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[Relationship between human immunodeficiency virus and sperm--implications in medically assisted procreation]
C Sifer1, J L Benifla, A Devaux
1Service d'histologie-embryologie cytogénétique et biologie de la reproduction, Hôpital Bichat-Claude-Bernard, Paris, France.
Gynecologie, Obstetrique & Fertilite
|June 22, 2000
Summary
Assisted reproductive technologies (ART) for HIV-discordant couples, using sperm preparation, significantly reduce HIV transmission risk during conception. This approach allows HIV-positive men to safely father children, with no reported seroconversions in thousands of procedures.
Area of Science:
- Reproductive Medicine
- Virology
- Public Health
Context:
- Increasing demand for assisted reproductive technologies (ART) among HIV-serodiscordant couples (HIV-positive male, HIV-negative female).
- Advances in antiretroviral therapy (ART) improve quality of life for HIV-positive individuals, fostering desire for biological children.
- Need for safe conception methods to minimize HIV transmission risk from infected males to female partners and newborns.
Purpose:
- To evaluate the safety and efficacy of ART, specifically intrauterine insemination (IUI) with sperm preparation, for HIV-serodiscordant couples.
- To assess the risk of HIV transmission during ART procedures involving sperm preparation.
- To determine the permissibility of ART for HIV-serodiscordant couples, considering viral transmission and sterility.
Summary:
- ART, particularly IUI with meticulously prepared sperm, has been employed since 1992 for HIV-serodiscordant couples.
- Despite challenges in completely eliminating HIV nucleic acids from sperm, approximately 2000 IUI procedures have resulted in zero reported female or newborn seroconversions.
- In vitro fertilization (IVF) shows similar potential, though further studies are needed. Strict sperm preparation protocols and virological testing are crucial for minimizing contamination risk.
Impact:
- ART with sperm preparation offers a viable and safe option for HIV-serodiscordant couples to conceive, significantly reducing viral transmission risks.
- Successful implementation in Europe, supported by legal frameworks, demonstrates the feasibility of ART for this population.
- Empowers HIV-positive men to father children while protecting their partners and offspring from HIV infection.