Complications of in vitro fertilization with intracytoplasmic sperm injection in human immunodeficiency virus serodiscordant couples.
BACKGROUND
Our experience with complications related to in vitro fertilization (IVF), particularly ovarian hyperstimulation syndrome (OHSS) and higher-order multiple gestations, in human immunodeficiency virus (HIV) serodiscordant couples undergoing IVF with intracytoplasmic sperm injection (ICSI) is presented.


METHODS
We retrospectively evaluated 132 consecutive IVF-ICSI cycles and the ensuing 43 pregnancies in 74 HIV-seropositive male discordant couples. The diagnosis of moderate and severe OHSS was based on clinical criteria. Higher-order multiple gestations were defined as viable triplets or greater by the end of the first trimester verified by ultrasonography.


RESULTS
The incidence of moderate and severe OHSS was 4.5% of initiated IVF cycles. Seven of the 43 (16.3%) pregnancies were higher-order multiple gestations (1 quadruplet and 6 triplet pregnancies), resulting in the delivery of 3 sets of triplets and 3 sets of twins, with an ongoing twin pregnancy. Four patients had undergone multifetal pregnancy reduction to twins. There were no seroconversions in the women and the infants.


CONCLUSIONS
HIV serodiscordant couples undergoing fertility treatment with IVF-ICSI should be made particularly aware of the risks of higher-order multiple gestations and OHSS.
Peña
Joseph E
JE
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Columbia-Presbyterian Medical Center, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 16-28, New York, NY 10032, USA.
Thornton
Melvin H
MH
Sauer
Mark V
MV
D000328:Adult; D005220:Fathers; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000379:methods; D015658:HIV Infections / Q000635:transmission; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D008499:Medical Records; D009518:New York / Q000453:epidemiology; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic