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Hum. Reprod. Advance Access originally published online on July 19, 2007
Human Reproduction 2007 22(9):2377-2381; doi:10.1093/humrep/dem175
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Azoospermic HIV-1 infected patients wishing to have children: proposed strategy to reduce HIV-1 transmission risk during sperm retrieval and intracytoplasmic sperm injection: Case Report

Louis Bujan1,2,6, Myriam Daudin1,2, Nathalie Moinard1,2, Pierre Plante1,2,3, Jean Parinaud4 and Christophe Pasquier5

1 Université Toulouse III Paul Sabatier, Research Group on Human Fertility, EA 3694, Toulouse, France 2 CECOS Midi-Pyrénées, Male Sterility Centre, Pôle d’Obstétrique, Gynécologie et Médecine de la Reproduction, University Hospital Paule de Viguier, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse Cedex 9, France 3 Service d’Uro-andrologie, Rangueil University Hospital, Toulouse, France 4 Reproductive Biology Unit, Pôle d’Obstétrique, Gynécologie et Médecine de la Reproduction, University Hospital Paule de Viguier, Toulouse, France 5 Laboratoire de Virologie, Purpan University Hospital, Toulouse, France

6 Correspondence address. Tel: +33 567 77 14 35; Fax: +33 567 77 10 49; E-mail: bujan.l{at}chu-toulouse.fr

BACKGROUND: To date, assisted reproductive technology (ART) with sperm washing is offered to serodiscordant couples with an human immunodeficiency virus-1 (HIV-1) infected male partner in order to have a child while reducing the risk of transmission to the woman. However, ART programmes are not possible if the man is azoospermic. We report here the first birth following intracytoplasmic sperm injection (ICSI) using frozen epididymal spermatozoa obtained after surgical sperm retrieval in a HIV-1 infected man with obstructive azoospermia.

METHODS: Sperm obtained by micro-epididymal sperm aspiration was frozen after density gradient preparation and tested for HIV-RNA and DNA. ICSI with frozen sperm was performed.

RESULTS: A twin pregnancy was obtained following ICSI. Two healthy girls were born. Maternal HIV-1 RNA and HIV-1 serology were negative during pregnancy and at delivery.

CONCLUSIONS: This case report demonstrates that ART is possible in azoospermic HIV-1 infected men. On the basis of current knowledge, we propose a strategy to reduce HIV-1 transmission risk during sperm retrieval and ICSI in couples where the man is HIV-1 infected and azoospermic.

Key words: azoospermic men/HIV/ICSI/virus/serodiscordant couples

Submitted on January 18, 2007; resubmitted on May 9, 2007; accepted on May 17, 2007.


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