HIV infection in serodiscordant couples does not have impact on the embryo quality and ICSI outcome

Postado na categoria em e atualizado em 01/01/2008

Authors: Marrco Melo, Marcos Meseguer, José Bellver, José Remohí, Antonio Pellicer, Nicolás Garrido

(Fertility and Sterility 2008; 89: 141-150)

OBJECTIVE: To evaluate the embryo quality in our program for HIV-1 serodiscordant couples (SDC) with the male infected in comparison with a tubal infertility control group.

DESIGN: Retrospective case-control study.

SETTING: Instituto Universitario IVI, Valencia, Spain PATIENTS: 30 SDC and 79 control couples without HIV-1 infection attending for ICSI. Only first cycles were considered.

INTERVENTION: Controlled ovarian hyperstimulation and ICSI, in both groups. In SDC group: sperm wash, nested polymerase chain reaction (PCR) in semen sample and capacitation by swim-up, after thawing semen sample. In control group: sperm capacitation by swim-up, after thawing semen sample.

MAIN OUTCOME MEASURE: ICSI procedure and embryo characteristics (fertilization, cleavage, embryo morphology and development) and cycle outcome (ongoing pregnancy and miscarriage rates).

RESULTS: Fertilization and cleavage rates were similar between the groups. On days 2 and 3 of embryo development, very similar embryo features were found between the groups. There was no difference in mean number of optimal embryos on day 3. When embryos were cultured up to 5- 6 days, a significant increase in embryo blockage was found in SDC group, in comparison with the control group. The mean number of optimal blastocysts on day 6 was comparable in both groups. No difference was found regarding number of cryopreserved and transferred embryos, implantation, pregnancy, multiple
pregnancy, and miscarriage rates between the groups.

CONCLUSIONS: HIV-1 infection in SDC with infected males does not appear to have a significantly negative impact on the embryo development and ICSI outcome.

KEYWORDS: embryo quality/ HIV-1/ ICSI/ nested PCR/ semen wash/ serodiscordant couples