Sperm washing to prevent HIV transmission from HIV-infected men but allowing conception in sero-discordant couples.
BACKGROUND
Sperm washing is a term used to describe the process in which individual spermatozoa are separated from the seminal fluid. Sperm washing is used to prevent HIV transmission but allow conception in sero-discordant couples, where the male is HIV positive, but the female is HIV negative. This procedure is based on the observation that HIV cannot attach itself to spermatozoa, but it can be found in the fluid and cells surrounding spermatozoa.


OBJECTIVE
To determine the benefits and harms of sperm washing of HIV-infected males when used to prevent the transmission of HIV but allowing conception in the HIV-negative female.


METHODS
We searched the Cochrane HIV/AIDS Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, SCORPUS, AIDsearch, AJOL, LILACS and INDEX MEDICUS. We also searched the following conference proceedings for relevant abstracts:The International AIDS Conference; The Conference on Retroviruses and Opportunistic Infections (CROI); The British HIV Association (BHIVA) Conference; The International Conference of Obstetricians and Gynecologists (FIGO); The American Academy of HIV Medicine Conference; The Australasian HIV/AIDS Conference; The American Society for Reproductive Medicine (ASRM) conferences and website; The European Society for Human Reproduction and Embryology (ESHRE) conferences and websites, and the British Fertility Society (BFS) conferences and website. We also conducted a search of the website: www.ClinicalTrials.gov. The date of the most recent Cochrane HIV/AIDS Group Controlled Trials Register search was on the 10th of November, 2010.


METHODS
We preferentially looked for randomised or quasi-randomised controlled trials on sperm washing, aimed at preventing HIV transmission from HIV infected men but allowing conception in sero-discordant couples, irrespective of publication status, year of publication, or language in the review.


METHODS
No relevant trials were identified for inclusion in this review.


RESULTS
Forty four studies were identified, but none of them were suitable for inclusion in this review.


CONCLUSIONS
Reports on the use of sperm washing to prevent HIV transmission from HIV infected men but allowing conception in sero-discordant couples is currently limited to observational studies. No randomised controlled trial has assessed the benefit or risk of sperm washing to prevent HIV transmission from HIV infected men but allow conception in sero-discordant couples. Thus, this systematic review identifies the need for a multicentre randomised controlled trial assessing the benefits and possible risks of sperm washing in preventing HIV transmission from HIV infected men but allow conception in sero-discordant couples.
Department of Health Policy and Management, Masters in Public Health (MPH), Harvard School of Public Health (HSPH), 677 Huntington Avenue, Boston, Massachusetts, USA, 02115.
Ahizechukwu C
AC
Eke
Chikelue
C
Oragwu
D005260:Female; D005306:Fertilization; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D018023:HIV Seronegativity; D006801:Humans; D008297:Male; D053625:Sperm Retrieval