Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia

Med J Aust. 2011 Nov 21;195(10):599-601. doi: 10.5694/mja11.10156.

Abstract

Objective: To describe the clinical outcomes for all HIV-serodiscordant couples attending an assisted reproduction program.

Design, setting and participants: Retrospective review of demographic, clinical and outcome data for all HIV-serodiscordant couples who attended an assisted reproduction program at a tertiary hospital in Melbourne, between its commencement in 2003 and June 2010.

Main outcome measures: Pregnancies, miscarriages, births, HIV transmission to the HIV-negative partner, semen quality and detection of HIV (HIV RNA and HIV DNA) in semen.

Results: As of June 2010, 39 HIV-positive clients had proceeded to assisted reproduction after the initial consultation in the program. There were 162 completed cycles, with 26 pregnancies (clinical pregnancy rate per cycle, 16.2% for HIV-positive men with an HIV-negative partner, and 15.4% for HIV-positive women). Of all 222 tested semen samples, 18 (8%) had HIV RNA detected despite these men receiving antiretroviral therapy and having an undetectable HIV viral load in plasma. Sperm velocity was significantly lower in HIV-positive clients receiving combination antiretroviral therapy than in a control group of recipient-recruited sperm donors (P = 0.01); there were no other significant differences in sperm quality between the two groups. No HIV transmission to babies or HIV-negative partners occurred.

Conclusion: Our findings show detectable HIV in 8% of semen samples from men with an undetectable HIV viral load in plasma, but confirm the safety of assisted reproduction for HIV-serodiscordant couples within a program with strict protocols for HIV treatment and testing of all semen before use.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Australia
  • Cohort Studies
  • Family Characteristics
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • HIV Seronegativity
  • HIV Seropositivity / transmission*
  • HIV-1 / isolation & purification
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control
  • Male
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Pregnancy Complications, Infectious / virology
  • Pregnancy Outcome*
  • Program Evaluation
  • RNA, Viral / analysis
  • Reproductive Techniques, Assisted*
  • Retrospective Studies
  • Risk Assessment
  • Semen / virology*
  • Semen Analysis
  • Urban Population
  • Young Adult

Substances

  • RNA, Viral