Reproductive treatment of HIV-1 discordant couples

The total number of people living with HIV had reached 39.5 million. In developed countries, the major risk for HIV transmission is by heterosexual intercourse. The general conditions and life expectancy of many patients with HIV infection are very good, and three-quarters of these individuals are in their reproductive years. For these reasons, a significant percentage of young couples with HIV in one partner can be expected to make plans for the future and to desire children. Clinicians practicing assisted reproduction should become familiar with guidelines for care in HIV-1 discordant couples in order to prevent HIV-1 transmission. Recent findings: The main themes covered by this chapter include: epidemiology of HIV-1 in the world; biology of the virus and its presence in the various parts of the sperm; recently published guidelines from the American Society for Reproductive Medicine; ethics and recommendations concerning assisted reproduction in people infected by virus; and clinical practices and evidence-based guidelines that allow assisted reproduction in HIV-serodiscordant couples. Summary: This chapter will review the safety, counselling points, and outcomes of HIV-1 serodiscordant couples undergoing assisted reproduction with sperm washing and other advanced reproductive technologies used to prevent HIV transmission in our center.