Safety of sperm washing and ART outcome in 741 HIV-1-serodiscordant couples.
BACKGROUND
To evaluate the safety of sperm washing and assisted reproduction technique (ART) outcome offered to serodiscordant couples with a human immunodeficiency virus-1 (HIV-1)-positive male.


METHODS
Sperm washing was performed and checked by RT-PCR on each semen sample before its fresh usage. Intrauterine insemination (IUI) or IFV/ICSI was offered according to fertility profile of each couple. Non-infected women underwent HIV testing 2 weeks before each procedure and for up to 6 months after.


RESULTS
Seven hundred and forty-one couples entered the study of a possible 2011 serodiscordant couples counselled over 4 years. Superovulation and IUI were performed in 581 couples, where the pregnancy rate per cycle and pregnancy rate per couple were 19 and 78%, respectively, with multiple pregnancy rate being 4%. One hundred and sixty couples were treated by IVF/ICSI, where pregnancy rate per cycle and per couple were 22 and 41%, respectively, with multiple pregnancy rate being 10%. All female partners were still HIV-1 negative at follow-up.


CONCLUSIONS
Sperm washing within a programme of reproductive counselling was proved to be safe in this large series of serodiscordant couples. The overall pregnancy rate (70.3%), independent of the procedure used (IUI or IVF/ICSI), justifies the effort of the medical team in setting up and implementing dedicated centres and of the individual patient in seeking a safe pregnancy.
Savasi
V
V
Department of Obstetrics and Gynaecology, Sacco Clinical Sciences Institute, University of Milan Medical School, Milan, Italy.
Ferrazzi
E
E
Lanzani
C
C
Oneta
M
M
Parrilla
B
B
Persico
T
T
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control*; D005260:Female; D005307:Fertilization in Vitro; D006679:HIV Seropositivity; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D013048:Specimen Handling / Q000379:methods*; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000821:virology*; D014019:Tissue Donors; D016896:Treatment Outcome; D019562:Viral Load