ASRM: HIGHLIGHTS IN FERTILITY AND STERILITY

At the Columbia University Medical Center, 420 cycles of IVF with intracytoplasmic sperm injection (ICSI) for HIV-positive men and their HIV-negative partners, have resulted in the births of 170 babies with no instances of HIV transmission to mothers or infants.

From January 1, 1998 through December 31, 2007, 128 sero-discordant couples used the procedure in 347 cycles that progressed to embryo transfer and resulted in 134 deliveries and on-going pregnancies.
Mark Sauer, MD and his colleagues report that the use of this service has expanded markedly since their first report in 2002 which contained data on just 25 couples. The following five years saw an additional 152 sero-discordant couples initiating treatment.

Although HIV-positive prospective parents are counseled about other options, such as adoption and donor sperm, many want to have a genetically related child. IVF with ICSI appears to be the safest way for them to accomplish that goal. The procedure incorporates sperm-washing and, by using just one sperm per egg, further minimizes the egg’s contact with seminal plasma and the leucocytes found in semen. And because only the embryo is transferred, the woman is never directly exposed to the man’s biological material.

David Adamson, MD, President of ASRM comments, “Columbia’s program has shown us that good screening and counseling, attentive patient treatment, collaboration with infectious disease specialists and meticulous lab work preserve health and create families. They show us, too how it is absolutely possible to expand access to ART services for HIV-positive patients.”

Sauer et al, Providing fertility care to men seropositive for human immunodeficiency virus: Reviewing 10 years of experience and 420 consecutive cycles of in vitro fertilization and intracytoplasmic sperm injection, Fertility and Sterility.

DNA From Herpes Family Viruses Frequently Found In Sperm And Seminal Fluid Of Asymptomatic Men

Researchers at the University of Crete, in Greece, have found evidence of relatively high percentages of infection with viruses of the herpes family in the sperm and seminal fluid of men with normal semen samples as well as men with abnormal semen samples.

To investigate the prevalence and effects of herpes viruses in the semen of asymptomatic men, they tested samples from 172 patients who had undergone routine semen analysis for seven viruses of the herpes family. Eighty patients had normal semen parameters and 92 had abnormal parameters (density, motility, morphology). None of the patients or their spouses reported any genital herpes infections in their medical histories.

Viral DNA from at least one member of the herpes virus family was detected in 143 of the 172 samples (83.1%). Infection with one or more virus type was not associated with normal or abnormal semen analysis. High concentrations of white blood cells were found in semen samples infected with the Epstein Barr virus, although no statistical association was established.

Departing from the methodology of previous studies, the researchers tested the sperm and seminal fluid from each sample separately. Viral DNA was detected at high levels in both semen components and at variable frequencies for each virus when spermatozoa and seminal fluid were compared. For example, cytomegalovirus (CMV) was found in the sperm of 51.7% of samples and in the seminal fluid of 38.3% of samples.

“This study provides a great jumping-off point for further research. It is important to remember that the prevalence of viruses in the herpes family in the general population is quite high. Although the presence of these viruses appears not to impact semen analysis parameters, we need further investigations into whether and how the virus might affect sperm function,” remarked Jay Sandlow, MD, President of the Society for Male Reproduction and Urology, an ASRM affiliate.

Neofytou et al, Prevalence of human herpes virus types 1-7 in the semen of me n attending an infertility clinic and correlation with semen parameters, Fertility and Sterility.

Education, Income Levels, Insurance Affect IVF Availability And Use In The United States

Large disparities exist between states in the availability of in vitro fertilization and its utilization. Seeking to describe these disparities, researchers from the Utah School of Medicine used publicly available data to quantify IVF availability and use in the United States as well as to identify underlying demographics.

Fertility clinics reported to the Centers for Disease Control that in 2005, 1,031 physicians performed 98,242 fresh IVF cycles. Based on estimates of the US population of women between 25 and 44, the 2005 national IVF availability was 2.5 physicians for every 100,000 reproductive-age women and IVF utilization was 236 fresh IVF cycles per 100, 000 reproductive-age women.

When availability and utilization were broken down state by state and correlated with other demographic data, it was found that states having insurance mandates for IVF coverage, higher median income, and a higher percentage of single people had significantly greater IVF availability and that IVF utilization was predicated on how urbanized the state was, whether there was IVF availability and the percentage of population 25 and older with bachelor’s degrees.

Hammoud et al, In vitro fertilization availability and utilization in the United States: a study of demographic, social, and economic factors, Fertility and Sterility.

The American Society for Reproductive medicine, founded in 1944, is an organization of more than 8,000 physicians, researchers, nurses, technicians, and other professionals dedicated to advancing knowledge and expertise in reproductive biology. Affiliated societies include the Society for Assisted Reproductive Technology, the Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, and the Society of Reproductive Surgeons.

Fertility and Sterility, ASRM’s peer-reviewed journal, is now available on-line.

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HIGHLIGHTS IN FERTILITY AND STERILITY Vol. 89, No. 6, June 2008

Ten Years Of Experience Shows IVF With ICSI Is Safe And Effective For HIV-Positive Men And Their Partners

DNA From Herpes Family Viruses Frequently Found In Sperm And Seminal Fluid Of Asymptomatic Men

Education, Income Levels, Insurance Affect IVF Availability And Use In The United States

HIGHLIGHTS IN FERTILITY AND STERILITY
Vol. 89, No. 6, June 2008