Women Infected with HIV Type 1 Have Poorer Assisted Reproduction Outcomes
OBJECTIVE:
To
compare the efficacy of assisted reproductive technology (ART) in women
infected with human immunodeficiency virus type 1 (HIV-1) versus HIV-negative
controls.
INTERVENTION(S):
Ovarian
stimulation, oocytes retrieval, standard in vitro fertilization (IVF) or
intracytoplasmic sperm injection, embryo transfer.
MAIN OUTCOME MEASURE(S):
Clinical
pregnancies and live-birth rates.
RESULT(S):
After
oocyte retrieval, all women infected with HIV-1 infected were matched 1:1 to
HIV-negative controls according to the following criteria: date of ART attempt,
age, parity, main cause of infertility, ART technique, and rank of attempt.
Only the first IVF cycle during the study period was considered for each
couple. We found no statistically significant differences between the two
groups for ovarian stimulation data, fertilization rate, or average number of
embryos transferred. The clinical pregnancy rate per transfer was statistically
significantly lower for the cases compared with the controls (12% vs. 32%), as
were the implantation rate (10% vs. 21%) and the live-birth rate (7% vs. 19%).
CONCLUSION(S):
In
one of the largest studies to pair six factors that influence the results of
ART, HIV infection in women was associated with poorer outcomes after ART.
These results suggest that women with controlled HIV-1-infection should be
counseled not to delay ART in cases of self-insemination failure or other
causes of infertility. Fertility preservation by vitrification of oocytes in
women whose pregnancy should be delayed may be an important future
consideration.
By: Stora C1, Epelboin S2, Devouche E1, Matheron S1, Epelboin L1, Yazbeck C1, Damond F1, Longuet P1, Dzineku F1, Rajguru M1, Delaroche L1, Mandelbrot L1,Luton D1, Patrat C1.
- 1Centre d'Assistance Médicale à la Procréation, Service de Gynécologie-Obstétrique, Hôpital Bichat-Claude Bernard, Paris, France.
- 2Centre d'Assistance Médicale à la Procréation, Service de Gynécologie-Obstétrique, Hôpital Bichat-Claude Bernard, Paris, France. Electronic address: sylvie.epelboin@aphp.fr.
- Fertil Steril. 2016 Jan 19. pii: S0015-0282(16)00004-2. doi: 10.1016/j.fertnstert.2015.12.138.
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