The impact of AIDS on artificial insemination by donor

Artificial insemination by donor (AID) provides a necessary service to a significant number of infertile couples. Its practice has been well controlled in Australia by careful donor screening and selection of suitable recipients. The potential for transmission of several infectious diseases has demanded a vigorous protocol for donor assessment and a strong movement away from the use of fresh semen. The description of human immunodeficiency virus (HIV) transmission by AID has increased the need for vigilance and has mandated, both by common sense and by Health Department Requirement (in Australia), the universal use of frozen donations. Antibody testing for HIV is not fail safe and must be supported by a carefully constructed lifestyle declaration form and a drive to recruit monogamous donors. The recruitment of sufficient donors has always been a problem and the advent of the HIV has not helped. Whilst transmission to laboratory staff appears to represent an extremely low risk, this possibility has required the development of safety protocols and appropriate staff training. This review outlines the current problems of running an AID programme given the knowledge that the HIV can be maintained in liquid nitrogen and transmitted atraumatically to a recipient.