospitals of Harvard Medical School from 1985 until 2012.

Semen quality is a measure of male fertility, a measure of the ability of sperm in semen to accomplish fertilization. Semen quality involves both sperm quantity and quality

Bedford Research Foundation

Bedford Research Foundation is a non-profit Institute that conducts stem cell research for diseases and conditions that currently have no known cure. The institute also created the Special Program of Assisted Reproduction (SPAR), a program that assists serodiscordant couples successfully achieve pregnancy. Dr. Ann Kiessling, the founder of Bedford Stem Cell Research Foundation, is the Laboratory Director.

Sperm donation is the provision by a man of his sperm with the intention that it be used in the artificial insemination or other 'fertility treatment' of a woman or women who are not his sexual partners in order that they may become pregnant by him. Where pregnancies go to full term, the sperm donor will be the biological father of every baby born from his donations.

Paul J. Turek

Dr. Paul J Turek is an American physician and surgeon, men's reproductive health specialist, and businessman. Turek is a recent recipient of a National Institutes of Health (NIH) grant for research designed to help infertile men become fathers using stem cells.

In sperm banks, screening of potential sperm donors typically includes screening for genetic diseases, chromosomal abnormalities and sexually transmitted infections (STDs) that may be transmitted through the donor's sperm. The screening process generally also includes a quarantine period, during which samples are frozen and stored for at least 6 months after which the donor will be re-tested for STIs. This is to ensure no new infections have been acquired or have developed during since the donation. If the result is negative, the sperm samples can be released from quarantine and used in treatments.

References

  1. "Sperm Washing: How it Works". American Radio Works.
  2. "Conceiving Ryan". American Radio Works.
  3. Byrn, RA; Zhang, D; Eyre, R; McGowan, K; Kiessling, AA (1997). "HIV-1 in Semen: an isolated virus reservoir". The Lancet . 350 (9085): 1141. doi:10.1016/S0140-6736(97)24042-0. PMID   9343504. S2CID   2894601.