How Does HIV Affect Fertility in Men and Women?

HIV, also known as Human Immunodeficiency Virus, can greatly impair fertility in both males and females, mostly because of its impacts on the reproductive system and overall well-being.

Let’s counter with some facts and statistics.

• 1 in 6 people globally affected by infertility: WHO

• Approximately 15% of couples worldwide, totaling 48.5 million couples, are affected by infertility. Men are exclusively accountable for 20-30% of infertility cases and contribute to 50% of all instances.

• The presence of discharge from the urethra in men is frequently attributed to Neisseria gonorrhoeae or Chlamydia trachomatis. Typically, males with urethritis, which is inflammation of the urethra, exhibit a discharge from the urethra, accompanied by or without painful urinating (dysuria). Failure to manage urethral discharge can lead to infertility and increase the risk of both transmitting and acquiring HIV.

• Infertility affects millions of people of reproductive age worldwide – and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.

• The presence of HIV infection and its subsequent treatment can have various direct and indirect effects on fertility. Severe immunosuppression can affect the process of ovulation and the amount of eggs stored in the ovaries. HIV infection is linked to a higher occurrence and more severe cases of infections in the reproductive tract, which can lead to infertility in the fallopian tubes.

• 39.0 million [33.1–45.7 million] people around the world had HIV at the end of 2022. About 0.7% to 0.8% of people around the world between the ages of 15 and 49 have HIV, but the impact of the epidemic still varies a lot from country to country and region to region.

Infertility can be affected by HIV in the following ways:

Impact on Men’s Fertility:

1. HIV can impact male fertility through multiple routes. It has the ability to directly invade the reproductive organs, specifically the testes, causing inflammation and harm.

• HIV can have an indirect impact on fertility by creating systemic consequences, such as immunological dysfunction, hormone abnormalities, and nutritional inadequacies. These effects might hinder the creation and functioning of sperm.

• Furthermore, several antiretroviral medicines employed in the treatment of HIV may have detrimental impacts on the quality of sperm and reproductive function.

• Opportunistic infections linked to HIV, such as sexually transmitted infections (STIs) or infections in the vaginal tract, might additionally affect male fertility by inducing inflammation and scarring in the reproductive organs.

Impact on Women’s Fertility:

• HIV can impact female fertility by mechanisms similar to those in men, such as direct infection of reproductive organs, immunological failure, hormonal abnormalities, and opportunistic infections.

• HIV infection can cause disruptions in the menstrual cycle, such as amenorrhoea (lack of menstruation) or oligomenorrhea (infrequent menstruation), which can impact ovulation and fertility.

• HIV-induced immune dysfunction may elevate the susceptibility to gynaecological infections, including pelvic inflammatory disease (PID), which can result in scarring and harm to the fallopian tubes and ovaries, ultimately causing infertility.

• HIV-infected women are at an increased risk of experiencing difficulties during pregnancy, such as miscarriage, premature birth, and transfer of HIV to the foetus. These complications can have negative effects on fertility and reproductive outcomes.

Transmission of HIV during Conception:

HIV can be transferred by the exchange of semen and vaginal secretions, which can potentially infect sexual partners during unprotected intercourse, especially when attempting to conceive a child.

HIV can be transmitted through natural conception, intrauterine insemination (IUI), or in vitro fertilisation (IVF) operations if adequate measures are not implemented to prevent transmission to the uninfected partner and the offspring.

Prevention and Management:

• Safe sex practices, including the consistent and correct use of condoms, can help prevent the sexual transmission of HIV and reduce the risk of infertility-related complications.

• HIV-positive individuals who desire to have children should seek preconception counseling and medical care to optimize their health and minimize the risk of transmission to partners and offspring.

• Fertility treatments, such as sperm washing and pre-exposure prophylaxis (PrEP) for the uninfected partner, can be used to reduce the risk of HIV transmission during assisted reproductive procedures.

• Overall, HIV can have complex and multifaceted effects on fertility in both men and women, highlighting the importance of comprehensive healthcare and support services for individuals affected by HIV who are considering parenthood.

How does the does the CIFAR Fertility Centre help in IVF treatment for HIV/AIDS-affected couples?

1. The CIFAR Fertility Centre in Gurgaon Delhi NCR Region, plays a crucial role in providing specialized care and support for HIV/AIDS-affected couples seeking IVF (In Vitro Fertilization) treatment.
2. CIFAR Fertility Centre likely has a team of best and experienced reproductive endocrinologists, fertility specialists (Dr Puneet Rana Arora, Director & Founder, CIFAR Fertility Center) who are experienced in managing fertility issues in HIV/AIDS-affected individuals.
3. They are knowledgeable about the latest advancements in both HIV/AIDS treatment and assisted reproductive technologies (ART), including IVF, and can tailor treatment plans to meet the unique needs and concerns of HIV-positive patients
4. The center ensures that both partners understand the risks and benefits associated with IVF treatment, including the potential risk of HIV transmission to the uninfected partner and offspring.