Assisted reproduction for HIV-positive people can be safe
People with HIV can safely conceive a child using assisted reproduction, according to a retrospective analysis of Australian data published in the 21 November issue of the Medical Journal of Australia.
The study reviews the outcomes of 37 HIV-positive people with HIV-negative partners (known as ‘serodiscordant’ couples) who took part in an assisted reproduction program at the Royal Women’s Hospital in Melbourne between 2003 and 2010.
In that time, 19 babies were born and no cases of HIV transmission to the baby or the HIV-negative partner occurred.
Dr Michelle Giles, an infectious diseases physician at the Royal Women’s Hospital, and co-authors said the study confirms the safety of assisted reproduction for serodiscordant couples within a program that includes strict protocols for HIV treatment and testing of all semen for detectable HIV before use.
Dr Giles noted that, for the partners of HIV-positive men, a slight risk remained. “For HIV-positive men, there are few options for biological parenthood that carry no risk of HIV transmission to their HIV-negative partners.”
However, she said recent international figures suggested the risk of HIV transmission occurring would be less than 1/6000 with assisted reproduction, compared with an estimated transmission risk of 1/1000 per single act of penile–vaginal intercourse in couples not on HIV treatment.
The clinical pregnancy rate per cycle in the study was 16.2% for HIV-positive men with an HIV-negative partner and 15.4% for HIV-positive women. In comparison, the clinical pregnancy rate for assisted reproductive technology treatment cycles in HIV-negative couples in Australia and New Zealand in 2008 was 22.6%.
The Royal Women’s Hospital began offering assisted reproductive techniques to HIV-positive men with HIV-negative female partners in 2003, and to HIV-positive women in 2006.
The choice of treatment offered includes intrauterine insemination or IVF/intracytoplasmic sperm injection, depending on the woman’s age, reproductive history, fertility and her partner’s sperm quality. Semen analysis is performed for all male clients and measures volume, sperm count, motility, velocity and morphology.
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so state
CONTACTS: Ms Sofia Dedes 0400 512 618
Media Manager, Royal Women’s Hospital