Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive

Vitorino, Raquel; Grinsztejn, Beatriz; Andrade, Carlos Augusto Ferreira de; Hökerberg, Yara Hahr Marques; Souza, Cláudia Teresa Vieira de; Friedman, Ruth Khalili; Passos, Sônia Regina Lambert

doi:10.1016/j.fertnstert.2011.01.127

Cited by 58 publications

(33 citation statements)

References 28 publications

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“…Assisted reproduction techniques included IUI with ovarian stimulation or natural cycles (10), IVF or IVF/ICSI. In studies that reported pregnancy outcomes per women, of the 4,184 couples that initiated a cycle of reproduction, 2,357 (56.3%, 95% CI=54.8%–57.8%) had a clinical pregnancy (Supplemental Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…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). In the two decades following the introduction of semen washing, many more studies have evaluated the effect of this method in conjunction with assisted reproductive technologies, such as IUI, in vitro fertilization (IVF), and IVF with intracytoplasmic sperm injection (ICSI), on HIV transmission in HIV-discordant couples (10–12). We conducted a systematic review and meta-analysis of these studies in order to estimate the safety and effectiveness of semen washing in reducing HIV transmission in HIV-discordant couples in which the male is infected.…”

Section: Introductionmentioning

confidence: 99%

“…The first by Vitorino et al (10) included 17 observational studies published through December 2007. The second review by Eke et al (11) searched for randomized controlled trials published through December 2010 but did not identify any.…”

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%

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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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“…No seroconversions in women or newborns were detectable at birth or after 3-6 months. Cumulative evidence suggests that ART is safe and effective for avoiding horizontal and vertical transmission in HIVserodiscordant couples [11].…”

Section: Discussionmentioning

confidence: 99%

Yes, It is Possible

Allahbadia

2015

J Obstet Gynecol India

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Human immunodeficiency virus-serodiscordant couples are actively seeking reproductive assistance and often consider or practice unsafe measures to achieve pregnancy. Reproductive issues and concerns unique to these couples need to be addressed before treatment.Assisted reproduction techniques can minimize the risk of infection and complete families associated with serodiscordant couples. Since 1987, more than 4000 published attempts have been reported in which processed spermatozoa from HIV-seropositive men were used to establish pregnancy in HIV-seronegative women. When the female partner is HIV positive, intrauterine insemination (IUI) will suffice in order to prevent horizontal infection. However, when the male partner is HIV positive, a technique developed in Milan over 15 years ago, involving sperm washing, is used in order to minimize infection of the healthy partner. Some couples need further treatment, due to inherent infertility, with advanced reproductive technology (ART) procedures, such as IVF or ICSI. Recent innovative approaches such as pre-exposure prophylaxis

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“…HIV serodiscordant couple who wish to have offspring but fear of disease contagious prohibited them from concieved naturally [4]. Intrauterine insemination without having direct sexual contact is one of the method to achieve this wish [5]. A study of a nationally representative sample of 2,864 HIV-infected adults receiving medical care in the UnitedStates showed that 28%-29% of HIV-infected men and women desire children in the future [2,6].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Intra Uterine Insemination for HIV Serodiscordant Couple

Halim¹,

Lubis²,

Novia³

2016

Kme

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IntroductionHIV serodiscordant couple who wish to have offspring but fear of disease contagious prohibittedthem from concieved naturally. Intrauterine insemination without having direct sexual contact is one of the method to achieve this wish. This study was aimed to evaluate the outcome of intrauterine insemination in HIV serodiscordant couple.Material and methodsRetrospective analytic study was done. HIV serodiscordant couple who have been treated with intrauterine insemination from January 2010 until June 2014 in Halim Fertility Centre Medan was included in this study.ResultsThere were 27 cycles of intrauterine insemination from HIV serodiscordant couple. The clinical pregnancy rate were 33.3%. None of the babies or mother after deliveries have HIV positive.ConclusionIntrauterine insemination in HIV serodiscordant couple appears to be effective and safe method to achieve pregnancy.

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Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive

Cited by 58 publications

References 28 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

Yes, It is Possible

Outcome of Intra Uterine Insemination for HIV Serodiscordant Couple

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