Assisted Reproductive Technology for Men and Women Infected with Human Immunodeficiency Virus Type 1

Al-Khan, Anthony; Colon, J; Palta, Vidya; Bardeguez, Arlene

doi:10.1086/344955

Cited by 18 publications

(13 citation statements)

References 40 publications

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“…Semen is centrifuged to separate live sperm (which do not carry HIV) from seminal plasma and non-germinal cells (which may carry HIV) and then inseminated into the female partner at the time of ovulation. This practice is well supported by the literature, which is extensive [12,[61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. In technical terms, sperm washing involves centrifuging ejaculated semen in a 40% to 80% colloidal silica density gradient to separate progressively motile HIV-free sperm from non-sperm components and seminal plasma, which remain in the supernatant.…”

Section: Sperm Washingmentioning

confidence: 99%

Canadian HIV Pregnancy Planning Guidelines

Loutfy

Margolese

Money

et al. 2012

Intl J Gynecology & Obste

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Objective Four main clinical issues need to be considered for HIV‐positive individuals and couples with respect to pregnancy planning and counselling: (1) pre‐conceptional health; (2) transmission from mother to infant, which has been significantly reduced by combined antiretroviral therapy; (3) transmission between partners during conception, which requires different prevention and treatment strategies depending on the status and needs of those involved; and (4) management of infertility issues. The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist HIV‐positive individuals and couples with their fertility and pregnancy planning decisions. These guidelines are evidence‐ and community‐based and flexible, and they take into account diverse and intersecting local/population needs and the social determinants of health. Outcomes Intended outcomes are (1) reduction of risk of vertical transmission and horizontal transmission of HIV, (2) improvement of maternal and infant health outcomes in the presence of HIV, (3) reduction of the stigma associated with pregnancy and HIV, and (4) increased access to pregnancy planning and fertility services. Evidence PubMed and Medline were searched for articles published in English or French to December 20, 2010, using the following terms: “HIV” and “pregnancy” or “pregnancy planning” or “fertility” or “reproduction” or “infertility” or “parenthood” or “insemination” or “artificial insemination” or “sperm washing” or “IVF” or “ICSI” or “IUI.” Other search terms included “HIV” and “horizontal transmission” or “sexual transmission” or “serodiscordant.” The following conference databases were also searched: Conference on Retroviruses and Opportunistic Infections, International AIDS Conference, International AIDS Society, Interscience Conference on Antimicrobial Agents and Chemotherapy, the Canadian Association of HIV/AIDS Research, and the Ontario HIV Treatment Network Research Conference. Finally, a hand search of key journals and conferences was performed, and references of retrieved articles were reviewed for additional citations. Subsequently, abstracts were categorized according to their primary topic (based on an outline of the guidelines) into table format with the following headings: author, title, study purpose, participants, results and general comments. Finally, experts in the field were consulted for their opinions as to whether any articles were missed. Values The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table) and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines. Sponsors The Society of Obstetricians and Gynecologists of Canada, Women and HIV Research Program, Women's College Research Institute, Women's College Hospital, ...

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Section: Sperm Washingmentioning

confidence: 99%

Canadian HIV Pregnancy Planning Guidelines

Loutfy

Margolese

Money

et al. 2012

Intl J Gynecology & Obste

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“…This indicated the importance of HIV/AIDS in HIV-positive people's consideration of whether to carry their desire through. It is also notable that historically the medical community has considered HIV a serious barrier to reproduction and has advised and counselled HIV-positive people accordingly (Al-Khan et al, 2003). This view in the medical fraternity was not limited to the West.…”

Section: Introductionmentioning

confidence: 99%

Considering childbearing in the age of highly active antiretroviral therapy (HAART): Views of HIV-positive couples

Ndlovu

2009

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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Objectives : Based on a qualitative study conducted in Bulawayo, Zimbabwe, this article examines how the availability of HAART since April 2004 may impact the views and choices of HIV-positive couples on childbearing. Methods : In-depth interviews were conducted with 15 couples where at least one partner was HIV positive. All respondents were of reproductive age and had or were confronting reproductive and sexual decision-making. Results : HAART seems to have had a profound impact on the subject of childbearing among those who still desire to have children. Where hitherto individuals had only a desire for a child many are now, as a result of the availability of HAART, actively planning to have one. HAART has not only transformed their physical state but it has also transformed mostly what had been desire into intention. The impact, however, has not been uniform. Some respondents still desired to have a child but were not yet convinced about the efficacy of HAART in preventing vertical transmission. Some respondents felt that HAART may have a negative impact on the foetus and as such were against childbearing by HIV-positive people. No respondent indicated that their desire or intention to have a child had been extinguished by the advent of HAART. Conclusion : Based on the findings of the study, HAART seems to have had a differential but nonetheless significant role in the reproductive plans of HIV-positive couples. The study also notes that there is a need to make available complete and unbiased information on HAART, mother-to-child transmission risk (MTCT) and pregnancy to HIV-positive couples so as to enable them to make informed decisions.

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“…L'AMP à risque viral est pratiquée en France depuis 1999, parallèlement cette activité s'est développée en Europe, notamment en Italie où les premiers couples sérodifférents pour le VIH ont été pris en charge dès 1992 [43][44][45] et plus récemment au États-Unis [46]. De nombreux couples sérodifférents où l'homme est infecté par le VIH ont été pris en charge avec succès aboutissant à la conception de plusieurs centaines d'enfants sans aucun cas rapporté à ce jour de contamination de la mère ou de l'enfant [43][44][45]47,48].…”

Section: Resultsunclassified