title: Semen residual viral load and reproductive outcomes in HIV-infected men undergoing ICSI after extended semen preparation.
abstract: The aim of this study was to evaluate the residual presence of the human immunodeficiency virus (HIV) following a triple gradient extended semen wash from ejaculates of serodiscordant couples, and analyse their reproductive outcomes after intracytoplasmic sperm injection (ICSI). For this purpose, a retrospective analysis of our database was performed in serodiscordant couples, with HIV-infected men and non-infected women, using fresh or frozen sperm with ICSI in oocytes from either the patients or donors from January 2006 to September 2013. Overall, the rate of positive HIV test after semen washing was 1.86%. The positive beta human chorionic gonadotrophin, clinical and ongoing pregnancy rates in patients with their own oocytes were 47.1%, 37.5% and 30.8%, respectively, and 58.6%, 50.8% and 39.1%, respectively, in oocyte donation cycles. To summarize, the described method of sperm washing based on triple gradient sperm selection coupled with extensive centrifugations is a highly reliable technique for HIV removal, as it provides lower than reported post-wash positive tests while maintaining high pregnancy rates in assisted reproduction cycles. Despite extensive personnel training and effectiveness of the washing protocol, post-wash HIV test on semen is recommended to identify residual positive samples.
authors.affiliation: Clínica EUGIN, Barcelona 08029, Spain.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Zamora
authors.affiliation: Clínica EUGIN, Barcelona 08029, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Obradors
authors.affiliation: IVF Consultancy Services, 144a New Walk, Leicester, LE1 7JA, UK.
authors.forename: Bryan
authors.initials: B
authors.lastname: Woodward
authors.affiliation: Clínica EUGIN, Barcelona 08029, Spain.
authors.forename: Valerie
authors.initials: V
authors.lastname: Vernaeve
authors.affiliation: Clínica EUGIN, Barcelona 08029, Spain. Electronic address: rvassena@eugin.es.
authors.forename: Rita
authors.initials: R
authors.lastname: Vassena
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D004717:Endometrium / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000628:therapy*; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009865:Oocytes / Q000166:cytology; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012661:Semen / Q000821:virology*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000821:virology; D016896:Treatment Outcome; D019562:Viral Load
keywords: HIV; ICSI; assisted reproductive treatment; sperm wash