title: Synchronous sperm retrieval and sperm washing in an intracytoplasmic sperm injection cycle in an azoospermic man who was positive for human immunodeficiency virus.
abstract: OBJECTIVE
  To present the first reported case of synchronous sperm retrieval followed by sperm washing before an intracytoplasmic sperm injection (ICSI) cycle in an HIV-positive azoospermic man.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Assisted reproduction center.
  
  
  METHODS
  A 40-year-old HIV-positive man with obstructive azoospermia due to vasal aplasia.
  
  
  METHODS
  Synchronous sperm retrieval, sperm washing, nucleic acid-based sequence amplification testing, and intracytoplasmic sperm injection.
  
  
  METHODS
  Successful sperm retrieval sufficient for sperm washing and fertilization.
  
  
  RESULTS
  Sufficient quantity of spermatozoa for washing was obtained at epididymal aspiration. After the wash, HIV ribonucleic acid (RNA) was undetectable with nucleic acid-based sequence amplification testing, enabling injection of oocytes collected after routine gonadotropin superovulation. Of seven oocytes collected from the 39-year-old woman partner, six were injected and five fertilized (83%). Three embryos were transferred on day 2. The pregnancy test was negative on this occasion.
  
  
  CONCLUSIONS
  This case demonstrates that sperm washing can be applied in cases of sperm retrieval where sperm volume and density is low, allowing the treatment of azoospermic HIV-positive men.
authors.affiliation: Assisted Conception Unit, Chelsea and Westminster Hospital, London, United Kingdom. james.nicopoullos@chelwest.nhs.uk
authors.forename: James D M
authors.initials: JD
authors.lastname: Nicopoullos
authors.forename: Leila C G
authors.initials: LC
authors.lastname: Frodsham
authors.forename: Jonathan W A
authors.initials: JW
authors.lastname: Ramsay
authors.forename: Paula A
authors.initials: PA
authors.lastname: Almeida
authors.forename: George
authors.initials: G
authors.lastname: Rozis
authors.forename: Carole
authors.initials: C
authors.lastname: Gilling-Smith
mesh_terms: D000328:Adult; D005260:Female; D006678:HIV / Q000235:genetics; D006679:HIV Seropositivity / Q000821:virology; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000821:virology; D007507:Therapeutic Irrigation; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D014649:Vas Deferens / Q000002:abnormalities
chemical_list: D012367:RNA, Viral