Safe conception for HIV-discordant couples: insemination with processed semen from the HIV-infected partner

Semprini, E.; Macaluso, Maurizio; Hollander, Lital; Vucetich, A.; Duerr, Ann; Mor, Gil; Ravizza, Marina; Jamieson, Denise J.

doi:10.1016/j.ajog.2013.02.009

Cited by 92 publications

(25 citation statements)

References 24 publications

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“…Twenty-nine studies in this review reported washing semen using a technique invented by Semprini in 1989 (Table 1) (8). Some studies used a polymerase chain reaction (PCR) to detect HIV DNA and RNA in the washed semen fractions (24).…”

Section: Resultsmentioning

confidence: 99%

“…Couples may risk sexual HIV transmission in order to achieve pregnancy if they do not have access to safer reproductive methods (4, 6, 7). Semen washing is a safer reproductive strategy that HIV-discordant couples in which the male is infected can use to achieve pregnancy (8). …”

Section: Introductionmentioning

confidence: 99%

“…Semen washing removes spermatozoa, which are not vectors for HIV, from surrounding seminal fluid, and the HIV-negative sperm fractions are used in assisted reproduction (8). The first study from 1989 offering semen washing to HIV-discordant couples with intrauterine insemination (IUI) found no HIV transmission to 29 uninfected female partners (9).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis

Zafer

Horváth

Mmeje

et al. 2016

Fertility and Sterility

103

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Objective To evaluate the effectiveness of semen washing in HIV-discordant couples in which the male partner is infected Design Systematic review and meta-analysis Setting All countries Patient(s) Forty single-arm, open label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen Intervention(s) Semen washing followed by IUI, IVF, or IVF/ICSI Main outcome measure(s) Primary outcome: HIV transmission to HIV-uninfected women; secondary outcomes: HIV transmission to newborns and proportion of couples achieving a clinical pregnancy Result(s) No HIV transmission occurred in 11,585 cycles of assisted reproduction using washed semen among 3,994 women (95% confidence interval [CI] = 0–0.0001). Among the subset of HIV-infected men without plasma viral suppression at the time of semen washing, no HIV seroconversions occurred among 1,023 women following 2,863 cycles of assisted reproduction using washed semen (95%CI= 0–0.0006). Studies that measured HIV transmission to infants reported no cases of vertical transmission (0/1,026, 95% CI= 0–0.0029). Overall, 56.3% (2,357/4,184, 95%CI=54.8%–57.8%) of couples achieved a clinical pregnancy using washed semen. Conclusion(s) Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized, controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. Integration of semen washing into HIV prevention interventions could help further reduce the spread of HIV.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis

Zafer

Horváth

Mmeje

et al. 2016

Fertility and Sterility

103

View full text Add to dashboard Cite

show abstract

“…This raises the question regarding the risks involved for the surrogate mother should the commissioning father be HIV-positive. In such a situation, it is assumed that sperm washing (to eliminate the chances of HIV infection [9][10][11][12][13] ) would be utilised to minimise the chance of infection of the surrogate mother.…”

Section: Legal Duties At Common Lawmentioning

confidence: 99%

Surrogacy commissioning fathers and HIV

Jordaan

2013

S Afr Med J

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“…When the man is HIV positive: sperm washing with intrauterine insemination or in vitro fertilization is the strategy that offers the lowest transmission risk 33 . The disadvantages are high cost and low availability in most public health services.…”

Section: Risk Reduction In Reproductionmentioning

confidence: 99%

Strategies to prevent HIV transmission to serodiscordant couples

Hallal

Raxach²,

Barcellos

et al. 2015

Rev. bras. epidemiol.

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The articles recovered exhibit four main strategies: (1) condom; (2) reduction of risks in sexual practices; (3) use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP) and pre-exposure prophylaxis (PrEP); (4) risk reduction in reproduction. Discussion: TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies. Conclusions: When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

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Safe conception for HIV-discordant couples: insemination with processed semen from the HIV-infected partner

Cited by 92 publications

References 24 publications

Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis

Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis

Surrogacy commissioning fathers and HIV

Strategies to prevent HIV transmission to serodiscordant couples

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