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Background:  The French law has allowed assisted reproductive techniques for HIV-infected patients since May 2001. We report here our 3 years’ experience concerning infected women.

Methods:  We referred 67 HIV⁺ women to our center for assisted reproductive techniques; 46 files are already complete. For 10 couples, infection concerned both partners. The median age of the patients was 36 (25 to 44), their median follicle-stimulating hormone basal level was 6,7 IU/L (0.1 to 13); 30 women were treated with ART, and 16 did not need any treatment. Their infection was well controlled with a median CD4 count of 471/mm³ [196 to 2449]. Plasmatic viral load was indetectable for 60.8% of the patients and was 2860 copies/mL [60 to 294,000] for the others. Assisted reproductive techniques were proposed to avoid male contamination for all the  couples and for the treatment of an associated infertility for 28 couples:  male infertility 5, female infertility 19, mixed infertility 3, preimplantation genetic diagnosis 1.

Results:  For 34 couples, 73 cycles of ovarian stimulation have already been performed leading to 8 arrests of stimulation and 65 assisted reproductive procedures:  intrauterine insemination 7, in vitro fertilization 8, intracytoplasmic sperm injection 42, and frozen-thawed embryo transfer 8. For in vitro fertilization and intracytoplasmic sperm injection, the median number of retrieved oocytes was 8.0 (0 to 17). At the first attempt, an elective single embryo transfer was performed for women aged < 35. Assisted reproductive techniques resulted in 12 single pregnancies:  none after intrauterine insemination or in vitro fertilization, 10 after intracytoplasmic sperm injection and 2 after frozen embryo transfer. Intracytoplasmic sperm injection, on account of a 23.8% pregnancy rate per retrieval, soon became our standard procedure:  7 babies are born, 2 miscarriages occurred, and 3 pregnancies are ongoing. A pregnancy was obtained for 35.3% of the couples and 20.6% of the couples are already parents. All the women were treated with ART at the end of their pregnancy, even if not treated before. Babies were born via caesarean section. They are healthy and postnatal viral load screening is negative. They are not fed at the breast.

Conclusions:  As previously demonstrated for HIV seropositive men, our results show that assisted reproductive techniques are feasible and safe for HIV seropositive women. Assisted reproductive techniques are efficient in avoiding contamination of the partner. Assisted reproductive techniques, especially intracytoplasmic sperm injection, also treat possible associated infertility with acceptable results in a population whose ovarian reserve may be impaired.

Keywords: ART; HIV; women