Henrion R, Mandelbrot L, Firtion G, Crémieux N, Henrion-Géant E
Clinique Universitaire Port-Royal, Paris.
Contracept Fertil Sex. 1993 Mar;21(3):217-21.
Growing numbers of women and men who are HIV infected and aware of their serostatus, want to have children. Gynecologists are involved in the dilemmas of counseling those couples about reproductive decisions. For HIV infected women, pregnancy is contra-indicated, mostly because of the risk of transmission to the fetus/infant. However, no rational argument can abolish the desire of many young women to have children in the face of the life-threatening infection. The clinical and immune status of the would-be mothers, her partner's serostatus and the availability of family members to rear an orphaned child, must be considered. For seronegative women with HIV-infected partners, after confirming that seroconversion is not occurring, the partner's clinical and immune status must be evaluated. The risk of transmission through unprotected intercourse increases with the degree of immune suppression in the partner. The couple's stability and the woman's motivations for becoming pregnant must also be carefully evaluated. About one third of such discordant couples separate after the birth of their child. For selected couples who have clearly decided to attempt pregnancy, the objective of reproductive counseling is to reduce their risk of heterosexual transmission. The partner's sperm should not be used for insemination because techniques have not yet been established to eliminate HIV from sperm preparations. Insemination with HIV-negative donors' sperm can be considered. An alternative is the "natural" method, consisting in having unprotected intercourse only during ovulation. Administration of zidovudine to the man in order to reduce the amount of virus excreted has been discussed.(ABSTRACT TRUNCATED AT 250 WORDS)
越来越多知晓自身感染艾滋病毒的男女想要孩子。妇科医生在为这些夫妇提供有关生育决策的咨询时面临诸多困境。对于感染艾滋病毒的女性，怀孕是禁忌的，主要是因为存在将病毒传播给胎儿/婴儿的风险。然而，面对这种危及生命的感染，许多年轻女性想要孩子的愿望是无法用理性的论据消除的。必须考虑准母亲的临床和免疫状况、其伴侣的血清学状态以及家庭成员抚养孤儿的能力。对于伴侣感染艾滋病毒但自身血清学阴性的女性，在确认不会发生血清转化后，必须评估其伴侣的临床和免疫状况。通过无保护性交传播病毒的风险会随着伴侣免疫抑制程度的增加而上升。还必须仔细评估这对夫妇关系的稳定性以及女性怀孕的动机。大约三分之一的这类血清学不一致的夫妇在孩子出生后会分开。对于那些明确决定尝试怀孕的特定夫妇，生育咨询的目的是降低他们异性传播的风险。不应使用伴侣的精子进行授精，因为尚未建立从精子制剂中消除艾滋病毒的技术。可以考虑使用艾滋病毒阴性供体的精子进行授精。另一种选择是“自然”方法，即仅在排卵期间进行无保护性交。已经讨论过让男性服用齐多夫定以减少病毒排出量的问题。（摘要截取自250字）
