Arti Barnes1, Daniel Riche2, Leandro Mena1, Thérèse Sison3, Lauren Barry4, Raveena Reddy5, James Shwayder4, John Preston Parry6. 1. Division of Infectious Diseases, Department of Medicine, University of Texas, Southwestern, Dallas, Texas. 2. Department of Pharmacy Practice, University of Mississippi Medical Center, Jackson, Mississippi. 3. University of Mississippi Medical School, Jackson, Mississippi. 4. Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi. 5. Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi. 6. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Mississippi Medical Center, University of Mississippi, Jackson, Mississippi. Electronic address: fertility@umc.edu.
Abstract
OBJECTIVE: To assess procreative outcomes for HIV-positive men and women with seronegative partners. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Twenty-four studies with extractable data for HIV-serodiscordant couples undergoing intrauterine insemination (IUI) or in vitro fertilization (IVF). INTERVENTION(S): None. PRIMARY OUTCOMES: HIV transmission to a seronegative partner and per cycle fecundability; secondary outcomes: analysis of multiple gestation rates, miscarriage rates, and cancellation rates. RESULT(S): For serodiscordant couples, HIV-positive men or women undergoing IUI and IVF treatment had a 17%, 30%, 14%, and 16% per cycle fecundability, respectively. Multiple gestation rates were 10%, 33%, 14%, and 29%, respectively. Miscarriage rates were 19%, 25%, 13%, and 20%, respectively. No HIV transmission was observed in 8,212 IUI and 1,254 IVF cycles, resulting in 95% confidence that the true rate is 4.5 transmissions per 10,000 IUI cycles or less. CONCLUSION(S): In serodiscordant couples, IUI and IVF seem effective and safe based on the literature. Evidence-based practice and social justice suggest that our field should increase access to care for HIV-serodiscordant couples. Published by Elsevier Inc.
OBJECTIVE: To assess procreative outcomes for HIV-positive men and women with seronegative partners. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Twenty-four studies with extractable data for HIV-serodiscordant couples undergoing intrauterine insemination (IUI) or in vitro fertilization (IVF). INTERVENTION(S): None. PRIMARY OUTCOMES: HIV transmission to a seronegative partner and per cycle fecundability; secondary outcomes: analysis of multiple gestation rates, miscarriage rates, and cancellation rates. RESULT(S): For serodiscordant couples, HIV-positive men or women undergoing IUI and IVF treatment had a 17%, 30%, 14%, and 16% per cycle fecundability, respectively. Multiple gestation rates were 10%, 33%, 14%, and 29%, respectively. Miscarriage rates were 19%, 25%, 13%, and 20%, respectively. No HIV transmission was observed in 8,212 IUI and 1,254 IVF cycles, resulting in 95% confidence that the true rate is 4.5 transmissions per 10,000 IUI cycles or less. CONCLUSION(S): In serodiscordant couples, IUI and IVF seem effective and safe based on the literature. Evidence-based practice and social justice suggest that our field should increase access to care for HIV-serodiscordant couples. Published by Elsevier Inc.
Authors: Ashley A Leech; James F Burgess; Meg Sullivan; Wendy Kuohung; Michal Horný; Mari-Lynn Drainoni; Cindy L Christiansen; Benjamin P Linas Journal: AIDS Date: 2018-11-28 Impact factor: 4.177
Authors: Maryam Zafer; Hacsi Horvath; Okeoma Mmeje; Sheryl van der Poel; Augusto E Semprini; George Rutherford; Joelle Brown Journal: Fertil Steril Date: 2015-12-11 Impact factor: 7.329