Human Reproduction, Vol. 16, No. 7, 1309-1315,
July 2001
© 2001 European Society of Human Reproduction and Embryology
ART in HIV-infected couples
Has the time come for a change of attitude?
1 Fertility clinic and IVF centre of the Université Libre de Bruxelles, 2 Immunodeficiency treatment unit and 3 AIDS Reference Laboratory of the Free University of Brussels (ULB), Brussels, Belgium
Today, in developed countries, many HIV-infected people remain in good health thanks to antiviral medication. A growing number of them want to have children. Medical possibilities for preventing contamination of the partners of seropositive men, through assisted reproduction, and of children thanks to antiviral medicines during pregnancy, are summarized. These changes result in ethical considerations which lead the authors to question the conventional systematic medical advise against pregnancy and has encouraged them to assist reproduction for a number of these couples. Today, the balance between the importance of the message of prevention and the benefit for patients of being assisted in their desire for a child has tilted towards medical intervention. It would seem legitimate today to intervene in the most favourable situations rather than see these couples take the risk of spontaneous conception outside health care structures. This implies the need to adapt medical structures (separate laboratory, appropriate procedure, precise protocols). This approach, which is coherent from the scientific point of view, respects both the autonomy of people carrying HIV as well as the essential interests of the child, in being born uninfected, and also has the enormous advantage of allowing access to parenthood without destroying the consistency of the message of prevention of sexual contamination.
Key words: assisted reproduction/HIV infection/ICSI/sexual transmission/vertical transmission
4 To whom correspondance should be addressed at: Hôpital Erasme, Route de Lennik 808, 1070 Brussels, Belgium. E-mail: ferticlin{at}med.ulb.ac.be
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