Report of the results of a 2 year programme of sperm wash and ICSI treatment for human immunodeficiency virus and hepatitis C virus serodiscordant couples.
BACKGROUND
Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) serodiscordant couples with the male infected can be helped to have children minimizing the transmission risk. Our aim was to evaluate the results of our assisted reproduction programme for these couples and to develop adequate strategies for their management.


METHODS
Members of serodiscordant couples: (i) HIV positive males attending our centre for sperm wash and assisted reproduction and (ii) HCV positive males needing assisted reproduction for infertility provided 134 semen samples for sperm wash. Before ICSI treatment, semen was confirmed to be negative for viral presence by reverse transcription and nested PCR after the sperm wash.


RESULTS
Sperm washes were effective in 90% of the samples. Regardless of the type of infection, no differences were found in semen quality, embryos obtained and pregnancy rates (40-48% per cycle). To date, 41 pregnancies and 23 newborns were obtained. Fertilization rates were lower in HCV than in HIV serodiscordant couples (59.3+/-5.3% versus 72.0+/-8.1%), probably because they were infertile couples for whom we recommended sperm wash and PCR. No seroconversion was detected in the patients' follow-up.


CONCLUSIONS
To date, sperm wash, nested PCR and ICSI is a safe and effective procedure that avoids HIV and HCV transmission with reasonable pregnancy rates, and is cost-effective.
IVI Valencia, Valencia, Valencia University School of Medicine, Valencia, Spain. nicolas.garrido@ivi.es
Nicolás
N
Garrido
Marcos
M
Meseguer
José
J
Bellver
José
J
Remohí
Carlos
C
Simón
Antonio
A
Pellicer
D000328:Adult; D018562:Disease Transmission, Infectious; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control; D006679:HIV Seropositivity; D016174:Hepacivirus; D006526:Hepatitis C / Q000517:prevention & control; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D012661:Semen / Q000502:physiology / Q000821:virology; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000502:physiology / Q000821:virology*; D016896:Treatment Outcome