Clinical

Sperm from HIV or HCV patients can be used for intracytoplasmic sperm injection

Last Updated: 2012-12-11 18:40:17 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Men with azoospermia and HIV or hepatitis C should not be excluded from fertility programs, the lead author of a new report told Reuters Health.

Dr. Marianne Leruez-Ville from Hopital Necker-Enfants Malades, Paris, France and colleagues say in their paper that sperm retrieved microscopically from azoospermic men infected with HIV-1 or hepatitis C virus (HCV) can be safely used for intracytoplasmic sperm injection (ICSI).

The paper reports on four men with HCV and two with HIV. All six had microsurgical epididymal sperm aspiration (MESA) or open testicular biopsy under general anesthesia. The retrieved spermatozoa were isolated and washed, as reported December 3rd online in Fertility and Sterility.

Sperm was recovered from five men; in all of those cases, HCV RNA and HIV RNA could not be recovered from the final processed sperm.

In all five cases where sperm were retrieved, the couples underwent up to four ICSI cycles. One couple achieved a pregnancy resulting in birth of a healthy child.

All four women who were HCV-negative partners of HCV-infected men remained HCV negative between two and 12 months after the last ICSI cycle, and the HIV-negative partner of the HIV-positive man remained HIV-negative after their ICSI cycle.

"The AZONECO study showed that a careful processing of epididymal and testicular samples is efficient for obtaining negative virologic testing of the final sperm suspensions and that ICSO cycles using such sperm suspensions are safe," the researchers conclude.

"However," they add, "we did not compare ejaculated sperm with testicular/epididymal sperm, so this study does not indicate that retrieval is preferable over the use of ejaculated sperm, and it should be limited to azoospermic men."

In email to Reuters Health, Dr. Leruez-Ville said that all ART labs that are experienced in dealing with testis biopsies could perform these preparation techniques.

SOURCE: http://bit.ly/TTu9ym

Fertil Steril 2012.