Laboratory for Research on Human Reproduction, Medicine Faculty and Department of Obstetrics and Gynaecology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.
Hum Reprod. 2010 Feb;25(2):374-9. doi: 10.1093/humrep/dep412. Epub 2009 Nov 26.
Until recently, only assisted reproduction was proposed to serodiscordant couples wishing to conceive. Nevertheless, recent publications have proposed unprotected sexual intercourse, targeting fertile days, for couples where antiretroviral treatment has lowered blood viral load to an undetectable level. Available data and the arguments for and against conception by safe sex versus the use of a strategy of unprotected sexual intercourse targeting fertile days are reviewed and analyzed. Although the rate of transmission of human immunodeficiency virus in serodiscordant couples in precise conditions (such as an undetectable viral load on treatment by highly active antiretroviral therapies and sexual intercourse limited to the fertile days) is very low, not zero, here we stress the various factors which can increase the risk of seroconversion in this particular population. In this context, it seems less cautious to abandon the recommendations of safe sex in serodiscordant couples desiring a child. The recourse to medically assisted procreation is advised, as long as evidence from further studies does not show that unprotected sexual intercourse, targeted to fertile days, does not have unexpected harmful consequences.
直到最近，只有辅助生殖被提议用于希望怀孕的血清不一致夫妇。然而，最近的出版物提出了无保护的性行为，针对生育日，对于那些接受抗逆转录病毒治疗已将血液病毒载量降低到无法检测水平的夫妇。本文回顾和分析了通过安全性行为受孕与使用针对生育日的无保护性行为策略的优缺点。尽管在特定条件下（例如通过高效抗逆转录病毒治疗使病毒载量无法检测和将性行为限制在生育日）血清不一致夫妇中人类免疫缺陷病毒的传播率非常低，但并非为零，在此我们强调了可能增加该特定人群血清转化风险的各种因素。在这种情况下，放弃血清不一致夫妇中安全性行为的建议似乎不太谨慎。建议求助于医学辅助生殖，只要进一步研究的证据表明，针对生育日的无保护性行为不会产生意外的有害后果。
