הפריה ו- HIV , אנא ענה לשאלתי

ניתן לטפל בעזרת זרע של גבר נושא HIV, אך מקובל לעשות זאת בעזרת הפריה, שמאפשרת שטיפה טובה יותר של השרמה ובידוד טוב יותר של הזרע. אפשר לבחור את מין העבור אם יש לכך סיבה רפואית. יש בהחלט סיכון מוגבר להריון מרובה עוברים. Report of the results of a 2 year programme of sperm wash AND ICSI treatment for human immunodeficiency virus AND hepatitis C virus serodiscordant couples. Hum Reprod. 2004 Aug 19 Garrido N, Meseguer M, Bellver J, Remohi J, Simon C, Pellicer A. IVI Valencia, Valencia, Spain; FIVI, (Fundacion IVI) Valencia, Spain. BACKGROUND: Human immunodeficiency virus (HIV) AND hepatitis C virus (HCV) serodiscordant couples with the male infected can be helped to have children minimizing the transmission risk. Our aim was to evaluate the results of our assisted reproduction programme for these couples AND to develop adequate strategies for their management. METHODS: Members of serodiscordant couples: (i) HIV positive males attending our centre for sperm wash AND assisted reproduction AND (ii) HCV positive males needing assisted reproduction for infertility provided 134 semen samples for sperm wash. Before ICSI treatment, semen was confirmed to be negative for viral presence by reverse transcription AND nested PCR after the sperm wash. RESULTS: Sperm washes were effective in 90% of the samples. Regardless of the type of infection, no differences were found in semen quality, embryos obtained AND pregnancy rates (40-48% per cycle). To date, 41 pregnancies AND 23 newborns were obtained. Fertilization rates were lower in HCV than in HIV serodiscordant couples (59.3+/-5.3% versus 72.0+/-8.1%), probably because they were infertile couples for whom we recommended sperm wash AND PCR. No seroconversion was detected in the patients' follow-up. CONCLUSIONS: To date, sperm wash, nested PCR AND ICSI is a safe AND effective procedure that avoids HIV AND HCV transmission with reasonable pregnancy rates, AND is cost-effective Assessing the clinical utility of in vitro fertilization with intracytoplasmic sperm injection in human immunodeficiency virus type 1 serodiscordant couples: report of 113 consecutive cycles. Fertil Steril. 2003 Aug;80(2):356-62. Pena JE, Thornton MH, Sauer MV. Department of Obstetrics AND Gynecology, Division of Reproductive Endocrinology, Columbia-Presbyterian Medical Center, Columbia University College of Physicians AND Surgeons, New York, New York 10032, USA. OBJECTIVE: To assess the utility AND safety of in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) in human immunodeficiency virus-1 (HIV-1) serodiscordant couples. DESIGN: Retrospective study. SETTING: University-based practice. PATIENT(S): HIV-1 seropositive men AND seronegative women undergoing IVF-ICSI.IVF-ICSI, HIV testing of female partner AND infants. MAIN OUTCOME MEASURE(S): IVF performance, pregnancy rates, AND HIV-1 seroconversion rate. RESULT(S): We initiated 113 IVF cycles in 61 serodiscordant couples. Due to poor ovarian response, 11.5% of cycles were canceled. The number of oocytes collected per retrieval was 17.11 +/- 9.52 (2 to 47), yielding 13.90 +/- 8.12 (1 to 42) mature oocytes suitable for ICSI, AND 9.34 +/- 5.45 (0 to 24) normal fertilized oocytes. We transferred 3.54 +/- 1.09 (1 to 6) embryos. The overall clinical pregnancy rate was 44.8% per embryo transfer (ET); ongoing/delivered pregnancy rate was 36.5% per ET, with a 57.1% multiple gestation rate. Cumulatively, 50.8% of couples achieved a successful pregnancy through IVF-ICSI, 54.1% when including frozen ET cycles. There were no HIV-1 seroconversions in patients OR delivered babies. CONCLUSION(S): HIV-1 serodiscordant couples who undergo IVF-ICSI to avoid disease transmission experience high rates of success, but also encounter complications from assisted reproductive technology similar to traditional patients. The best candidates appear to be younger women without strong risk factors for ovarian hyperstimulation syndrome.