title: Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia.
abstract: OBJECTIVE
  To describe the clinical outcomes for all HIV-serodiscordant couples attending an assisted reproduction program.
  
  
  METHODS
  Retrospective review of demographic, clinical and outcome data for all HIV-serodiscordant couples who attended an assisted reproduction program at a tertiary hospital in Melbourne, between its commencement in 2003 and June 2010.
  
  
  METHODS
  Pregnancies, miscarriages, births, HIV transmission to the HIV-negative partner, semen quality and detection of HIV (HIV RNA and HIV DNA) in semen.
  
  
  RESULTS
  As of June 2010, 39 HIV-positive clients had proceeded to assisted reproduction after the initial consultation in the program. There were 162 completed cycles, with 26 pregnancies (clinical pregnancy rate per cycle, 16.2% for HIV-positive men with an HIV-negative partner, and 15.4% for HIV-positive women). Of all 222 tested semen samples, 18 (8%) had HIV RNA detected despite these men receiving antiretroviral therapy and having an undetectable HIV viral load in plasma. Sperm velocity was significantly lower in HIV-positive clients receiving combination antiretroviral therapy than in a control group of recipient-recruited sperm donors (P = 0.01); there were no other significant differences in sperm quality between the two groups. No HIV transmission to babies or HIV-negative partners occurred.
  
  
  CONCLUSIONS
  Our findings show detectable HIV in 8% of semen samples from men with an undetectable HIV viral load in plasma, but confirm the safety of assisted reproduction for HIV-serodiscordant couples within a program with strict protocols for HIV treatment and testing of all semen before use.
authors: Royal Women's Hospital, Melbourne, VIC, Australia. m.giles@alfred.org.au
authors: Michelle L
authors: ML
authors: Giles
authors: Shlomi
authors: S
authors: Barak
authors: Gordon
authors: G
authors: Baker
authors: Samantha
authors: S
authors: Perna
authors: Sepehr
authors: S
authors: Tabrizi
authors: Vicki
authors: V
authors: Greengrass
authors: Harold
authors: H
authors: Bourne
authors: Gary N
authors: GN
authors: Clarke
authors: Suellen A
authors: SA
authors: Peak
authors: Jennifer F
authors: JF
authors: Hoy
authors: Penelope
authors: P
authors: Foster
authors: Rachael L
authors: RL
authors: Knight
mesh_terms: D000328:Adult; D001315:Australia; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control* / Q000821:virology; D011256:Pregnancy Outcome; D015397:Program Evaluation; D012367:RNA, Viral / Q000032:analysis; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D018570:Risk Assessment; D012661:Semen / Q000821:virology*; D055101:Semen Analysis; D014505:Urban Population; D055815:Young Adult
chemical_list: D012367:RNA, Viral