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Thinking about having a baby

african baby

Lots of people living with HIV are parents. If you follow medical advice closely, you’ll protect your baby from mother-to-child transmission.

Can I have a baby if I have HIV?

Yes. With the right care, HIV positive women can give birth to children without passing on HIV. There are many types of medical interventions that can reduce the risk of mother-to-child transmission.


How can we conceive if one of us is HIV negative and one has HIV?

The following conditions need to be met:

  1. The partner with HIV is on treatment and taking it as prescribed,
  2. they have had an undetectable viral load for at least 6 months, and
  3. neither of you has any other sexually transmitted infections (STIs).

If someone is on effective HIV treatment and has an undetectable viral load, they cannot pass on HIV - it can take up to six months on treatment for some people to become undetectable (and so for the treatment to become effective).

Before deciding not to use condoms, get advice from your HIV doctor or nurse so they can confirm it is safe to do so. You’ll also both need a sexual health check-up to make sure neither of you has an STI as these can affect your baby’s health.

HIV treatment is also one of the ways a baby is protected from HIV during pregnancy and labour.

If you're thinking about having unprotected sex, it’s very important that you and your partner discuss your options and the risks with your healthcare team before you make a decision to have unprotected sex.


What do I need to know about getting pregnant?

It’s a good idea to chat to an HIV doctor or a nurse so they can advise you about conceiving when you're living with HIV. They'll also be able to check if you're in good overall health. 

  • Pregnancy will be easier if HIV is not causing serious health problems at the moment.
  • If you have an STI, or any other infection, you need to wait until it has been treated.
  • It's important to follow the advice for all women who are planning pregnancy. This includes stopping smoking, eating healthily, avoiding alcohol and taking folic acid supplements.
  • UK guidelines recommend that everyone with HIV starts treatment. If you're diagnosed during pregnancy you'll start treatment straight away. If you already know you're living with HIV you'll generally stay on your current treatment - your doctor will advise you.

The best time to conceive

Women have a few days each month when they are most fertile – around the time of ovulation (when an egg is released from the ovaries). Most doctors recommend having regular unprotected sex every two or three days throughout the month to have the best chance of conceiving.


What if I need fertility treatment?

Some women find it difficult to become pregnant, and there can be medical reasons for this which can be helped. If you're not pregnant after a year of trying (sooner if you are 36 or older or already know you have fertility problems), go to your GP as they will be able to refer you for tests if necessary.

People with HIV can receive fertility treatment.

Access to fertility treatment varies according to where you live and there are different types of treatment depending on the problem. These include:

  • Medicine to encourage ovulation.
  • Surgery for women to help with problems like blocked fallopian tubes (meaning an egg can’t travel along them easily) or endometriosis (where areas of womb lining starts to grow outside the womb).
  • Surgery for men if there's a blockage preventing him from releasing sperm, or surgery to retrieve sperm.
  • Assisted conception – there are two methods, intrauterine insemination (IUI) - placing sperm directly into the woman’s womb - and in vitro fertilisation (IVF). IVF is where the woman takes injections to produce a lot more eggs than she normally would. These are retrieved through surgery and they are fertilised with sperm. If a good quality embryo develops it will then be placed back into her womb with the hope of her becoming pregnant.

NHS Choices have a good introduction to fertility treatment.


Adoption

Adoption can be another route to having a family, this can be a long and intense process, however having HIV does not automatically mean you can’t apply.

Children who need to be adopted in the UK tend to have been through a lot of trauma which means adoptive parents go through a robust assessment and training process.


Get free support:


Next: HIV treatment during pregnancy ››

 

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The Information Standard: Certified member

This article was last reviewed on 15/8/2017 by Anna Peters

Date due for the next review: 15/8/2020

Content Author: S. Corkery (NAM)

Current Owner: Kerri Virani

More information:

HIV Transmission Risk Persists During the First 6 Months of Antiretroviral Therapy, Mujugira A1, Celum C, Coombs RW, Campbell JD, Ndase P, Ronald A, Were E, Bukusi EA, Mugo N, Kiarie J, Baeten JM; Partners PrEP Study Team
National Center for Biotechnology Information
US National Library of Medicine
2016 Aug 15;72(5):579-84. doi: 10.1097/QAI.0000000000001019

HIV treatment as prevention and HPTN 052, Cohen MS1, McCauley M, Gamble TR
National Center for Boiotechnology Information
US National Library of Medicine

HIV Transmission Risk Persists During the First 6 Months of Antiretroviral Therapy
Mujugira A1, Celum C, Coombs RW, Campbell JD, Ndase P, Ronald A, Were E, Bukusi EA, Mugo N, Kiarie J, Baeten JM; Partners PrEP Study Team
National Center for Biotechnology Information
US National Library of Medicine
2016 Aug 15;72(5):579-84. doi: 10.1097/QAI.0000000000001019.

HIV treatment as prevention and HPTN 052
Cohen MS1, McCauley M, Gamble TR
National Center for Boiotechnology Information
US National Library of Medicine

Can I get IVF treatment on the NHS?
NHS Choices
23/7/15

Planning your pregnancy
NHS Choices
20/1/17

Infections in pregnancy that may affect your baby
NHS Choices
28/1/15

Planning another pregnancy
NHS Choices
1/10/15

BHIVA guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2015
Writing Group:
Duncan Churchill Chair Laura Waters Vice Chair, N Ahmed, B Angus, M Boffito, M Bower, D Dunn, S Edwards, C Emerson, S Fidler, †M Fisher, R Horne, S Khoo, C Leen, N Mackie, N Marshall, F Monteiro, M Nelson, C Orkin, A Palfreeman, S Pett, A Phillips, F Post, A Pozniak, I Reeves, C Sabin, R Trevelion, J Walsh, E Wilkins, I Williams, A Winston

START trial finds that early treatment improves outcomes for people with HIV
Gus Cairns
NAM, Aidsmap
27/5/15

New British guidelines recommend treatment for everyone living with HIV
Keith Alcorn
NAM, Aidsmap
24/6/15

START trial provides definitive evidence of the benefits of early HIV treatment
Liz Highleyman
Produced in collaboration with hivandhepatitis.com
NAM, Aidsmap
21/7/15

When am I most fertile during my cycle?
NHS Choices
18/5/16

First for adoption
About the children

Treating infertility
NHS Choices
14/2/17

HIV and having a baby
Greta Hughson
NAM, Aidsmap
December 2015

New British guidelines recommend treatment for everyone with HIV by Keith Alcorn, 24 June 2015, NAM

Townsend C et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 22: 973-981, 2008

The British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA) Position statement on the use of antiretroviral therapy to reduce HIV transmission, January 2013

British Association of Adoption and Fostering

NHS choices -Infertility

Human Fertilisation and Embryology Authority

Lehman DA & Farquhar C Biological mechanisms of vertical immunodeficiency virus (HIV-1) transmission. Rev Med Virol 17: 381-403, 2007

BHIVA Guidelines for the management of HIV infection in pregnant women 2012 (updated 2014)

Fakoya A et al. UK Guidelines for the management of sexual and reproductive health of people living with HIV infection (2008) BHIVA, BASHH, FRSH

National Institute for Health and Care Excellence Fertility: Assessment and treatment for people with fertility problems NICE Guidance CG156, 2013