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Erschienen in: The Journal of Obstetrics and Gynecology of India 3/2016

13.11.2015 | Editorial

Yes, It is Possible

verfasst von: Gautam N. Allahbadia

Erschienen in: The Journal of Obstetrics and Gynecology of India | Ausgabe 3/2016

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Abstract

Human immunodeficiency virus-serodiscordant couples are actively seeking reproductive assistance and often consider or practice unsafe measures to achieve pregnancy. Reproductive issues and concerns unique to these couples need to be addressed before treatment. Assisted reproduction techniques can minimize the risk of infection and complete families associated with serodiscordant couples. Since 1987, more than 4000 published attempts have been reported in which processed spermatozoa from HIV-seropositive men were used to establish pregnancy in HIV-seronegative women. 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 15 years ago, involving sperm washing, is used in order to minimize infection of the healthy partner. Some couples need further treatment, due to inherent infertility, with advanced reproductive technology (ART) procedures, such as IVF or ICSI. Recent innovative approaches such as pre-exposure prophylaxis (PrEP) with antiretroviral drugs may reduce further the susceptibility of the uninfected female partner. 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. There are no reports of HIV infection of laboratory personnel resulting from processing the gametes/embryos for serodiscordant couples using current laboratory protocols. Cross-contamination of the gametes or embryos of other couples in the same laboratory has also not been reported. The risk is theoretical only, particularly when standard universal precautions are used.
Literatur
1.
Zurück zum Zitat Mandelbrot L, Heard I, Henrion-Geeant E, et al. Natural conception in HIV-negative women with HIV-infected partners. Lancet. 1997;349:850–1.CrossRefPubMed Mandelbrot L, Heard I, Henrion-Geeant E, et al. Natural conception in HIV-negative women with HIV-infected partners. Lancet. 1997;349:850–1.CrossRefPubMed
2.
Zurück zum Zitat Coll O, Vidal R, Martinez de Tejada B, et al. Management of HIV serodiscordant couples. The clinician point of view. Contracept Fertil Sex. 1999;27(6):399–404.PubMed Coll O, Vidal R, Martinez de Tejada B, et al. Management of HIV serodiscordant couples. The clinician point of view. Contracept Fertil Sex. 1999;27(6):399–404.PubMed
3.
Zurück zum Zitat Marina S, Marina F, Alcolea R, et al. Human immunodeficiency virus type 1-serodiscordant couples can bear healthy children after undergoing intrauterine insemination. Fertil Steril. 1998;70(1):35–9.CrossRefPubMed Marina S, Marina F, Alcolea R, et al. Human immunodeficiency virus type 1-serodiscordant couples can bear healthy children after undergoing intrauterine insemination. Fertil Steril. 1998;70(1):35–9.CrossRefPubMed
4.
Zurück zum Zitat Pasquier C, Daudin M, Righi L, et al. Sperm washing and virus nucleic acid detection to reduce HIV and hepatitis C virus transmission in serodiscordant couples wishing to have children. AIDS. 2000;14(14):2093–9.CrossRefPubMed Pasquier C, Daudin M, Righi L, et al. Sperm washing and virus nucleic acid detection to reduce HIV and hepatitis C virus transmission in serodiscordant couples wishing to have children. AIDS. 2000;14(14):2093–9.CrossRefPubMed
5.
