Bujan Louis, Sergerie Martin, Kiffer Nicolas, Moinard Nathalie, Seguela Geneviève, Mercadier Brigitte, Rhone Pascale, Pasquier Christophe, Daudin Myriam
Université Toulouse-III Paul Sabatier, EA 3694, Research Group on Human Fertility, France.
Eur J Obstet Gynecol Reprod Biol. 2007 Nov;135(1):76-82. doi: 10.1016/j.ejogrb.2007.04.011. Epub 2007 Jun 1.
Assisted reproduction techniques can minimize the risk of HIV female contamination when the male partner is HIV-infected. The aim of this study was to investigate the efficiency of sperm washing and intrauterine insemination (IUI) in these couples.
Retrospective comparative study. Eighty-four HIV-1 serodicordant couples underwent 294 IUI. The control group was composed of 90 couples (320 IUI cycles) with donor sperm. Spermatozoa from HIV-1 infected male partner were prepared and tested for HIV-1 according to sperm washing method. Spermatozoa from HIV-1 and donor male were frozen before IUI. IUI were performed after ovarian stimulation. Main outcomes measures were pregnancy rate per cycle and baby take-home rate per couples.
Although the pregnancy rate and baby take-home rate were higher in IUI with sperm washing than in IUI using donor sperm (18.0 versus 14.7 and 52.4 versus 41.1, respectively), the differences were not statistically significant. In serodiscordant couples, blood estradiol levels under ovarian stimulation and total motile sperm inseminated were a determining factor in achieving pregnancy. No female HIV-1 contamination occurred.
This study demonstrates that sperm washing and IUI are highly effective in enabling serodiscordant couples with an HIV-1 infected male partner to have a child.
当男性伴侣感染艾滋病毒时,辅助生殖技术可将艾滋病毒感染女性的风险降至最低。本研究的目的是调查这些夫妇中精子洗涤和宫内人工授精(IUI)的有效性。
回顾性比较研究。84对艾滋病毒-1血清学不一致的夫妇接受了294次宫内人工授精。对照组由90对夫妇(320个宫内人工授精周期)组成,使用供体精子。根据精子洗涤方法,对来自艾滋病毒-1感染男性伴侣的精子进行制备并检测艾滋病毒-1。来自艾滋病毒-1感染男性和供体男性的精子在宫内人工授精前进行冷冻。在卵巢刺激后进行宫内人工授精。主要观察指标为每个周期的妊娠率和每对夫妇的活产率。
尽管精子洗涤宫内人工授精的妊娠率和活产率高于使用供体精子的宫内人工授精(分别为18.0对14.7和52.4对41.1),但差异无统计学意义。在血清学不一致的夫妇中,卵巢刺激下的血雌二醇水平和授精的总活动精子数是实现妊娠的决定性因素。未发生女性艾滋病毒-1感染。
本研究表明,精子洗涤和宫内人工授精对于使男性伴侣感染艾滋病毒-1的血清学不一致夫妇生育孩子非常有效。