Special Program of Assisted Reproduction
Encyclopedia
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
") to assist couples achieve a pregnancy who would otherwise risk transmitting the father's HIV
infection to the mother and the child through intercourse.
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:
) 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 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.
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
discordant couples (serodiscordant
Serodiscordant
Serodiscordant is a term used to describe a couple in which one partner is HIV positive and the other is HIV negative. Serodiscordant relationships are also referred to as "magnetic". The term seroconcordant is its antonym, used to describe a couple in which both partners are of the same HIV...
) at the Bedford Research Foundation’s clinical laboratory. The program takes advantage of ART (Assisted Reproduction Technology
Reproductive technology
Reproductive technology encompasses all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology, contraception and others.-Assisted reproductive technology:...
) procedures (including "sperm washing
Sperm washing
Sperm washing is a term used to describe the process in which individual sperms are separated from the seminal fluid. The sperms are then used in intrauterine insemination or in vitro fertilization ....
") to assist couples achieve a pregnancy who would otherwise risk transmitting the father's HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
infection to the mother and the child through intercourse.
SPAR employs extremely stringent safety standards; samples will only be submitted for "sperm washing
Sperm washing
Sperm washing is a term used to describe the process in which individual sperms are separated from the seminal fluid. The sperms are then used in intrauterine insemination or in vitro fertilization ....
" and cryopreservation
Cryopreservation
Cryopreservation is a process where cells or whole tissues are preserved by cooling to low sub-zero temperatures, such as 77 K or −196 °C . At these low temperatures, any biological activity, including the biochemical reactions that would lead to cell death, is effectively stopped...
that have first been screened for HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
virus particles and infected cells by specialized molecular biology
Molecular biology
Molecular biology is the branch of biology that deals with the molecular basis of biological activity. This field overlaps with other areas of biology and chemistry, particularly genetics and biochemistry...
tests. Only samples that have been determined to have an undetectable HIV viral burden will be submitted for infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
procedures.
Assisted Reproductive Technologies
Reproductive technology
Reproductive technology encompasses all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology, contraception and others.-Assisted reproductive technology:...
(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
Sperm
The term sperm is derived from the Greek word sperma and refers to the male reproductive cells. In the types of sexual reproduction known as anisogamy and oogamy, there is a marked difference in the size of the gametes with the smaller one being termed the "male" or sperm cell...
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:
- Hepatitis B (and possibly Hepatitis C)
- Human T Cell Leukemia Virus (HTLV-1)
- Human Immunodeficiency Virus (HIV)
History
SPAR began in 1994 at the New England Deaconess Hospital (now Beth Israel Deaconess Medical CenterBeth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center in Boston, Massachusetts is a major flagship teaching hospital of Harvard Medical School. It was formed out of the 1996 merger of Beth Israel Hospital and New England Deaconess Hospital...
) as a support group for couples wishing to parent when one of them had an incurable sexually transmitted disease
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
. 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
Beth Israel Hospital
Beth Israel Hospital may refer to:*Beth Israel Deaconess Medical Center in Boston*Beth Israel Medical Center in Manhattan*Beth Israel Medical Center in Newark...
and the New England Deaconess Hospital (now Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center in Boston, Massachusetts is a major flagship teaching hospital of Harvard Medical School. It was formed out of the 1996 merger of Beth Israel Hospital and New England Deaconess Hospital...
) necessitated the creation of an independent Massachusetts
Massachusetts
The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...
public charity, the Assisted Reproduction Foundation (now the Bedford Stem Cell Research Foundation
Bedford Stem Cell Research Foundation
Bedford Stem Cell 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 , a program that assists serodiscordant couples successfully...
directed by Dr. Ann Kiessling
Ann Kiessling
Dr. Ann A. Kiessling is an American reproductive biologist and is currently one of the leaders in human parthenogenic stem cell research at The Bedford Stem Cell Research Foundation. She also has an appointment in the Department of Surgery at Harvard Medical SchoolDr. Kiessling is noted for her...
), 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 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
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
disease.
In the Spring of 2000 a ground breaking study was completed, giving significant insight to the role of semen producing organs in HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
anti-viral
Antiviral drug
Antiviral drugs are a class of medication used specifically for treating viral infections. Like antibiotics for bacteria, specific antivirals are used for specific viruses...
therapy.