title: [Fertility treatment options for discordant couples living with HIV].
abstract: BACKGROUND
  Serodiscordant couples live with the risk of HIV infection of the negative partner when attempting to become pregnant. Using density gradient centrifugation (DGC), spermatozoa can be separated from other seminal compartments. Isolated spermatozoa do not contain detectable HIV RNA. DGC followed by artificial insemination may significantly reduce the risk of infection. The Hadassah AIDS Center (HAC) has recently initiated a fertility center for serodiscordant couples.
  
  
  METHODS
  Our patient population includes serodiscordant couples in which the male is HIV positive. The male semen is washed using the DGC procedure. Washed semen is tested for HIV by standard PCR methods. Intrauterine insemination (IUI) is attempted using the washed semen.
  
  
  RESULTS
  A total of 55 couples have registered for this procedure. This includes 16 men who have sex with men, 7 who have hemophilia and 8 couples of Ethiopian origin. The average female age is 33 years. Seven (12%) men had inadequate sperm counts and were referred for IVF. Overall, 34 semen samples were tested for HIV. Only one was found to be positive. During the procedure, 22 couples underwent at least one IUI attempt and 16 (72%) females became pregnant, 3 of them after the first IUI attempt. All women tested for HIV after IUI were found to be negative.
  
  
  CONCLUSIONS
  The pregnancy success rate during the first year of operation was 72%, similar to that reported by other centers in Europe. There were no seroconversions of the female partner. Serodiscordant couples living with HIV in Israel today may consider starting a family, while significantly reducing the risk of infecting the negative female partner.
authors.affiliation: Clinical Microbiology and Infectious Diseases Unit, Hadassah Medical Center. kerenop@hadassah.org.il
authors.forename: Karen
authors.initials: K
authors.lastname: Olshtain-Pops
authors.forename: Shlomo
authors.initials: S
authors.lastname: Maayan
authors.forename: Yoel
authors.initials: Y
authors.lastname: Shufaro
authors.forename: Alex
authors.initials: A
authors.lastname: Simon
authors.forename: Awad
authors.initials: A
authors.lastname: Srur
authors.forename: Nurit
authors.initials: N
authors.lastname: Mador
authors.forename: Dana
authors.initials: D
authors.lastname: Wolf
authors.forename: Margalit
authors.initials: M
authors.lastname: Lorber
mesh_terms: D000328:Adult; D002499:Centrifugation, Density Gradient; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005220:Fathers; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006679:HIV Seropositivity / Q000175:diagnosis / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D007557:Israel; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D016133:Polymerase Chain Reaction / Q000379:methods; D015980:Public Health Practice / Q000706:statistics & numerical data; D012367:RNA, Viral / Q000032:analysis; D013094:Spermatozoa / Q000637:transplantation / Q000821:virology
chemical_list: D012367:RNA, Viral