title: Human immunodeficiency virus infection and fertility care in the United Kingdom: demand and supply.
abstract: OBJECTIVE
  To collect data on the demand and provision of fertility care in HIV-infected couples in the United Kingdom and data on the etiology of subfertility in this population.
  
  
  METHODS
  A postal questionnaire survey and audit of causes of infertility in HIV-infected women.
  
  
  METHODS
  Seventy-four Human Embryology and Fertilisation Authority-registered assisted conception units (ACUs) and 294 genitourinary medicine (GUM) clinics in the United Kingdom were sent questionnaires.
  
  
  METHODS
  Sixty-five HIV-infected women attending the Research Clinic at the Chelsea and Westminster ACU.
  
  
  METHODS
  None.
  
  
  METHODS
  Number of ACUs treating HIV-infected patients and number of GUM clinics receiving requests for referral, as well as the etiology of subfertility in HIV-infected women attending our clinic.
  
  
  RESULTS
  Response rates from ACUs and GUM clinics were 93% and 63%, respectively. Fourteen ACUs (20%) were treating HIV-infected men; of these, seven (10%) performed sperm washing, but only two (3%) tested sperm for HIV after processing, before use. Nine units (13%) treated HIV-infected women, but only three ACUs (4%) had separate laboratories for handling potentially infected gametes or embryos. Of the 15,211 patients registered in 81 GUM clinics, 4% of the men and 16% of the women had requested advice on conceiving. An audit of the Chelsea and Westminster HIV fertility clinic demonstrated a 40% prevalence of tubal factor infertility in HIV-infected women.
  
  
  CONCLUSIONS
  Demand is high, and set to increase, but current suboptimal practice in some centers is placing unaffected partners and the unborn child at risk of seroconversion.
authors.affiliation: Assisted Conception Unit, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: Leila C G
authors.initials: LC
authors.lastname: Frodsham
authors.forename: Fiona
authors.initials: F
authors.lastname: Boag
authors.forename: Simon
authors.initials: S
authors.lastname: Barton
authors.forename: Carole
authors.initials: C
authors.lastname: Gilling-Smith
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003376:Counseling; D004622:Embryo, Mammalian / Q000821:virology; D005260:Female; D052776:Female Urogenital Diseases / Q000628:therapy; D005854:Germ Cells / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D007247:Infertility, Female / Q000150:complications / Q000453:epidemiology; D008297:Male; D052801:Male Urogenital Diseases; D011295:Prenatal Care; D015995:Prevalence; D027724:Reproductive Techniques, Assisted; D013094:Spermatozoa / Q000821:virology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014572:Urology