Objective To describe the results and the safety of assisted reproductive t
echniques (artificial insemination and in vitro fertilization with intracyt
oplasmic sperm injection (IVF-ICSI)) to assist reproduction in HIV-1 sero-d
iscordant couples.
Methods The patients were couples asking for assisted reproductive techniqu
es because the man was infected with HIV-1. The study period was from Febru
ary 1997 to December 1998. Fertility and infectious diseases in men and wom
en were evaluated. Sperm was prepared to eliminate HIV-1 viral particles an
d a polymerase chain reaction test was performed to exclude the presence of
HIV-1. Artificial insemination in stimulated cycles and IVF-ICSI were perf
ormed.
Results A total of 155 artificial insemination cycles were performed in 64
patients (2.4 cycles per patient, with a. mean number of sperm of 2.4 x 10(
6)). In all 32 pregnancies were achieved (20.6% of the cycles). The pregnan
cy rate per couple was 50% (32/64). A good pregnancy rate was observed if t
he number of motile inseminated spermatozoa was > 500 000. A total of 16 cy
cles of IVF-ICSI were performed in 11 couples; four pregnancies were achiev
ed. The pregnancy rates per replacement and per patient were 26.6% and 36.4
%, respectively. The implantation rate was 18.1%. No infection among women
or newborns was observed following artificial insemination or IVF-ICSI.
Conclusion Although female partner infection cannot completely be ruled out
, artificial insemination and IVF-ICSI after sperm preparation appear to be
safe techniques in sero-discordant couples for HIV-1.