title: [Assisted reproductive technology in the presence of chronic viral disease].
abstract: BACKGROUND
  The first fertility unit dedicated to the treatment of couples infected with chronic viral diseases in Israel was established at the Rambam Medical Center in 2010. A multidisciplinary approach is needed in order to provide appropriate treatment to the viral disease, and to minimize the risks of infecting the partner, the embryo and others in the fertility unit.
  
  
  OBJECTIVE
  To review 2 years-experience providing fertility care to couples seropositive for HIV, HBV and HCV.
  
  
  METHODS
  Retrospective study.
  
  
  RESULTS
  Between the years 2010-2012, 92 couples underwent 183 oocyte retrievals and fresh embryo transfers and 77 cycles of frozen-thawed embryo transfer. Forty three percent of the couples were seropositive to HBV, 30% seropositive to HIV, 20% seropositive to HCV and 7% infected with more than one virus. In 52.3% of cases the male partner was infected, in 38% the female partner was infected and in 9.7% both partners were infected. Fifty one percent of the couples received antiviral therapy before admission to the unit or did not need antiviral therapy due to inactive disease. Twenty nine percent of the couples received anti-viral drugs while being treated in the fertility unit and 10% needed anti-viral treatment before beginning fertility treatment due to high viral load. Horizontal or vertical viral disease transmissions were not recorded.
  
  
  CONCLUSIONS
  Upon admission to the fertility unit the majority of couples had good control of their viral infections and either was under anti-viral treatment or did not need any further treatment. From our experience and a review of the literature, controlling the viral disease is the key to safe fertility treatment, and eliminating the risk of infecting the embryo, newborn, partner, and others within the fertility unit.
authors.forename: Shahar
authors.initials: S
authors.lastname: Kol
authors.forename: Samer
authors.initials: S
authors.lastname: Tannus
authors.forename: Avraham
authors.initials: A
authors.lastname: Lightman
authors.forename: Joseph
authors.initials: J
authors.lastname: Itskovitz
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D019694:Hepatitis B, Chronic / Q000517:prevention & control* / Q000635:transmission; D019698:Hepatitis C, Chronic / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D033183:Interdisciplinary Communication; D007557:Israel; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control / Q000821:virology; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012747:Sexual Partners; D019562:Viral Load
chemical_list: D000998:Antiviral Agents