Providing fertility care to men seropositive for human immunodeficiency virus: reviewing 10 years of experience and 420 consecutive cycles of in vitro fertilization and intracytoplasmic sperm injection
Received 6 March 2008; received in revised form 4 April 2008; accepted 4 April 2008. published online 13 June 2008.
Objective
To review 10 years of experience providing fertility care to men seropositive for human immunodeficiency virus (HIV) using sperm washing and in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI).
Design
Retrospective study.
Setting
University-based practice.
Patient(s)
HIV-seropositive men with HIV-seronegative partners.
We initiated 420 cycles (355 fresh and 65 frozen cycles) in 181 couples. Due to poor ovarian response, 16% of stimulations were canceled. The number of oocytes collected per retrieval was 15.0 ± 0.5, providing 12.1 ± 0.5 mature oocytes suitable for ICSI, yielding 9.0 ± 0.3 embryos per couple. The overall clinical pregnancy rate/embryo transfer was 45%; ongoing/delivered pregnancy rate/embryo transfer was 37%. The most frequent obstetric complication was multiple gestation (41%), with 5% experiencing high order multiple birth. An attendant high rate of preterm delivery was noted, as 43% of infants were born premature. No maternal or neonatal HIV infections or deaths occurred.
Conclusion(s)
We have found IVF-ICSI to be an expeditious and safe means for HIV-serodiscordant couples to achieve pregnancy with minimal risk of viral infection. Risks and liabilities of IVF-ICSI relate to multiple gestations and will occur in a significant number of participants.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
Reprint requests: Mark V. Sauer, M.D., The Center for Women's Reproductive Care at Columbia University, 1790 Broadway, 2nd Floor, New York, NY 10019 (FAX: 646-756-8280).
M.V.S. has nothing to disclose. J.G.W. has nothing to disclose. N.C.D. has nothing to disclose. G.S.N. has nothing to disclose. P.V. has nothing to disclose. V.J. has nothing to disclose. M.M.G. has nothing to disclose.
ABSTRACT