Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 28

Mark V. Sauer and Shelley Dolitsky

Department of Obstetrics, Gynecology & Reproductive Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA

Case History 1: A 37‐year‐old woman presents for reproductive counseling. The patient has a history of substance abuse and contracted HIV from a contaminated hypodermic needle at age 27. She states that for over 8 years she has not used illicit drugs and now wishes to conceive with her husband. She has no significant medical or surgical history. She has never been pregnant, and her gynecologic history is notable for irregular periods, with her menstrual cycles occurring from 30 –58 days. The patient’s husband is also HIV‐seropositive. He acquired HIV from a sexual relationship with a male partner when he was aged 23. He has one child from a previous partner and no other significant medical or surgical history. Both the patient and her husband are under the care of an infectious disease specialist, and they are compliant with their highly active antiretroviral therapy. They have both achieved an undetectable viral load with CD4 counts of 800 and 600 cells/mm3, respectively.

Case History 2: A 27‐year‐old woman presents for reproductive counseling. The patient acquired HIV from a sexual relationship when she was 18 years. Since diagnosis, she has been cared for by an infectious disease specialist, and as a result of compliance with medical treatment, she has achieved an undetectable plasma viral load; CD4 has always been >400 cells/mm3. Her boyfriend is HIV‐seronegative, and they have always practiced safe sex with condoms. She has no significant medical or surgical history, but she was hospitalized for pelvic inflammatory disease twice in her early 20s which resolved with antibiotic therapy.