Assisted reproductive technologies and HIV-1 serodiscordant couples

Objective To describe the results and the safety of assisted reproductive techniques (artificial insemination and in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI)) to assist reproduction in HIV-1 sero-discordant couples. Methods The patients were couples asking for assisted reproductive techniques because the man was infected with HIV-1. The study period was from February 1997 to December 1998. Fertility and infectious diseases in men and women were evaluated. Sperm was prepared to eliminate HIV-1 viral particles and a polymerase chain reaction test was performed to exclude the presence of HIV-1. Artificial insemination in stimulated cycles and IVF-ICSI were performed. Results A total of 155 artificial insemination cycles were performed in 64 patients (2.4 cycles per patient, with a. mean number of sperm of 2.4 x 10(6)). In all 32 pregnancies were achieved (20.6% of the cycles). The pregnancy rate per couple was 50% (32/64). A good pregnancy rate was observed if the number of motile inseminated spermatozoa was > 500 000. A total of 16 cycles of IVF-ICSI were performed in 11 couples; four pregnancies were achieved. The pregnancy rates per replacement and per patient were 26.6% and 36.4%, respectively. The implantation rate was 18.1%. No infection among women or newborns was observed following artificial insemination or IVF-ICSI. Conclusion Although female partner infection cannot completely be ruled out, artificial insemination and IVF-ICSI after sperm preparation appear to be safe techniques in sero-discordant couples for HIV-1.