INFERTILITY AMONG HUMAN IMMUNODEFICIENCY VIRUS-POSITIVE WOMEN - INCIDENCE AND TREATMENT DILEMMAS

The increasing demand for fertility advice among human immunodeficienc y virus (HIV)-positive women under our care led us to review the incid ence of infertility and the ethical problems associated with its manag ement, All HIV-positive women who attended the HIV outpatients clinic from October 1990 to the end of January 1996 were studied, The main ou tcome measures were: the number of women undergoing infertility invest igations before and after HIV diagnosis, their demographic and social details, and the outcome of these investigations, Most of the 183 wome n studied were in their reproductive years (mean age 32.7 +/- 6.7 year s), Nine women had undergone infertility investigations, and/or treatm ent before HIV diagnosis, three of whom were diagnosed with HIV during routine testing prior to IVF treatment, Six declined further infertil ity treatment after discovering their HIV status. Eight women have und ergone infertility investigations after HIV diagnosis but none have ac hieved pregnancy to date, Management decisions may have been hampered by ethical uncertainties in several cases, In conclusion therefore, as requests for infertility treatment from HIV-infected women occur and may become more common as the prevalence of HIV infection in women con tinues to rise, the ethical issues associated with the management of t his problem demand urgent attention so that clear guidelines are avail able to aid treatment decisions.