Fertility services for human immunodeficiency virus-positive patients: provider policy, practice, and perspectives.
OBJECTIVE
To examine demand for, and access to, fertility services for HIV-positive patients in the United States.


METHODS
An electronic survey.


METHODS
The URL for the Web-based survey was e-mailed to those surveyed.


METHODS
The 916 members of the Society of Reproductive Endocrinology and Infertility of the American Society of Reproductive Medicine.


METHODS
Policy and practice in evaluation and treatment of HIV-positive and HIV-serodiscordant couples who desire conception, demand for services, and perceived barriers to providing these services.


RESULTS
The response rate was 22%. Forty percent of respondents reported policies. Fifty-one percent reported requests. Sixty-four percent reported offering treatment to HIV-serodiscordant couples, and 57% reported offering treatment to HIV-positive couples. Treatments most frequently offered to HIV-serodiscordant male-positive couples were reproductive surgery (50%), ovulation induction (46%), and intracytoplasmic sperm injection (45%). Twenty-nine percent of those offering treatment test-washed specimens for HIV. Factors limiting care included the following: low volume of requests (45%), concern for child welfare (37%), no laboratory policy (32%), and legal risk (32%).


CONCLUSIONS
Patients who are HIV-positive are seeking fertility services in the United States. The small demand is a major limiting factor to provision of services. There is a lack of global application of current American Society of Reproductive Medicine guidelines. Provider education is needed to ensure that the safest reproductive services are offered to HIV-positive patients. Legal reform is imperative to improve access to reproductive services for the HIV-positive population.
Stanitis
Julie A
JA
Department of Obstetrics and Gynecology, Baystate Medical Center, Western Campus of Tufts University, Springfield, Massachusetts. Electronic address: julie.stanitis@bhs.org.
Grow
Daniel R
DR
Department of Obstetrics and Gynecology, Baystate Medical Center, Western Campus of Tufts University, Springfield, Massachusetts.
Wiczyk
Halina
H
Department of Obstetrics and Gynecology, Baystate Medical Center, Western Campus of Tufts University, Springfield, Massachusetts.
D003695:Delivery of Health Care / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006679:HIV Seropositivity / Q000635:transmission*; D019538:Health Care Surveys; D006282:Health Personnel / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D006291:Health Policy / Q000331:legislation & jurisprudence / Q000639:trends*; D006801:Humans; D008297:Male; D010062:Ovulation Induction / Q000706:statistics & numerical data / Q000639:trends; D028701:Patient Rights; D010818:Practice Patterns, Physicians'; D034121:Reproductive Health Services / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D027724:Reproductive Techniques, Assisted / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D020554:Sperm Injections, Intracytoplasmic / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends; D014481:United States