HUMAN-IMMUNODEFICIENCY-VIRUS TYPE 1-SERODISCORDANT COUPLES CAN BEAR HEALTHY-CHILDREN AFTER UNDERGOING INTRAUTERINE INSEMINATION

Objective: To use semen from men who were seropositive for human immun odeficiency virus type 1 (HIV-1) to inseminate their partners without infecting them. Design: Prospective study. Setting: Private practice. Patient(s): Sixty-three HIV-1-seropositive men and their HIV-1-seroneg ative female partners. Intervention(s): The men provided 107 semen sam ples that were prepared with the use of the Percoll and swim-up techni ques. The presence of HIV-1 was determined in the fraction of motile s permatozoa obtained after washing. If HIV-1 was not detected, IUI was performed in stimulated cycles. Main Outcome Measure(s): Human immunod eficiency Virus type 1 RNA and DNA were detected with the use of the p olymerase chain reaction technique modified for spermatozoa. Result(s) : One hundred seven semen samples were washed. Human immunodeficiency virus type 1 was not detected in 101 samples (94.4%) and was detected in 6 samples (5.6%). In the latter cases, IUI was not performed. One h undred one IUI procedures were performed in 63 women. Thirty-one pregn ancies resulted, for a pregnancy rate of 30.7% per cycle and 49.2% per inseminated woman. Thirty-seven healthy children were born. The resul ts of tests for the detection of HIV-1 and antibodies to HIV-1 in the inseminated women were negative. Conclusion(s): On the basis of these results, testing for HIV-1 with the use of the polymerase chain reacti on technique on the semen fraction obtained after washing appears to p revent infection in the inseminated woman. This method makes it possib le to help HIV-1-seropositive men to have children without infecting t heir female partners. (Fertil Steril(R) 1998;70: 35-9. (C)1998 by Amer ican Society for Reproductive Medicine.).