title: Providing assisted reproductive care to male haemophiliacs infected with human immunodeficiency virus: preliminary experience.
abstract: Outlined is our experience with couples in whom the male was both human immunodeficiency virus (HIV) seropositive and a haemophiliac who underwent assisted reproductive technologies (ART) in order to attain family goals while minimizing the risk of HIV transmission. We report their demographics, attitudes towards assisted reproduction, and ART performance and outcomes. The study included HIV serodiscordant couples (n = 11) who underwent ART at a university-based infertility practice from August 1997 to May 2002. Prior to treatment, couples prospectively completed a survey regarding their demographics and attitudes towards assisted reproduction. All couples underwent ART and pregnancy outcomes were analysed. The majority of the patients were fully employed, college-educated, in good health, married and motivated to have a child while minimizing the risk of HIV transmission. Eleven couples underwent 25 cycles of ART [19 in vitro fertilization (IVF) cycles; five frozen embryo transfer cycles; and one oocyte donation cycle] resulting in nine successful pregnancies. The ongoing/delivered pregnancy rate per initiated IVF cycle was 42.1% per embryo transfer. Eight of 11 (72.7%) couples achieved a successful pregnancy. More than half (six of 11; 54.5%) the couples conceived during their initial attempt. Four of nine (44.4%) pregnancies were multiple gestations, including three sets of triplets. All female recipients tested seronegative for HIV at 3 and 6 months post-embryo transfer. All delivered babies (n = 8) tested seronegative for HIV at birth and 3 months postpartum. Four pregnancies are currently ongoing. ART should be considered for HIV serodiscordant couples with haemophilia who desire to have children in order to minimize the risk of viral infection.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Columbia-Presbyterian Medical Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Peña
authors.forename: J
authors.initials: J
authors.lastname: Klein
authors.forename: M H
authors.initials: MH
authors.lastname: Thornton
authors.forename: M V
authors.initials: MV
authors.lastname: Sauer
mesh_terms: D000328:Adult; D001294:Attitude to Health; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000523:psychology; D015658:HIV Infections / Q000150:complications* / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted / Q000523:psychology; D011795:Surveys and Questionnaires