Zurück zum Zitat Bujan L, Pasquier C, Labeyrie E, et al. Insemination with isolated and virologically tested spermatozoa is a safe way for human immunodeficiency type 1 virus-serodiscordant couples with an infected male partner to have a child. Fertil Steril. 2004;82(4):857–62.CrossRefPubMed Bujan L, Pasquier C, Labeyrie E, et al. Insemination with isolated and virologically tested spermatozoa is a safe way for human immunodeficiency type 1 virus-serodiscordant couples with an infected male partner to have a child. Fertil Steril. 2004;82(4):857–62.CrossRefPubMed
6.
Zurück zum Zitat van Leeuwen E, de Vries JW, Jurriaans S, et al. Intra uterine insemination with processed sperm for HIV serodiscordant couples in whom the man is HIV positive. Ned Tijdschr Geneeskd. 2005;149(8):423–4.PubMed van Leeuwen E, de Vries JW, Jurriaans S, et al. Intra uterine insemination with processed sperm for HIV serodiscordant couples in whom the man is HIV positive. Ned Tijdschr Geneeskd. 2005;149(8):423–4.PubMed
7.
Zurück zum Zitat Marina S, Marina F, Alcolea R, et al. Pregnancy following intracytoplasmic sperm injection from an HIV-1-seropositive man. Hum Reprod. 1998;13(11):3247–9.CrossRefPubMed Marina S, Marina F, Alcolea R, et al. Pregnancy following intracytoplasmic sperm injection from an HIV-1-seropositive man. Hum Reprod. 1998;13(11):3247–9.CrossRefPubMed
8.
Zurück zum Zitat Ohl J, Partisani M, Wittemer C, et al. Assisted reproduction techniques for HIV serodiscordant couples: 18 months of experience. Hum Reprod. 2003;18(6):1244–9.CrossRefPubMed Ohl J, Partisani M, Wittemer C, et al. Assisted reproduction techniques for HIV serodiscordant couples: 18 months of experience. Hum Reprod. 2003;18(6):1244–9.CrossRefPubMed
9.
Zurück zum Zitat Savasi V, Ferrazzi E, Lanzani C, et al. Safety of sperm washing and ART outcome in 741 HIV-1-serodiscordant couples. Hum Reprod. 2006;22(3):772–7 Epub 2006 Nov 15.CrossRefPubMed Savasi V, Ferrazzi E, Lanzani C, et al. Safety of sperm washing and ART outcome in 741 HIV-1-serodiscordant couples. Hum Reprod. 2006;22(3):772–7 Epub 2006 Nov 15.CrossRefPubMed
10.
Zurück zum Zitat Sauer MV, Choi J. HIV seroconversion in a woman preparing for assisted reproduction: an inherent risk in caring for HIV-serodiscordant couples. Reprod Biomed Online. 2006;12(3):375–7.CrossRefPubMed Sauer MV, Choi J. HIV seroconversion in a woman preparing for assisted reproduction: an inherent risk in caring for HIV-serodiscordant couples. Reprod Biomed Online. 2006;12(3):375–7.CrossRefPubMed
11.
Zurück zum Zitat Vitorino RL, Grinsztejn BG, deAndrade CA, et al. Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive. Fertil Steril. 2011;95(5):1684–90. doi:10.1016/j.fertnstert.2011.01.127 Epub 2011 Feb 16.CrossRefPubMed Vitorino RL, Grinsztejn BG, deAndrade CA, et al. Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive. Fertil Steril. 2011;95(5):1684–90. doi:10.​1016/​j.​fertnstert.​2011.​01.​127 Epub 2011 Feb 16.CrossRefPubMed
12.
Zurück zum Zitat Barnes A, Riche D, Mena L, et al. Efficacy and safety of intrauterine insemination and assisted reproductive technology in populations serodiscordant for human immunodeficiency virus: a systematic review and meta-analysis. Fertil Steril. 2014;102(2):424–34. doi:10.1016/j.fertnstert.2014.05.001 Epub 2014 Jun 18.CrossRefPubMed Barnes A, Riche D, Mena L, et al. Efficacy and safety of intrauterine insemination and assisted reproductive technology in populations serodiscordant for human immunodeficiency virus: a systematic review and meta-analysis. Fertil Steril. 2014;102(2):424–34. doi:10.​1016/​j.​fertnstert.​2014.​05.​001 Epub 2014 Jun 18.CrossRefPubMed
13.
