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I'm here in Sydney, Australia, at IAS 2007 with Pietro Vernazza, a physician at the Cantonal Hospital in St. Now, when we sent them, then, to the infertility clinic, this is a procedure that is quite time consuming. We were sort of accepting that a major group of these clients, and all those outside of the program, were taking the risk and having unprotected sex. Second thing: We make sure they don't have some asymptomatic chlamydia or other sexually transmitted diseases, because that increases the risk of transmission.
Tenofovir has the advantage of a very, very long intracellular half-life that is about a week.
The question I have been asked at the poster discussion is: Why do you give it at all, since the risk is so low? Now, through this procedure you get about 1% of the motile sperm, which also explains a little bit why this method doesn't work as well as natural conception. I think it's more open, but there is still this stigma around, and there are still some people who think HIV-positive people, or discordant couples, should not have a child.
I think you're definitely helping with this study, and with explaining how couples do not, necessarily, need the help of fertility clinics to have a baby. One interesting experience I had during the interviews with the couples: When I asked the couples, "What do you think is the risk of transmission when you have sex tonight?" Their estimate was in the range between 5 and 100%, a little bit higher for the women than for the men. But within a few years, I'm sure that knowledge will disseminate, and it will change the habit of everybody. I think that's a very good point, and that's why I think this discussion about risk and behavior -- how do we make decisions about our sexual life -- is something that belongs in a steady partnership.
So that is a little bit different situation than having sex with a partner who just tells me, "I'm suppressed." So I think it would be smart to restrict unprotected intercourse to couples where the partners know each other very well.
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The progressively increasing stimulation of the pelvic nerves causes these very specialized nerves to release small pockets of vaso-active intestinal polypeptides (VIP - first described from the intestines).
Both the small arteries (arterioles), that supply fresh blood to the tissue as well as the small veins (venules), that drain blood from the tissue become dilated.
With vaso-congestion the vessels that surround the vagina become permeable (porous) and allow the fluid component of blood to saturate the vaginal mucosa in-between the cells. Conception is a relaxing visualisation to support your mind and body to conceive and have a healthy baby.
Conception is part of The Fertile Body Method: Natural Fertility Companion CD which will be available in 2012. Conception only occurs in the distal fallopian tube with a single sperm fertilizing an ovum.
Sperm must have the capacity and ability to swim 6 - 7 inches through the entire uterus and the fallopian tube to fertilize the ovum. Natural Conception Lubrication capacitates sperm so that they can swim the 6 - 7 inches, and then can penetrate and fertilize the ovum.
Gallen, Switzerland, and he's going to talk a little bit about his poster, which is very interesting. We have been involved in the past 10 years in insemination with processed semen from [serodiscordant] couples who wanted to conceive a child.
And the fourth point, which is probably the most important: We give a pre-exposure prophylaxis to the woman prior to the sexual contact -- the unprotected sexual act to conceive the baby. When the urine test is positive [for ovulation], the next day, then the same evening, they have sex. So it is taken up over one or two days, and then it remains there at the place of action within the cells for a week.
Because in actuality, we don't know whether the tenofovir did help at all in these couples. We know in the Swiss HIV cohort that approximately 150 to 200 [serodiscordant] couples always have unprotected sex, with fully suppressed virus, and they don't transmit. I know in the United States a lot of fertility clinics do not want to publicly acknowledge that they help discordant couples. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently.
The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. With the help of these programs you can let go of despair, grief and anger and begin to feel more positive and hopeful which can lead to your success.
The initial stimulation of the pelvic nerves causes an enlargement of the blood vessels that supply the vagina and clitoris. These vaso-active peptides (proteins) cause the blood vessels that surround the vagina to dilate (causing more blood flow). What results is an increased amount of blood arriving at the tissue, while at the same time even less blood being allowed to drain away. This fluid component of blood accumulates in the lumen of the vagina and provides the lubrication. Now, we also have studied, together with colleagues in the United States, the risk of transmission as a function of HIV viral load and semen.

About one third of the women who came for the first consultation would never show up for an insemination.
But the rest will do it [have unprotected sexual intercourse in order to conceive] by themselves. I think we give it to give a sort of psychological, additional argument, but I agree it's really a theoretically miniscule risk.
All of the couples started with the first cycle, and 20% of the women got pregnant after one exposure or sexual contact. They still keep this high risk in their brain, and we haven't really openly talked about the changes in the risk of transmission, which we obviously observe. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. Whether a negative test result or something else it has the power to send you in to a deep despair. These events and others similar can leave you on the floor, devastated and just unable to believe things could happen for you. Genital stimulation creates the sensation of pleasure in the brain, which then acts to increase electrical action of the pelvic nerves to increase vaginal and clitoral blood vessel changes.
What I realized from 2000 onwards: All these couples that came in for treatment were very select couples, where the male [HIV-positive] partner was on a fully suppressive treatment.
Then, in addition, I talked to Enrico Semprini, who was the first who started with the insemination [click here to view some of Semprini's publications]. And within Europe, all the centers have about one third no-shows, [these are people] who just don't follow up.
The additional safety is that we teach them just to have sex at the right time, when ovulation is happening (with a urine test). But it will never prove that there is no risk, because to prove that there is no risk is almost impossible, since we don't see any transmission from individuals with fully suppressed virus to the steady partner. We see many new cases of HIV infection, but none of these new cases are associated with a sexual exposure to a partner on HAART with fully suppressed HIV.
The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. Eat what you want when you want and be more in tune with what your body really needs – stopping full and eating more healthily. This is called vaso-congestion, and it is the basis of all sexual arousal both in the vagina and in the clitoris. The vaginal lubrication is medically referred to as a transudate because it transverses across the vaginal mucosa into the vagina.
If I'm negative and my partner is positive, and even though he was undetectable the last time he went to the doctor, there is a possibility that he was not adherent and there was some viral breakthrough, so that he becomes detectable. Just like how a car rolling down a hill builds up speed with time, a woman's sexual arousal builds in intensity over a period of time. So that, during these interviews, causes a lot of questions, like, "Why I haven't I been told?" It also helps when I can reassure the couple that the question of sexual transmission risk is something that I have been involved with for the past 15 years. All the fertility clinics in Europe that have now gained experience with HIV-positive individuals, they actually can also help them [these infertile couples]. But for the majority of couples who just want to conceive a child, the natural way is much simpler.

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