[Infertility treatment in HIV serodiscordant couples]

The altered epidemiology and life expectancy of HIV patients has resulted in an increasing number of couples, in which one member is HIV positive, who desire children. The only completely safe options available to these couples, to fulfill their desire for offspring, are adoption or, in the case of HIV positive males, sperm donation. Nevertheless, many couples desire genetically related offspring. When the female partner is HIV positive, intrauterine insemination (IUI) will suffice in order to prevent horizontal infection. However, when the male partner is HIV positive, a technique developed in Milan over a decade ago, involving sperm washing, is used in order to minimize infection of the healthy partner. Thus far, there have been approximately 3000 cycles, and 497 pregnancies with over 300 deliveries and not one infection of either the female partner, or the infant. In Israel, the Rambam Medical Center recently published an article in "Harefuah" stating that they had offered this treatment to serodiscordant couples. Some couples need further treatment, due to inherent infertility, with advanced reproductive technology (ART) procedures, such as IVF or ICSI. Numerous ART centers worldwide treat these couples. Most centers are equipped with separate laboratory space for collecting specimens from infected patients and provide separate storage tanks for freezing infected gametes and embryos in order to protect other patients using the facility. In Israel, a country in which fertility treatment is widely available and easily accessible to all, not even a single center provides HIV serodiscordant couples with advanced fertility treatment.