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CARS Archives



AIDS and Assisted Reproduction
Title: Assisted reproduction for couples infected with the human immunodeficiency virus type 1
Author: D. Anderson, et al.
Address: Boston, MA
Source: Fertility and Sterility 72: 592-594 (October) 1999
Summary:In 1990, the Centers for Disease Control issued a recommendation against insemination with semen from men infected with human immunodeficiency virus (HIV). Soon after, the American Society for Reproductive Medicine (ASRM) issued guidelines against the provision of assisted reproductive technology (ART) services to HIV-infected individuals or couples. This author argues that the ASRM needs to review and reconsider their position. One physician recently reported that he had performed 1,585 inseminations of HIV-infected partners' sperm in 513 HIV-negative women and achieved 228 pregnancies. Another physician reported that after 101 IUI procedures in 63 seronegative women, 31 pregnancies were achieved. There have been no reported seroconversions in either clinic. A recent study examining seroconversion in 92 HIV-discordant couples who practiced repeated unprotected intercourse for the purpose of conceiving reported 4 seroconversions (5%), which is significantly higher than the rate reported by the European ART clinics (P<.001). The author suggests that ART services should be offered to HIV-1-discordant couples at a limited number of research-intensive centers that have outstanding clinical success rates and mechanisms in place carry out rigorous research protocols. Ultimately, these protocols should be simple enough to be used in community health care centers and fertility clinics in developing countries.
Comment: Clinic rights, patient rights, societal rights -- what is right?

 

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