Overview

SPAR Quick Start Guide

Although each step can have several parts and complications may arise depending on the needs of the couple; SPAR has essentially four stages:

1. Evaluation of male and female partners
   The process begins with an evaluation of the HIV infected male with respect to duration of disease, current health status, confounding infections, such as Hepatitis virus or prostatitis, and current antiviral therapy.
   
   During a personal conference with Dr. Kiessling, she will explain the entire process, the potential pitfalls, and help locate collaborating infertility clinics. Be sure to thoroughly read the SPAR Info Pack (links on the left) before scheduling a consultation, we also request that you complete and mail the Infection History Questionaire and the Consult Request.
   
   
2. Collection of two HIV Undetectable Specimens
   The semen viral burden is determined by a highly sensitive PCR assay for HIV that detects both free virus particles (HIV RNA) in seminal plasma and virus infected cells (HIV proviral DNA).
   
   Semen specimens may be collected in the privacy of the patient's home and shipped overnight to the laboratory for testing.

3. Semen Specimens are tested for HIV, the sperm is "washed" and cryopreserved
   Cryopreserved sperm from specimens with an undetectable viral burden can be shipped to the collaborating clinic for use in IVF or Oligospermia cup procedures. Intra-uterine Insemination (IUI) is NOT an approved SPAR procedure. The clinic can either retain the liquid nitrogen dry shipper for the duration of the procedure and return unused sperm, or transfer the tested specimens to the clinic’s nitrogen freezers.

4. Treatment at a Collaborating Infertility Clinic
   More than two dozen infertility centers worldwide collaborate with the Bedford Foundation with infertility procedures that meet the needs of the couple. The Bedford clinical lab will only send cryopreserved sperm from semen specimens with an undetectable viral burden. Most collaborating clinics offer IVF as the infertility treatment of choice, but an increasing number also offer insemination via oligospermia cup.

A Brief History

The Special Program of Assisted Reproduction (SPAR) started in 1994 as a support group for couples living with incurable, sexually transmitted diseases, such as HIV/AIDS. The patient couples began raising money to fund the research needed to improve the safety of attempting pregnancy without transmitting the father's infection to the mother and baby.

By 1996 sufficient funds had been raised to establish the Bedford Research Foundation (formerly the Assisted Reproduction Foundation) as an independent Massachusetts public charity.

Within two years, the Foundation had supported the development of methods for reducing, and perhaps eliminating, the risks of infection to the mother and the child. These methods included sensitive assays for Human Immunodeficiency Virus (HIV) infection in semen. The goal was to develop laboratory tests and procedures to make it possible for couples living with HIV disease to be cared for in the infertility center of their choice.

The first SPAR baby, Baby Ryan, was born in May 1999. Baby Ryan's birth was attended by Minnesota Public Radio reporter, Stephen Smith, whose prize winning story is posted at www.americanradioworks.org, along with his earlier story describing SPAR. (hear more about this at www.americanradioworks.org)

The success of SPAR demonstrates the speed and efficiency with which dedicated public charities can bring about biomedical advances.