In order to broaden our reach in HIV prevention, we propose this new approach within the existing prevention strategy to expand fertility service options that will address all the reproductive desires of HIV-affected individuals and couples. They need positive guidance and support from health care providers to minimize sexual HIV transmission. Without this assistance in achieving pregnancy safely, HIV-affected individuals and couples risk HIV transmission to the uninfected partner, especially in the absence of ART, viral suppression, and/or PrEP.9 The eMTCT spectrum of care provides an ideal construct for the inclusion of pre-pregnancy services particularly when engagement of the male partner is achieved to reduce the risk of HIV transmission to the uninfected partner and developing fetus. To achieve this, advocacy groups will also need to call for policy changes to include the integration of couples counseling and fertility service options for achieving pregnancy safely into existing HIV care and prevention strategies.