Hum. Reprod. Advance Access originally published online on August 19, 2004
Human Reproduction 2004 19(11):2581-2586; doi:10.1093/humrep/deh460
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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
1 IVI Valencia, Valencia, 2 FIVI, (Fundación IVI) Valencia, 3 Departments of Paediatrics, Obstetrics and Gynaecology, Valencia University School of Medicine, Valencia and 4 Department of Obstetrics and Gynecology Hospital Dr Peset, Valencia, Spain
5 To whom correspondence should be addressed at: Instituto Valenciano de Infertilidad, Andrology Laboratory and Semen Bank; Plaza de la Policía Local 3, Valencia 46015, Spain. Email: nicolas.garrido{at}ivi.es
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.
Key words: HCV/HIV/ICSI/nested PCR/semen wash/serodiscordant
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