Management guidelines for assisted reproduction in the HIV infected couple

Abstract

Human immunodeficiency virus (HIV) is a chronic disease that mostly affects individuals of reproductive age. Many of these individuals express the desire to have their own biological children. The two major ethical concerns remain the welfare of the offspring and the avoidance of seroconversion of the uninfected partner. Currently the life expectancy of an HIV infected individual is estimated at 20 years from the time of diagnosis. Today HIV treatments and practices can limit the risk of viral transmission to the offspring and uninfected partner. A multidisciplinary team approach and pre-conceptual counselling always remains mandatory in the management of these couples. Treatment should be individualised depending on which partner is affected and the underlying cause of infertility. Three scenarios are possible with regard to HIV status: positive female partner and negative male partner, negative female partner and positive male partner and both partners positive. These options will be discussed further. Health care facilities should thus, if it is economically and technically feasible, aim to offer fertility services to HIV infected individuals and discordant couples who are willing to use risk reducing treatment modalities.

Keywords: Assisted Reproduction; HIV serodiscordant and Concordant couples