BACKGROUND
Since 1999, we have treated HIV-positive men with sperm washing as part of a risk-reduction programme.
METHODS
Retrospective analysis of the sperm-washing database from the treatment of 245 couples with 439 cycles of intrauterine insemination assessed the effects of patient factors (age, maternal FSH, rank of attempt), markers of HIV-disease [time since diagnosis, CD4 count, viral load (VL), use of highly active antiretroviral therapy (HAART)], cycle factors (natural versus stimulated, number of follicles, fresh versus frozen sperm) and sperm parameters on clinical (CPR) and ongoing pregnancy rate (OPR).
RESULTS
Overall 111–245 (45.4%) couples achieved a clinical pregnancy (CPR: 13.5% and OPR: 9.6% per insemination) with no seroconversions. The mean duration since HIV diagnosis was 5.8 years, 73% of men were on antiretroviral therapy, there was an undetectable VL in 64% and the median CD4 was 409 cells/mm3. A significantly decreased OPR and a non-significantly increased miscarriage rate (MR) was observed after the female age of 40. Similarly, there was a significant increased OPR and decreased MR for women with a mean cycle maternal FSH of <6.4 IU/l. There was no effect of VL, CD4 count, use of HAART or time since diagnosis on the outcome. Nor was there a difference in the OPR according to paternal age, rank of attempt, cycle regime or number of follicles. Semen volume, sperm concentration, total count and progressive motility and post-wash concentration, progressive motility and total motile count inseminated were significantly higher in successful cycles. The use of frozen sperm had a significant negative impact on outcome.
CONCLUSIONS
This study of the potential safe and successful reproductive options available to HIV-positive men demonstrates that maternal age and semen quality, rather than HIV factors, remain the most important determinants of cycle success.
- World Health Organization reference values for human semen characteristics [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Economic consequences of overweight and obesity in infertility: a framework for evaluating the costs and outcomes of fertility care [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Maternal metabolism and obesity: modifiable determinants of pregnancy outcome [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Brain imaging studies of appetite in the context of obesity and the menstrual cycle [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Options for fertility preservation in prepubertal boys [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Xenografting of testicular tissue from an infant human donor results in accelerated testicular maturation [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Karyotype of miscarriages in relation to maternal weight [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Endoglandular trophoblast, an alternative route of trophoblast invasion? Analysis with novel confrontation co-culture models [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Regulation of extravillous trophoblast invasion by uterine natural killer cells is dependent on gestational age [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Functional regulation of thymic stromal lymphopoietin on proliferation and invasion of trophoblasts in human first-trimester pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Home self-administration of vaginal misoprostol for medical abortion at 50-63 days compared with gestation of below 50 days [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Prospective study of the forearm bone mineral density of long-term users of the levonorgestrel-releasing intrauterine system [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Functional attenuation of human sperm by novel, non-surfactant spermicides: precise targeting of membrane physiology without affecting structure [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- The risk of post-molar gestational trophoblastic neoplasia is higher in heterozygous than in homozygous complete hydatidiform moles [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Cumulative ongoing pregnancy rate achieved with oocyte vitrification and cleavage stage transfer without embryo selection in a standard infertility program [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Pregnancy outcome in female childhood cancer survivors [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Offering excess oocyte aspiration and vitrification to patients undergoing stimulated artificial insemination cycles can reduce the multiple pregnancy risk and accumulate oocytes for later use [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Avoidance of weekend oocyte retrievals during GnRH antagonist treatment by simple advancement or delay of hCG administration does not adversely affect IVF live birth outcomes [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Who should pay for assisted reproductive techniques? Answers from patients, professionals and the general public in Germany [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Long-term cryostorage of sperm in a human sperm bank does not damage progressive motility concentration [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Screening for biomarkers of spermatogonia within the human testis: a whole genome approach [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Avoiding transgenerational risks of mitochondrial DNA disorders: a morally acceptable reason for sex selection? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Cross border reproductive care in six European countries [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Morphometric dimensions of the human sperm head depend on the staining method used [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- ESX1 gene expression as a robust marker of residual spermatogenesis in azoospermic men [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Innovative virtual reality measurements for embryonic growth and development [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Consecutive or non-consecutive recurrent miscarriage: is there any difference in carrier status? