final program.qxd - Parallels Plesk Panel

As the man is seronegative, his semen is prepared in the usual lab. When IVF is
performed, the follicular fluid is treated in the viral risk lab. When IUI is performed, no
specific lab is required but seropositive women are referred to the specific centres to allow
a correct registration.
Some French results concerning ART for seropositive couples were given in December
2005 by the Agence de Biomédecine. The enquiry was led in 2003 and 2004 and
concerned 11 centres. The number of attempts is stable for seropositive men between
2003 and 2004. For women the number is increasing.
The number of inseminations has increased between 2003 and 2004. Respectively 13
and 17% of the inseminations lead to an onging pregnancy (men or/and woman
seropositive). The number of IVF or ICSI has slightly increased between 2003 and 2004.
Respectively 18 and 20% of the procedures lead to an onging pregnancy, frozen embryos
included (men or/and woman seropositive).
When considering together seropositive men and women, more than 75% of the babies
were born after insemination in 2004. This can be explained because the seropositive
partner is the male in 2/3 of the cases. Their semen is often normal and their female
partner have no infertility. Results can be different when you consider only seropositive
women whose self-inseminations failed.
ABSTRACTS
In our centre in Strasbourg, 87 seropositive men gave semen for ART from January 2001
to December 2005. Seminal plasma was positive with more than 10 000 copies in 4 cases
and uninterpretable in 5 cases (inhibitors). These samples could not be used. Seminal
plasma was positive less than 10 000 copies in 18 cases and negative in 116 cases
allowing the negative final fraction to be used for ART. Final fraction was positive in tree
cases for RNA and in one case for DNA, so these samples were discarded. These findings
confirm that the viral validation of processed semen is necessary in ART programs. Final
fraction was uninterpretable in 6 cases and another semen sample had to be tested for
these patients. 85,3% of the samples could be used immediately.
In our Centre 122 couples underwent an ART procedure. IUI is not performed as often as
IVF because more than half of the couples include infertile seropositive women. For them
IVF is the procedure of choice. But even with IVF or ICSI results for women are much
lower than for men (19% of the couples became parents in case of female seropositivity
vs 50% for male seropositivity). Three main explanations can be taken into account:
- women are more often really infertile (otherwise self-inseminations would have worked),
- we perform mainly elective single embryo transfers to avoid multiple pregnancies and
- ovarian response to stimulation may be impaired as a result of the infection.
Nevertheless these results are acceptable.
Pluridisciplinary teams are proud of their ART programs because, in spite of many
difficulties, the wish to become parents can become true for many seropositive couples.
ART must be considered as a tool of a victory against discrimination as well as against the
spreading of the epidemic.
“ Focusing FIRST on PEOPLE “ 43 w w w . i s h e i d . c o m