EVALUATION OF THE EFFICIENCY OF MEDICAL CARE FOR HIV-DISCORDANT COUPLES

Objective. To study whether reproductive function can be realized in HIV-discordant couples. Subjects and methods. Thirty-five HIV-discordant couples (the man was infected in 26 couples and the woman in 9) signed the informed consent form; they underwent the infection screening and reproduction function evaluation. Ejaculates were treated. The resulting live sperm suspensions were divided into 2 portions. One portion was tested for HIV infection; the other was cryopreserved. Either intrauterine insemination (IUI) or in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI) was performed if a negative result was obtained from the reference laboratory. Results. The discordant couples where only the man was infected underwent 17 IUIs and 10 IVF/ICSI cycles. Only one of 8 women got pregnant and gave birth after IUI. Following IVF/ICSI, 8 of 9 patients got pregnant; one gave birth, and 7 continued their pregnancy. The discordant couples where only the woman was infected received 4 IUIs and 3 IVF/ICSI cycles. After IUI, one of 3 patients got pregnant and gave birth to a baby whose HIV status could not be ascertained. Following IVF/ICSI, one of 3 patients got pregnant and gave birth to a baby whose HIV status was negative. Conclusion. The experience with HIV-discordant couples in the Chelyabinsk Center for Family Planning and Reproduction has shown that the use of different methods of assisted reproductive technology is not accompanied by a risk for infection in a partner and hence such couples should be provided with an access to reproductive care.

HIV-discordant couples, intrauterine insemination, IVF/ICSI