Afternoon Symposium - LPG, SMRU, and SRBT - Assisted Reproduction for the HIV-discordant Couple
Time:4:15 pm - 6:15 pm
Location:Room 6E - San Diego Convention Center
Erma Z. Drobnis, Ph.D. (Chair), University of Missouri Women’s Health Center
Sangita K. Jindal, Ph.D., Montefiore Institute
Ann Kiessling, Ph.D., Bedford Research Foundation
John Y. Phelps, J.D., Ph.D., University of Texas Health Branch
Assisted Reproduction for the HIV-discordant Couple
Needs Assessment and Description
Due to improved treatments for human immunodeficiency
virus (HIV) infection, this disease is now viewed as a chronic
illness and many infected individuals wish to have children.
Although treatment of HIV-discordant couples, in which
the man is HIV-positive and the woman is not, is common
in other countries, with more than 4000 cycles of in vitro
fertilization (IVF) or intrauterine insemination (IUI) reported
in the literature, practitioners in the United States have
been reluctant to treat these couples. This live course
for physicians, clinicians and reproductive scientists will
review the legal, scientific and technical aspects of current
treatments available for HIV-discordant couples
At the conclusion of this session, participants should be able
- Describe why HIV-discordant couples require assisted
- Cite the risk of HIV transmission in HIV-discordant couples.
- Identify government regulations regarding treatment of
- Review methods of treating HIV-discordant couples
including identification of measures to protect patients
and clinic personnel when treating HIV-positive men in a
An HIV-discordant couple comes to your clinic for
treatment. They are married and use condoms regularly.
They have been counseled to consider donor insemination,
adoption, or remaining childless, and they remain
committed to having a genetically-related child. After the
initial workup, she is judged to be a good candidate for
intrauterine insemination (IUI). All tests for infectious diseases
are negative for both partners. His semen analysis results are
|Sperm concentration (million/mL)
|Total Sperm (million)
|Progressive Motility (%)
|Normal Morphology (%)
|Leucocyte concentration (million/mL)
He is under the treatment of an infectious disease specialist
and his viral load and CD4 counts were stable for more than
a year until 4 months ago when he discontinued his Highly
Active Antiretroviral Therapy (HAART). After participating in
this session, in my practice I will tell the patient the following
about re-starting his HAART treatment:
- He should wait to start taking HAART because it is known
to decrease sperm motility and his sperm motility is
- He should avoid HAART because this treatment is known
to cause birth defects in the children of treated fathers.
- He should re-start his HAART because it increases CD4
count, which is associated with improved semen quality.
- He should follow the advice of his infectious disease
specialist and re-start HAART if indicated for his disease.
- He should re-start his HAART to decrease the viral load
and infectivity of his semen.
- Not applicable to my area of practice.