Groundbreaking NEW Pathway to Parenthood for HIV-Positive Patients in New York

A Groundbreaking NEW Pathway to Parenthood for HIV-Positive Patients in New York State through the efforts of The Center for Human Reproduction (CHR) in NYC

In April 2021, the CHR had the privilege of consulting with a male couple who hoped to start a family through gestational surrogacy and egg donation. Both partners, diagnosed with HIV-1 several years prior, had achieved undetectable viral loads through antiretroviral therapy. Despite advances in reproductive medicine that allow HIV-positive individuals to safely contribute gametes, New York State regulations initially prohibited the use of semen from individuals with a history of HIV for surrogacy.

We advised the couple to seek help from the Bedford Research Foundation’s Special Program of Assisted Reproduction (SPAR) in Massachusetts, which specializes in preparing virus-free semen specimens for assisted reproduction. Their specimens were thoroughly tested and confirmed free of any detectable virus. However, New York’s stringent tissue bank regulations presented a significant hurdle, requiring us to advocate for an exception to the existing rules. After extensive correspondence with the New York State Department of Health (NYS DOH), including highlighting the safety of SPAR’s protocols, the Department carefully considered this unique case.

Following this discussion, in March 2023, the NYS DOH updated its policies, reflecting the "Undetectable = Untransmittable" (U = U) principle. This new guidance allows exceptions for individuals living with HIV to contribute reproductive tissues under strict conditions, including maintaining undetectable viral loads, comprehensive counseling for an intended gestational carrier, and adherence to rigorous safety protocols. Most recently, in January 2025, the NYS DOH finally granted an exception for this couple’s case, enabling the use of their embryos in gestational surrogacy.

This milestone highlights the progress made in ensuring that individuals living with HIV can safely pursue parenthood through assisted reproduction. The approval demonstrates the importance of updated medical policies that reflect current scientific understanding and advances in reproductive technology. By addressing these barriers, this case has helped create a clearer pathway for others. We are proud to have supported this couple in overcoming barriers and paving the way for future families.

For further information, please contact [email protected]. David H. Barad, MD, MS, the CHR’s Director Clinical IVF and Research and a Senior Scientist led the negotiations with the NYS DOH for all those years to resolution and is available for further comments.