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Human immunodeficiency virus type 1--serodiscordant couples can bear healthy children after undergoing intrauterine
S Marina1, F Marina, R Alcolea
1Instituto de Reproducción Cefer (Centro Médico Teknon), Barcelona, Spain. CEFER@MEDITEX.ES
Objective:
To use semen from men who were seropositive for human immunodeficiency virus type 1 (HIV-1) to inseminate their partners without infecting them.
Design:
Prospective study.
Setting:
Private practice.
Patient(S):
Sixty-three HIV-1-seropositive men and their HIV-1-seronegative female partners.
Intervention(S):
The men provided 107 semen samples that were prepared with the use of the Percoll and swim-up techniques. The presence of HIV-1 was determined in the fraction of motile spermatozoa obtained after washing. If HIV-1 was not detected. IUI was performed in stimulated cycles.
Main Outcome Measure(S):
Human immunodeficiency virus type 1 RNA and DNA were detected with the use of the polymerase chain reaction technique modified for spermatozoa.
Result(S):
One hundred seven semen samples were washed. Human immunodeficiency virus type 1 was not detected in 101 samples (94.4%) and was detected in 6 samples (5.6%). In the latter cases, IUI was not performed. One hundred one IUI procedures were performed in 63 women. Thirty-one pregnancies resulted, for a pregnancy rate of 30.7% per cycle and 49.2% per inseminated woman. Thirty-seven healthy children were born. The results of tests for the detection of HIV-1 and antibodies to HIV-1 in the inseminated women were negative.
Conclusion(S):
On the basis of these results, testing for HIV-1 with the use of the polymerase chain reaction technique on the semen fraction obtained after washing appears to prevent infection in the inseminated woman. This method makes it possible to help HIV-1-seropositive men to have children without infecting their female partners.