Olshtain-Pops Karen, Maayan Shlomo, Shufaro Yoel, Simon Alex, Srur Awad, Mador Nurit, Wolf Dana, Lorber Margalit
Clinical Microbiology and Infectious Diseases Unit, Hadassah Medical Center.
Harefuah. 2013 Apr;152(4):216-9, 246-7.
Serodiscordant couples live with the risk of HIV infection of the negative partner when attempting to become pregnant. Using density gradient centrifugation (DGC), spermatozoa can be separated from other seminal compartments. Isolated spermatozoa do not contain detectable HIV RNA. DGC followed by artificial insemination may significantly reduce the risk of infection. The Hadassah AIDS Center (HAC) has recently initiated a fertility center for serodiscordant couples.
Our patient population includes serodiscordant couples in which the male is HIV positive. The male semen is washed using the DGC procedure. Washed semen is tested for HIV by standard PCR methods. Intrauterine insemination (IUI) is attempted using the washed semen.
A total of 55 couples have registered for this procedure. This includes 16 men who have sex with men, 7 who have hemophilia and 8 couples of Ethiopian origin. The average female age is 33 years. Seven (12%) men had inadequate sperm counts and were referred for IVF. Overall, 34 semen samples were tested for HIV. Only one was found to be positive. During the procedure, 22 couples underwent at least one IUI attempt and 16 (72%) females became pregnant, 3 of them after the first IUI attempt. All women tested for HIV after IUI were found to be negative.
The pregnancy success rate during the first year of operation was 72%, similar to that reported by other centers in Europe. There were no seroconversions of the female partner. Serodiscordant couples living with HIV in Israel today may consider starting a family, while significantly reducing the risk of infecting the negative female partner.
血清学不一致的夫妇在尝试怀孕时，未感染艾滋病毒的一方存在感染风险。使用密度梯度离心法（DGC），可将精子与精液的其他成分分离。分离出的精子不含可检测到的艾滋病毒RNA。DGC后进行人工授精可能会显著降低感染风险。哈达萨艾滋病中心（HAC）最近为血清学不一致的夫妇设立了一个生育中心。
我们的患者群体包括男性为艾滋病毒阳性的血清学不一致夫妇。男性精液采用DGC程序进行洗涤。洗涤后的精液通过标准PCR方法检测艾滋病毒。尝试使用洗涤后的精液进行宫内授精（IUI）。
共有55对夫妇登记了该程序。其中包括16名男同性恋者、7名血友病患者以及8对埃塞俄比亚裔夫妇。女性的平均年龄为33岁。7名（12%）男性精子计数不足，被转诊进行体外受精。总体而言，对34份精液样本进行了艾滋病毒检测。仅发现1份呈阳性。在此过程中，22对夫妇至少尝试了一次IUI，16名（72%）女性怀孕，其中3名在首次IUI尝试后怀孕。所有在IUI后检测艾滋病毒的女性均为阴性。
运营第一年的妊娠成功率为72%，与欧洲其他中心报告的成功率相似。女性伴侣没有血清转化情况。如今，以色列感染艾滋病毒的血清学不一致夫妇在显著降低未感染女性伴侣感染风险的同时，可以考虑组建家庭。