Zurück zum Zitat Sauer M. Sperm washing techniques address the fertility needs of HIV seropositive men: a clinical review. Reprod Biomed Online. 2005;10:135–40.CrossRefPubMed Sauer M. Sperm washing techniques address the fertility needs of HIV seropositive men: a clinical review. Reprod Biomed Online. 2005;10:135–40.CrossRefPubMed
14.
Zurück zum Zitat HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. http://aidsinfo.nih. gov/contentfiles/lvguidelines/PerinatalGL.pdf. Accessed 9 April 2015. HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. http://​aidsinfo.​nih. gov/contentfiles/lvguidelines/PerinatalGL.pdf. Accessed 9 April 2015.
15.
Zurück zum Zitat Kambin S, Batzer F. Assisted reproductive technology in HIV serodiscordant couples. Sex Reprod Menopause. 2004;2:92–100.CrossRef Kambin S, Batzer F. Assisted reproductive technology in HIV serodiscordant couples. Sex Reprod Menopause. 2004;2:92–100.CrossRef
16.
Zurück zum Zitat Sauer MV, Wang JG, Douglas NC, et al. Providing fertility care to men seropositive for human immunodeficiency virus: reviewing 10 years of experience and 420 consecutive cycles of in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril. 2009;91:2455–60.CrossRefPubMed Sauer MV, Wang JG, Douglas NC, et al. Providing fertility care to men seropositive for human immunodeficiency virus: reviewing 10 years of experience and 420 consecutive cycles of in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril. 2009;91:2455–60.CrossRefPubMed
17.
Zurück zum Zitat Peckham C, Newell ML. Preventing vertical transmission of HIV infection. N Engl J Med. 2000;343:1036–7.CrossRefPubMed Peckham C, Newell ML. Preventing vertical transmission of HIV infection. N Engl J Med. 2000;343:1036–7.CrossRefPubMed
18.
Zurück zum Zitat Practice Committee of American Society for Reproductive Medicine. Recommendations for reducing the risk of viral transmission during fertility treatment with the use of autologous gametes: a committee opinion. Fertil Steril. 2013;99:340–6.CrossRef Practice Committee of American Society for Reproductive Medicine. Recommendations for reducing the risk of viral transmission during fertility treatment with the use of autologous gametes: a committee opinion. Fertil Steril. 2013;99:340–6.CrossRef
19.
Zurück zum Zitat Centers for Disease Control and Prevention. Achievements in public health. Reduction in perinatal transmission of HIV infection—United States, 1985–2005. MMWR Morb Mortal Wkly Rep. 2006;55:592–7. Centers for Disease Control and Prevention. Achievements in public health. Reduction in perinatal transmission of HIV infection—United States, 1985–2005. MMWR Morb Mortal Wkly Rep. 2006;55:592–7.
22.
Zurück zum Zitat Vernazza PL, Graf I, Sonnenberg-Schwan U, et al. Preexposure prophylaxis and timed intercourse for HIV-discordant couples willing to conceive a child. AIDS. 2011;25:2005–8.CrossRefPubMed Vernazza PL, Graf I, Sonnenberg-Schwan U, et al. Preexposure prophylaxis and timed intercourse for HIV-discordant couples willing to conceive a child. AIDS. 2011;25:2005–8.CrossRefPubMed
24.
Zurück zum Zitat Gilling-Smith C. HIV prevention. Assisted reproduction in HIV-discordant couples. AIDS Read. 2000;10(10):581–7.PubMed Gilling-Smith C. HIV prevention. Assisted reproduction in HIV-discordant couples. AIDS Read. 2000;10(10):581–7.PubMed
Metadaten
Titel
Yes, It is Possible
verfasst von
Gautam N. Allahbadia
Publikationsdatum
13.11.2015
Verlag
Springer India
Erschienen in
The Journal of Obstetrics and Gynecology of India / Ausgabe 3/2016
Print ISSN: 0971-9202
Elektronische ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-015-0802-x

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