Author/Authors :
Molina، Irene نويسنده Human Reproduction Unit, Clinical Management Unit for Obstetrics and Gynaecology, Virgen de las NievesUniversity Hospital, Granada Institute for Healt , , Carmen Gonzalvo، Mar?a del نويسنده Human Reproduction Unit, Clinical Management Unit for Obstetrics and Gynaecology, Virgen de las NievesUniversity Hospital, Granada Institute for Healt , , Clavero، Ana نويسنده Human Reproduction Unit, Clinical Management Unit for Obstetrics and Gynaecology, Virgen de las NievesUniversity Hospital, Granada Institute for Healt , , L?pez-Ruz، Miguel ?ngel نويسنده Infectious Disease Unit, Internal Medicine Service, Virgen de las Nieves University Hospital, Granada, Spain , , Mozas، Juan نويسنده Human Reproduction Unit, Clinical Management Unit for Obstetrics and Gynaecology, Virgen de las NievesUniversity Hospital, Granada Institute for Healt , , Pasquau، Juan نويسنده Infectious Disease Unit, Internal Medicine Service, Virgen de las Nieves University Hospital, Granada, Spain , , Sampedro، Antonio نويسنده Microbiology Service, Virgen de las Nieves University Hospital, Granada, Spain , , Mart?nez، Luis Mariano Cerca نويسنده , , Antonio Castilla، José نويسنده Human Reproduction Unit, Clinical Management Unit for Obstetrics and Gynaecology, Virgen de las NievesUniversity Hospital, Granada Institute for Healt ,
Abstract :
Background: Assisted reproductive technology (ART) with washed semen can
achieve pregnancy with minimal risk of horizontal and vertical transmission of
chronic viral diseases (CVD) such as human immunodeficiency virus (HIV), hepatitis
C virus (HCV) and hepatitis B virus (HBV) among serodiscordant couples. However,
few studies have been made of the use made by these couples of ARTs or of the
obstetric results achieved.
Materials and Methods: In this retrospective study, 93 men who were seropositive for
HIV, HCV or HBV and who underwent assisted reproduction treatment at our centre
(Hospital Universitario Virgen de las Nieves, Granada, Spain) were included. Washed
semen was tested to detect viral particles. Non-infected women were tested before and
after each treatment, as were the neonates at birth and after three months.
Results: A total of 62 sperm samples were washed, and none were positive for the detection
of viral molecules. Semen samples from 34 HBV positive males were not washed
since the female partner had immunity to hepatitis B. In total, 38 clinical pregnancies
were achieved (22% per cycle and 40.9% per couple) out of 173 cycles initiated, and 28
births were achieved (16.2% per cycle and 30.1% per couple), producing 34 live births.
The rate of multiple pregnancies was 21.4%. Obstetric and neonatal results were similar
in the groups of couples studied. At follow-up, no seroconversion was detected in the
women or neonates.
Conclusion: Sperm washing and intracytoplasmic sperm injection are shown to be
a safe and effective option for reducing the risk of transmission or super infection
in serodiscordant or concordant couples who wish to have a child. Pregnancies obtained
by ART in couples when the male is CVD infected achieve good obstetric
and neonatal results.
