Safety and efficacy of sperm washing in HIV-1-serodiscordant couples where the male is infected: results from the European CREAThE network

Abstract

This first multicentre retrospective study of assisted reproduction following sperm washing demonstrates the method to be effective and to significantly reduce HIV-1 transmission risk to the uninfected female partner. These results support the view that assisted reproduction with sperm washing could not be denied to serodiscordant couples in developed countries and, where possible, could perhaps be integrated into a global public health initiative against HIV in developing countries.

Fertility-related research needs among women at the margins

“…Overview of fertility-related research areas for women of reproductive age. 23(45): [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] many factors aside from HIV influence decisions to terminate pregnancy, and that abortion is less common among women living with HIV in the antiretroviral era. 3,26 Further knowledge regarding post-abortion care and approaches to effectively integrate HIV and post-abortion care services should be expanded.…”

“…33 Guidelines for safer conception -relevant to both women living with HIV and women affected by HIV through their partner's HIV status-are available in several high-income countries as well as in South Africa, [34][35][36][37][38] and are under development by the World Health Organization. However, safer conception implementation has been largely limited to high income settings where resources and infrastructure facilitate options including spermwashing, intrauterine insemination (IUI), in-vitro fertilization (IVF), [39][40][41] and/or close monitoring of natural conception while using antiretrovirals. 42,43 Evidence from resource-limited settings has focused on the need for safer conception services, with efficacy and effectiveness verification of these interventions largely outstanding.…”

Le tractus génital masculin

“…En France et dans plusieurs pays d'Europe, une prise en charge dans le cadre d'une assistance médicale à la procréation (AMP) est proposée aux couples dont l'homme est séropositif afin d'éviter la contamination de sa partenaire et de l'embryon par le virus. Les techniques d'AMP permettent d'utiliser des spermatozoïdes dans lesquels aucun ARN/ ADN viral n'est détecté et de les isoler des composants infectés du sperme [23]. En cas de charge virale sémi-nale positive, la qualité du sperme est essentielle (un nombre important de spermatozoïdes doit être testé) et représente un facteur limitant pour de nombreux couples.…”

How the global call for elimination of pediatric HIV can support HIV-positive women to achieve their pregnancy intentions

“…68 One such example is the use of artificial insemination, which allows for conception while not introducing the risk of horizontal HIV transmission from an HIV-positive woman to her HIV-negative male partner during unprotected intercourse. 69 Though shown to be effective in research and clinical settings in regions such as western Europe, these methods are not available in many of the settings with the highest burden of HIV worldwide; where they are available, cost and other limitations place them out of reach for many HIV-affected couples.…”