Fertility assessment in non-infertile HIV-infected women and their partners

Coll, O.; López, Maite; Vidal, R.; Figueras, F.; Suy, Anna; Hernández, Sandra; Loncá, Montserrat; Palacio, Montse; Martínez, Estebán; Vernaeve, V.

doi:10.1016/s1472-6483(10)60897-8

Cited by 40 publications

(22 citation statements)

References 24 publications

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“…Infected women who have advanced disease (21) or are wasted (15) have an increase in anovulatory cycles. One small study demonstrated a 27.8% incidence of tubal occlusion on hysterosalpingogram among seropositive women (196), but this is not supported elsewhere in the literature. One would expect an increase in tubal factor infertility with HIV infection similar to what has been seen in other groups of women with sexually transmitted infections.…”

Section: Fertilitymentioning

confidence: 85%

Gynecologic Issues in the HIV-Infected Woman

Cejtin

2008

Infectious Disease Clinics of North America

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With the advent of highly active antiretroviral therapy (HAART), women living with HIV can now enjoy longer lifespans in relative good health as well as the prospect of bearing children with an overwhelmingly low risk of vertical transmission. Thus, increasingly, seropositive women are now facing issues around longevity as well as those associated with fertility. The clinician caring for the HIV-infected woman must be alert to the gynecologic issues that are prevalent in this population. Among those faced by the gynecologist are menstrual abnormalities, lower genital tract neoplasia, sexually transmitted infections, the need for gynecologic surgery, and menopausal issues including osteopenia/osteoporosis. Contraception in HIV seropositive women presents unique management issues, because of the necessity for a dual role of prevention of both pregnancy and HIV transmission, the possible effect of birth control on HIV infection, and the interaction between birth control and HIV therapies. With ever increasing frequency, the gynecologist will be presented with the seropositive woman or couple who wishes to conceive. The purpose of this chapter is to review the current knowledge on the relationship between HIV infection and menstrual abnormalities, genital neoplasias, contraceptive options, surgical complications, and menopause with its associated disorders. Special considerations in the seropositive woman contemplating pregnancy will also be discussed. The treatment of pelvic infections is discussed elsewhere in this volume, and only changes in standard therapy because of concurrent HIV-infection will be discussed here.

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Section: Fertilitymentioning

confidence: 85%

Gynecologic Issues in the HIV-Infected Woman

Cejtin

2008

Infectious Disease Clinics of North America

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“…Furthermore, the clinical presentation among HIV-infected women with PID may be more severe than in uninfected women [36, 37]. A cross-sectional study from Spain of 130 HIV-infected women undergoing fertility assessment found that almost one-third had evidence of tubal occlusion [38]. Another potential contributing factor to subfertility in HIV-infected women is a possible increase in amenorrhea, oligomenorrhea, and irregular periods, particularly with lower CD4 counts [39–42].…”

Section: Rationale For Preconception Carementioning

confidence: 99%

Preconception and Contraceptive Care for Women Living with HIV

Hoyt¹,

Storm²,

Aaron

et al. 2012

Infectious Diseases in Obstetrics and Gynecology

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Women living with HIV have fertility desires and intentions that are similar to those of uninfected women, and with advances in treatment most women can realistically plan to have and raise children to adulthood. Although HIV may have adverse effects on fertility, recent studies suggest that antiretroviral therapy may increase or restore fertility. Data indicate the increasing numbers of women living with HIV who are becoming pregnant, and that many pregnancies are unintended and contraception is underutilized, reflecting an unmet need for preconception care (PCC). In addition to the PCC appropriate for all women of reproductive age, women living with HIV require comprehensive, specialized care that addresses their unique needs. The goals of PCC for women living with HIV are to prevent unintended pregnancy, optimize maternal health prior to pregnancy, improve maternal and fetal outcomes in pregnancy, prevent perinatal HIV transmission, and prevent HIV transmission to an HIV-uninfected sexual partner when trying to conceive. This paper discusses the rationale for preconception counseling and care in the setting of HIV and reviews current literature relevant to the content and considerations in providing PCC for women living with HIV, with a primary focus on well-resourced settings.

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“…Sauer et al reported that ART outcome was not altered in male-HIV couples (13), despite poorer sperm quality (21)(22)(23). Likewise, acceptable pregnancy rates of 23.9% were reported in female-HIV couples (16).…”

mentioning

confidence: 99%