Reproductive assistance in HIV-1 discordant couples.
The total number of people living with HIV has reached 39.5 million. In developed countries, the major risk for HIV transmission is by heterosexual intercourse. The general condition and life expectancy of many patients with HIV infection is very good, and three-quarter of these individuals are in their reproductive years. For these reasons a large number of young couples are expected to make future plans to have children. Assisted reproduction in HIV-1 discordant couples has become important for clinicians in preventing HIV-1 transmission. The main theme covered in this article is epidemiology of HIV-1 in the world, the biology of the virus present in the sperm, the recently published guidelines from the American Society for Reproductive Medicine and ethics recommendations concerning assisted reproduction in people infected by virus, and all clinical aspects and scientific data published that have been modified to allow assisted reproduction in HIV-serodiscordant couples. To evaluate in clinical practice the safety of HIV-1 assisted reproduction with sperm washing and the outcome of assisted reproductive technologies offered to HIV-1 serodiscordant couples counselled for the prevention of HIV transmission.