Influence of male human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection on the reproductive outcomes in serodiscordant couples: a case–control study

• Published in: Andrology (Oxford) Vol. 7; no. 6; pp. 852 - 858
• Main Authors: Cito, G., Coccia, M. E., Fucci, R., Picone, R., Cocci, A., Russo, G. I., Rizzello, F., Trotta, M., Badolato, L., Basile, V., Criscuoli, L., Serni, S., Carini, M., Natali, A.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2019
• Subjects: Birth rate; HCV; Hepatitis; Hepatitis C; HIV; Human immunodeficiency virus; Infections; intracytoplasmic sperm injection; Reproductive health; Sperm; HIV; intracytoplasmic sperm injection; HCV
• ISSN: 2047-2919; 2047-2927
• DOI: 10.1111/andr.12623

Background
Nowadays, serodiscordant couples (SDCs) with human immunodeficiency virus (HIV) or hepatitis C virus (HCV)‐infected men have the chance to conceive safely, giving birth with a minimum risk of cross‐infection.
Objective
To assess the impact of male HIV and HCV infection on the assisted reproductive technologies (ART) outcomes in SDCs, with HIV or HCV seropositive men and negative partners.
Materials and methods
Of 153 couples: 24 in Group 1 (HIV‐seropositive men), 60 in Group 2 (HCV‐seropositive men) and 69 in Group 3 (controls). Sperm‐washing procedure was performed using a three‐step system. Fresh ICSI cycles were carried out in HIV SDCs, HCV SDCs and controls. Seminal parameters, fertilization rate (FR), cleavage rate (CR), pregnancy rate per cycle (PR/C), miscarriage rate, implantation rate (IR) and live birth rate were evaluated.
Results
All the seropositive men have undetectable viral loads at the time of insemination, and both partners were free from co‐morbid infections. The median number of embryos transferred was 2.0 (IQR 1.0–3.0), with no differences among groups. FR was significantly reduced in HIV and HCV SDCs compared to the controls (66%, 61% and 75%, respectively; p < 0.01). CR was similar between groups (p = 0.3). IR was 12.1%, 11.1% and 14.1%, respectively, in the three groups (p = 0.30). PR/C was 21.7%, 17.6% and 20.2% in HIV, HCV and controls, respectively. Live birth rate per cycle was 17.4%, 15.7% and 15.9%, respectively. There were no significant differences in clinical pregnancies per cycle, as well as miscarriages and live births (p = 0.30; 0.30; 0.60, respectively).
Conclusions
The sperm‐washing technique with ICSI may generate a promising way to improve pregnancy outcomes and to reduce the risk of viral transmission in these couples. In this setting, we can correctly counsel HIV‐ and HCV‐infected men of SDCs with regard to the likelihood of father their own biological child.