Establishing a clinical program for human immunodeficiency virus 1-seropositive men to father seronegative children by means of in vitro fertilization with intracytoplasmic sperm injection.

Abstract

We assessed the safety and efficacy of providing assisted reproduction to men who are seropositive for human immunodeficiency virus type 1 (HIV-1). HIV-1-serodiscordant couples underwent in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI). Patients were screened for HIV-1 3 and 6 months after embryo transfer to determine safety. Infants and mothers were tested at delivery and at 3 months after delivery. Clinical outcomes were compared with those of matched control couples who had undergone IVF-ICSI to measure efficacy. There were no seroconversions in women (n = 34) or offspring (n = 25) after 55 embryo transfers. Treatment efficacy was similar to that for control couples: retrieved eggs (15.8 +/- 1.3 vs 12.3 +/- 0.8); fertilization rate (64.9% vs 68.0%); embryos cryopreserved (1.1 +/- 0.3 vs 0.3 +/- 0.1, P <.05); clinical pregnancies per embryo transfer (45.5% vs 35.4%); ongoing or delivered pregnancies per embryo transfer (30.9% vs 25.0%). Although findings are preliminary, IVF-ICSI provides HIV-1-serodiscordant couples with a reasonably safe means of having children because their assisted reproduction performance is similar to that of conventional patients.