She discovered that the options that allowed this were high-tech and expensive. In vitro fertilization (IVF) or intrauterine insemination (IUI) cost anywhere from $865 to $8,158 for one round, not including fertility drugs, which can run up to $5,000 per IVF cycle, according to the National Infertility Association. Then there’s ICSI, which stands for intracytoplasmic sperm injection, a process that takes IVF one step further. A scientist injects one sperm into one egg and allows it to grow before placing it in a woman’s uterus. That procedure costs about $1,500 more per cycle than IVF. All three options are available to HIV-mixed status couples only after they’ve also paid $200 or more for a process called sperm washing, which separates sperm from the seminal fluid via chemicals and centrifuge. That sperm, now “washed” of potentially infectious seminal fluid, can then be used to fertilize an egg.
There remains some debate on the safety and effectiveness of sperm washing. A woman contracted HIV in 1990 from her husband while the couple was doing sperm washing, leading everyone from the American Society for Reproductive Medicine to the Centers for Disease Control to recommend against doctors helping HIV-affected couples with insemination using the sperm of HIV-positive men. ASRM reversed its policy in 2002 . The CDC guidelines are in place to this day. It’s unclear how many clinics are willing to provide HIV-affected couples with sperm washing, but some fertility clinics claim it may be as few as 25 .
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