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- A longitudinal study of contraception and pregnancies in the same women followed for a quarter of a century [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Predictors of bleeding and user satisfaction during consecutive use of the levonorgestrel-releasing intrauterine system [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Large prospective, pregnancy and infant follow-up trial assures the health of 1000 fetuses conceived after treatment with the GnRH antagonist ganirelix during controlled ovarian stimulation [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Altered aquaporin expression in women with polycystic ovary syndrome: hyperandrogenism in follicular fluid inhibits aquaporin-9 in granulosa cells through the phosphatidylinositol 3-kinase pathway [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Fast-release orodispersible tramadol as analgesia in hysterosalpingography with a metal cannula or a balloon catheter [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Xenotransplantation of cryopreserved human ovarian tissue into murine back muscle [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Predictors of psychological distress in patients starting IVF treatment: infertility-specific versus general psychological characteristics [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Psychological adjustment, knowledge and unmet information needs in women undergoing PGD [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Psychological well-being and sexarche in women with polycystic ovary syndrome [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Is human fecundity declining in Western countries? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Current achievements and future research directions in ovarian tissue culture, in vitro follicle development and transplantation: implications for fertility preservation [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Human studies on genetics of the age at natural menopause: a systematic review [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Beyond oxygen: complex regulation and activity of hypoxia inducible factors in pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Current knowledge of the aetiology of human tubal ectopic pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Economic contraction and birth outcomes: an integrative review [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Teratogenic mechanisms of medical drugs [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Levels of semenogelin in human spermatozoa decrease during capacitation: involvement of reactive oxygen species and zinc [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Apoptosis and meiotic segregation in ejaculated sperm from Robertsonian translocation carrier patients [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- In humans, zona pellucida glycoprotein-1 binds to spermatozoa and induces acrosomal exocytosis [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Variants of the EPPIN gene affect the risk of idiopathic male infertility in the Han-Chinese population [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Epidermal clitoral inclusion cysts: not a rare complication of female genital mutilation [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- PCOSMIC: a multi-centre randomized trial in women with PolyCystic Ovary Syndrome evaluating Metformin for Infertility with Clomiphene [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Single versus double intrauterine insemination in multi-follicular ovarian hyperstimulation cycles: a randomized trial [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Soluble HLA-G is an independent factor for the prediction of pregnancy outcome after ART: a German multi-centre study [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Obstetric outcomes after transfer of vitrified blastocysts [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Occasional involvement of the ovary in Ewing sarcoma [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Y chromosome microdeletions, sperm DNA fragmentation and sperm oxidative stress as causes of recurrent spontaneous abortion of unknown etiology [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Development and preliminary validation of the fertility status awareness tool: FertiSTAT [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Xenotransplantation of human ovarian tissue to nude mice: comparison between four grafting sites [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Involvement of CFTR in oviductal HCO3- secretion and its effect on soluble adenylate cyclase-dependent early embryo development [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Effect of endometriosis on the protein expression pattern of follicular fluid from patients submitted to controlled ovarian hyperstimulation for in vitro fertilization [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Activin A regulates trophoblast cell adhesive properties: implications for implantation failure in women with endometriosis-associated infertility [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Clinical significance of sperm DNA damage in assisted reproduction outcome [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Fall in implantation rates following ICSI with sperm with high DNA fragmentation [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Ultra-conservative fertility-sparing strategy for bilateral borderline ovarian tumours: an 11-year follow-up [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Fertility after autologous ovine uterine-tubal-ovarian transplantation by vascular anastomosis to the external iliac vessels [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Uterus transplantation in the baboon: methodology and long-term function after auto-transplantation [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Transfer of a selected single blastocyst optimizes the chance of a healthy term baby: a retrospective population based study in Australia 2004-2007 [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Disclosure patterns of mode of conception among mothers and fathers-5-year follow-up of the Copenhagen Multi-centre Psychosocial Infertility (COMPI) cohort [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Sperm DNA integrity in cancer patients before and after cytotoxic treatment [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Speriolin is a novel human and mouse sperm centrosome protein [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- No influence of body mass index on first trimester fetal growth [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- HLA sharing among couples appears unrelated to idiopathic recurrent fetal loss in Saudi Arabia [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- The influence of delayed blastocyst formation on the outcome of frozen-thawed blastocyst transfer: a systematic review and meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]