Assisted reproductive technologies to establish pregnancies in couples with an HIV-1-infected man

Abstract:

In 1996, the introduction of highly active antiretroviral therapy (HAART) led to a spectacular increase in life expectancy, AIDS-free survival, and quality of life of HIV-1-infected men and women with access to this therapy. 8 These radically changed clinical circumstances led to the publication of numerous debates in authoritative journals with a plea to reconsider the ban on reproduction for HIV-1-infected couples. 9-11 The first argument to offer HIV-1-infected couples artificial reproductive technologies was ‘harm minimisation’. IUI with processed semen seemed to be safe, as seroconversions of the treated women or their offspring after IUI with HIV-negative sperm had never been described. 12 Withholding these techniques could lead patients to practice unprotected intercourse with an unknown but presumably higher risk of HIV-1 infection. Second, in 1998 the US Supreme Court declared that an asymptomatic HIV-1 infection should be considered a handicap falling under the protection of the Americans with Disabilities Act (ADA). 13 As discrimination of people with any handicap under the ADA is unlawful, it was felt that the categorical exclusion of people with an HIV infection from assisted reproductive technology programmes was also unlawful. 14 The third–moral–argument was that medical interventions should not be discriminatory. Couples with HIV infection were not essentially different from couples with other chronic diseases or couples with an increased chance of having offspring with anomalies, for whom there was no ban on assisted reproductive technologies, for instance couples with diabetes, and women in their forties who have an …

Año de publicación:

2009

Keywords:

Fuente:

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