title: Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of assisted reproduction techniques (ART) in human immunodeficiency virus (HIV) serodiscordant couples.
  
  
  METHODS
  Systematic review of five databases of noncomparative open intervention and observational studies of serodiscordant couples undergoing ART, with study selection and data extraction performed independently and in duplicate.
  
  
  METHODS
  Tertiary fertility centers.
  
  
  METHODS
  HIV serodiscordant couples where the man is HIV positive.
  
  
  METHODS
  Intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic injection (ICSI) performed after washed semen viral testing.
  
  
  METHODS
  Pregnancy rates per cycle, cumulative pregnancy, abortion rate, and HIV seroconversion in newborns or women.
  
  
  RESULTS
  Of the 658 abstracts retrieved, 41 were selected for review, and 17 full articles were included (3,900 IUI cycles in 1,184 couples in 11 aggregated studies and 738 ICSI/IVF cycles in 579 couples across 10 studies). The IUI and ICSI results were, respectively: pregnancy rates per cycle, 18% and 38.1%; cumulative pregnancy, 50% and 52.9%; and abortion rate, 15.6% and 20.6%. No seroconversions in women or newborns were detectable at birth or after 3 to 6 months.
  
  
  CONCLUSIONS
  Cumulative evidence suggests that ART is safe and effective for avoiding horizontal and vertical transmission in HIV serodiscordant couples.
authors.affiliation: Clinical Epidemiology Laboratory, Evandro Chagas Clinical Research Institute (IPEC), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
authors.forename: Raquel Loja
authors.initials: RL
authors.lastname: Vitorino
authors.forename: Beatriz Gilda
authors.initials: BG
authors.lastname: Grinsztejn
authors.forename: Carlos Augusto Ferreira
authors.initials: CA
authors.lastname: de Andrade
authors.forename: Yara Hahr Marques
authors.initials: YH
authors.lastname: Hökerberg
authors.forename: Claudia Teresa Vieira
authors.initials: CT
authors.lastname: de Souza
authors.forename: Ruth Khalili
authors.initials: RK
authors.lastname: Friedman
authors.forename: Sonia Regina Lambert
authors.initials: SR
authors.lastname: Passos
mesh_terms: D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology / Q000473:pathology / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D012661:Semen / Q000502:physiology / Q000821:virology*; D016896:Treatment Outcome