title: Outcomes of assisted reproductive techniques for HIV-1-discordant couples using thawed washed sperm in Taiwan: comparison with control and testicular sperm extraction/microscopic epididymal sperm aspiration groups.
abstract: OBJECTIVE
  An increasing number of human immunodeficiency virus-1 (HIV-l)-discordant couples in Taiwan have been seeking fertility help. We conducted the first clinical trial in Taiwan of assisted reproductive technology (ART) using sperm washing and viral load measurement.
  
  
  METHODS
  From 2005 to 2009, we performed 22 ART cycles on 14 HIV-1-discordant couples. The sperm washing involved density gradient centrifugation followed by swim-up method. HIV-1 RNA was checked by real-time reverse transcription-polymerase chain reaction with a sensitivity of 40 copies/mL. In addition, we enrolled two other groups of ART recipients using frozen sperm to compare the clinical outcomes.
  
  
  RESULTS
  There were five pregnancies in the fresh cycles (23.8%) of HIV-1-discordant couples and the cumulative pregnancy per couple was 42.9% (6/14). The data were comparable with normal controls and testicular sperm extraction/microscopic epididymal sperm aspiration groups. The nine babies and the 14 women in this study showed no seroconversion.
  
  
  CONCLUSIONS
  The preliminary data showed good ART results in HIV-1-discordant couples. Fertility services should not be withheld from individuals with HIV-1, although larger series are needed to reach conclusions about safety.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Ming-Yih
authors.initials: MY
authors.lastname: Wu
authors.forename: Li-Jong
authors.initials: LJ
authors.lastname: Chang
authors.forename: Mei-Jou
authors.initials: MJ
authors.lastname: Chen
authors.forename: Kuang-Han
authors.initials: KH
authors.lastname: Chao
authors.forename: Yu-Shih
authors.initials: YS
authors.lastname: Yang
authors.forename: Hong-Nerng
authors.initials: HN
authors.lastname: Ho
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D015925:Cryopreservation; D005260:Female; D006679:HIV Seropositivity; D015497:HIV-1; D006801:Humans; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013048:Specimen Handling / Q000379:methods*; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000821:virology*; D018709:Statistics, Nonparametric; D013624:Taiwan; D019562:Viral Load