Human immunodeficiency virus infection and fertility care in the United Kingdom: demand and supply.
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.
Frodsham
Leila C G
LC
Assisted Conception Unit, Chelsea and Westminster Hospital, London, United Kingdom.
Boag
Fiona
F
Barton
Simon
S
Gilling-Smith
Carole
C
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