Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 31

Challenge: Managing the fertility needs of HIV‐seropositive women.

Background:

 Over 17 million women worldwide live with HIV.

 Most newly diagnosed cases of HIV occur in women between the ages of 15–44 years.

 One‐third of HIV‐infected individuals wish to have children despite their diagnosis.

 Tubal disease is common among HIV‐infected patients.

 An untreated and unattended HIV‐seropositive woman may transmit the virus to her partner and child.

Management options:

 Consult specialists in infectious disease, maternal‐fetal medicine and social services.

 If tubes are patent, attempt self‐insemination, ovulation induction IUI or natural cycle IUI.

 If tubes are blocked or there is male factor infertility present, consider ICSI.

 Material from viral carriers should be processed in a separate laboratory or designated space within the main laboratory using dedicated equipment.

 Maintain viral load as near to undetectable as possible.

 Avoid medications known to be contraindicated in pregnancy (e.g. efavirenz).

Prevention:

 Antiretroviral therapy improves survival and enhances quality of life of HIV‐infected patients.

 Antiretroviral therapy reduces the risk of vertical transmission to fetus and child.

 Safe sex with condoms should be practiced to reduce risk of infection to the male partner.