The case for routine HIV screening before IVF treatment - A survey of UKIVF centre policies

The case for routine human immunodeficiency virus (HIV) screening of all co uples seeking assisted reproductive treatment is so strong that it should b e made obligatory for all couples entering IVF programmes to be given infor mation about HIV transmission, and offered testing. In August 1999, questio nnaires regarding routine HIV screening of couples seeking IVF treatment we re sent to the medical directors of the 74 licensed assisted conception uni ts in the UK, Of the 45 (60.8%) centres who responded, 19 (42.2%) routinely screen both partners for HIV antibodies, 25 (55.5%) do not screen and one centre selectively screens high-risk patients. There was no significant dif ference in the proportion of centres that routinely carried out screening w ith regards to the unit size: six out of 13 (46.2%) small units compared wi th 13/32 (40.6%) large units. In all, 17 centres (37.8%) rated HIV screenin g as essential, nine (20%) as desirable, 11 (24.4%) as not required, while eight (17.8%) centres did not comment. Of the 19 centres that have a routin e screening policy, 18 have management protocols in the event that the test is positive, Of these 18 centres, 12 adhere rigidly to the protocol, while five centres adhere to the protocol with few exceptions and the remaining one uses its protocol for guidance only. The main reasons for not employing routine HIV screening were: the lack of cost effectiveness, low prevalence of HIV infection in their population, necessity for and cost of counsellin g, uncertainty about the need for screening and potential delay to start of treatment.