Case Series of Fertility Treatment in HIV-Discordant Couples (Male Positive, Female Negative) The Ontario Experience 英文参考文献.docVIP

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Case Series of Fertility Treatment in HIV-Discordant Couples (Male Positive, Female Negative) The Ontario Experience 英文参考文献.doc

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Case Series of Fertility Treatment in HIV-Discordant Couples (Male Positive, Female Negative) The Ontario Experience 英文参考文献

CaseSeriesofFertilityTreatmentinHIV-Discordant Couples(MalePositive,FemaleNegative):TheOntario Experience TrentNewmeyer1*,SandyN.Tecimer2,3,DeniseJaworsky2,3,StevenChihrin4,KevinGough3,5 ,Anita Rachlis3,6,JamesMartin7,SairaMohammed2,MonaR.Loutfy2,3,5 1BrockUniversity,St.Catharines,Ontario,Canada,2Women’sCollegeResearchInstitute,Women’sCollegeHospital,Toronto,Ontario,Canada,3UniversityofToronto, Toronto,Ontario,Canada,4UniversityofWesternOntario,London,Ontario,Canada,5St.Michael’sHospital,Toronto,Ontario,Canada,6SunnybrookHealthSciences Centre,Toronto,Ontario,Canada,7SouthernOntarioFertilityTechnologies,London,Ontario,Canada Abstract Thesuccessofcombinationantiretroviraltherapiesforthetreatmentofhumanimmunodeficiencyvirus(HIV)hasresultedin prolongedlifeexpectancy(over40yearsfromdiagnosis)andanimprovedqualityoflifeforpeoplelivingwithHIV.Therisk ofverticalHIVtransmissionduringpregnancyhasbeenreducedtolessthan1%.Asaresultofthesebreakthroughsandas manyoftheseindividualsareofreproductiveage,fertilityissuesarebecomingincreasinglyimportantforthispopulation. OnepopulationinwhichconceptionplanningandreductionofhorizontalHIVtransmissionwarrantsfurtherresearchisHIV- discordant couples where the male partner is HIV-positive and the female partner is HIV-negative. Sperm washing is a techniquecarriedoutinafertilityclinicthatseparatesHIVfromtheseminalfluid.Althoughspermwashingfollowedby intrauterineinseminationsignificantlyreducestheriskofhorizontalHIVtransmission,therehasbeenlimitedaccesstothe procedure in North America. Furthermore, little is known about the conception decision-making experiences of HIV- discordantcoupleswhomightbenefitfromspermwashing.Chartreviewsandsemi-structuredinterviewswerecompleted with12HIV-discordantcouplesinOntario,Canada.CoupleswererecruitedthroughHIVclinicsandonefertilityclinicthat offeredspermwashing.Participantsidentifiedanumberoffactorsthataffectedtheirdecision-makingaroundpregnancy planning. Access to sperm washing and other fertility services w