Fertility options for HIV patients.
OBJECTIVE
This paper reviews the latest reproductive options for HIV infected couples. In light of the new treatment options and improved prognosis for HIV patients, policymakers have issued recent statements to guide physicians in the care of HIV patients desiring fertility. We will review the advances in reproductive technologies and ethical considerations that have led to these most recent statements.


RESULTS
Millions of young adults of reproductive age are afflicted with the HIV virus. With the improvement in treatment options for HIV patients and the increase in their life expectancy it is not surprising that many HIV patients desire children. Assisted reproductive technologies can assist serodiscordant couples in achieving pregnancy while at the same time minimizing risk of HIV transmission to the uninfected partner. Several European fertility clinics have a great deal of experience in providing both intrauterine inseminations and in-vitro fertilization to serodiscordant couples without seroconversion of the uninfected female partners. This is both a medical and an ethical issue. Guidelines from policymakers regarding this issue have changed over the years as a result of both changes in disease prognosis and the reproductive technologies.


CONCLUSIONS
Reproductive technologies provide a logical way to minimize HIV transmission for HIV couples desiring pregnancy. Although the most recent research is compelling, much more needs to be performed in order to establish the safety of these techniques. Protocols need to be put in place in order to assist physicians in better serving these patients. In addition, many ethical and legal issues need to be addressed before these treatments can become standard of care in the United States.
Bendikson
Kristin Anne
KA
Brigham and Women's Hospital, Boston, Massachusetts, USA.
Anderson
Deborah
D
Hornstein
Mark D
MD
D004992:Ethics, Medical; D005260:Female; D015658:HIV Infections / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D012099:Reproductive Techniques