New fertility treatment options for people with HIV and same-sex couples

New legislation will allow patients with non-transmissible HIV to donate eggs and sperm to known recipients, as well as making fertility treatment easier for some same-sex couples.

The decision follows health minister Maria Caulfield's announcement of the intended changes to the law during a parliamentary debate in October 2023 (see BioNews 1213). Currently, only HIV-positive men in heterosexual relationships can provide sperm for their partners' use. HIV-positive women are excluded from sharing eggs with a same-sex partner, as are those who wish to donate gametes to friends or family members, or who require surrogacy.

'We have changed the law to ensure equality for people living with HIV when accessing IVF, allowing them to donate their eggs and sperm,' said Caulfield. 'In addition, the change will allow female same-sex couples to access IVF with no extra screening costs, the same as heterosexual couples.'

The law change is being enacted though a statutory instrument, which allows small changes to existing laws without having to create an Act of Parliament. The statutory instrument, which was drafted with input from the government Advisory Committee for the Safety of Blood Tissues & Organs, was laid in parliament and an accompanying statement was read in both houses.

The change will also mean that same-sex female couples who wish to have 'shared motherhood' or 'reciprocal IVF' – where one partner carries the pregnancy using the other's egg – will no longer have to go through the same extensive tests as egg donors.

Prior to donation, HIV-positive individuals will undergo tests to ensure their gametes are safe for donation. They will need to have an undetectable HIV viral load, meaning the virus is present at levels too low to be transmitted. They must also have received antiretroviral treatment for at least six months, and the gamete recipient must be aware of the donor's HIV diagnosis, meaning that people with HIV will not be able to donate sperm or eggs to unknown recipients.

The National AIDS Trust, with support from PET (the Progress Educational Trust – the charity that publishes BioNews) has campaigned to raise awareness of how the law excluded same-sex couples (see BioNews 1172).

'As an HIV rights organisation, we have worked hard, over many years, to bring about this change, and are delighted that this discriminatory law will be coming to an end. Changing this needless and unfair obstacle is a huge win for both HIV and LGBT+ rights', said Deborah Gold, chief executive officer of the National AIDS Trust.

The change was also welcomed by the British Fertility Society (BFS) and the Human Fertilisation and Embryology Authority (HFEA).

'The BFS had long advocated, supported and worked towards removal of barriers to treatment,' Dr Ephia Yasmin, secretary of the BFS told BioNews. 'We welcome timely revision of laws as new information and evidence come in so that greater parity is facilitated for access to treatments for family building. With that principle, BFS welcomes changes in the law with regards to reciprocal (shared parenthood) and known gamete donation.'

Julia Chain, chair of the HFEA, said: 'For known donation from individuals with undetectable HIV, we anticipate that the first clinics may be able to begin to offer this treatment around three months following a change in the law'.