title: Should HCV discordant couples with a seropositive male partner be treated with assisted reproduction techniques (ART)?
abstract: OBJECTIVE
  The debate on HCV discordant couples requiring assisted reproduction is still open today, and specific guidelines have not yet been established on whether or not physicians should treat HCV discordant couples who require ART. We studied the results of our reproductive assistance with sperm washing in HCV discordant couples, all treated in a single center, including the serological status of mothers and babies, and the outcome of the pregnancies.
  
  
  METHODS
  Prospective study conducted between January 2008 and December 2010 in our Reproductive Center in Sacco Hospital, University of Milan. Thirty-five HCV serodiscordant infertile couples with an HCV viremic positive male partner were enrolled. All of them completed the immuno-virological and fertility triage, and were treated according to our clinical protocols.
  
  
  RESULTS
  Forty-seven superovulation and IUI and 38 second-level ART procedures are reported. The pregnancy rates for IUI and ICSI are similar to those reported by the Italian ART register. All the 85 sperm samples were treated with sperm washing technique to reduce HCV in semen and the possible risk of transmission. We did not observe any preterm delivery or negative perinatal outcome. No mothers or babies are infected by HCV.
  
  
  CONCLUSIONS
  This is the biggest prospective study conducted in a single center involving HCV discordant infertile couples in an ART program. Although sexual transmission of HCV is very low, in subfertile or infertile couples sperm washing should be used to treat HCV positive semen before ART. We suggest that it is not necessary to perform nested PCR to detect HCV RNA in the final swim-up. Since the presence of HCV in semen implies a possible risk of nosocomial contamination, safety regulations must be strictly applied in assisted reproduction laboratories.
authors: Department of Obstetrics and Gynecology, Reproductive Medicine Centre, DSC L. Sacco Hospital, University of Milan, Milan, Italy.
authors: Valeria
authors: V
authors: Savasi
authors: Monica
authors: M
authors: Oneta
authors: Bina
authors: B
authors: Parrilla
authors: Irene
authors: I
authors: Cetin
mesh_terms: D000328:Adult; D002469:Cell Separation / Q000379:methods; D015331:Cohort Studies; D003428:Cross Infection / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D006785:Hospitals, University; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D007248:Infertility, Male / Q000150:complications / Q000503:physiopathology / Q000821:virology*; D007558:Italy; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012661:Semen / Q000166:cytology / Q000821:virology*; D013094:Spermatozoa / Q000821:virology; D014766:Viremia / Q000150:complications / Q000517:prevention & control* / Q000635:transmission / Q000821:virology