[Insemination from HIV-positive males].
BACKGROUND
Discordant couples, in which the man is HIV positive and the woman is HIV negative, face limited options when they wish to produce healthy children whilst practicing safe sex. In order to conceive they must abandon unprotected sex, which carries high risk of HIV infection to the woman.


OBJECTIVE
To develop a method for removing the HIV from semen and then perform intra uterine insemination, following verification of the HIV-negative spermatozoa fraction by PCR.


METHODS
Motile spermatozoa were isolated from semen samples by the gradient and "swim-up" techniques. HIV-RNA was tested before and after the procedure in both the semen and the purified spermatozoa fraction. Insemination was performed on ovulation day only when the absence of any viral particles was verified by PCR.


RESULTS
Four couples underwent a total of 8 cycles of intra uterine insemination (IUI). Presently, two healthy babies were born. The two mothers and newborn were found to be HIV negative following the delivery.


CONCLUSIONS
We report a safe procedure which enables biological parenthood for HIV-1 discordant couples without the risk of infecting the female partner. Our clinical data corroborate with the collaborative European data on this subject.
Lowenstein
Lior
L
Department of Obstetrics and Gynecology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. l_lior@rambam.health.gov.il
Lightman
Abraham
A
Kra-Oz
Zipi
Z
Itskovitz-Eldor
Joseph
J
Bergman
Harieta
H
Lorber
Margalit
M
D000328:Adult; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D018023:HIV Seronegativity; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012367:RNA, Viral / Q000032:analysis; D012661:Semen / Q000821:virology
D012367:RNA, Viral