Assisted Reproductive Technologies in HIV-Discordant Couples

Assisted reproductive technologies (ART) have revolutionised fertility care for couples in which one partner is living with HIV and the other is not. Advances in antiretroviral therapy have achieved sustained viral suppression, transforming HIV into a manageable chronic condition and enabling safe conception. Core strategies combine effective plasma viral load control with specialised laboratory methods to remove or inactivate virus in gametes. Sperm washing followed by intrauterine insemination (IUI) represents a landmark technique for male-positive couples wishing to conceive without exposing the uninfected partner. In vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) extend these options when additional infertility factors are present. In settings where high-end laboratory facilities are scarce, timed vaginal insemination offers a low-tech alternative that can be integrated with antiretroviral prophylaxis. Regulatory frameworks and professional guidelines vary internationally, influencing access to dedicated storage and processing facilities. Recent efforts emphasise patient-centred counselling, routine viral load monitoring, and multidisciplinary coordination among reproductive specialists, infectious-disease experts and laboratory technologists. The cumulative evidence underscores that with appropriate virological control and meticulous gamete handling, HIV-discordant couples can achieve pregnancy and healthy live birth rates comparable to those of HIV-negative couples, with negligible risk of partner or neonatal transmission.

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Assisted Reproductive Technologies in HIV-Discordant Couples publication trend

The graph below shows the total number of articles in assisted reproductive technologies in hiv-discordant couples across all publications each year (not limited to Nature Index journals).

Technical terms

HIV-discordant couple: A partnership in which one individual is HIV-positive and the other is HIV-negative.

Antiretroviral therapy (ART): Combination drug regimens that suppress HIV replication and reduce viral load to undetectable levels.

Sperm washing: Laboratory method to separate motile spermatozoa from seminal fluid and cell debris, removing viral particles.

Intrauterine insemination (IUI): Placement of processed sperm directly into the uterine cavity to facilitate fertilisation.

In vitro fertilisation (IVF): Fertilisation of oocytes with sperm outside the body, with embryos subsequently transferred to the uterus.

Intracytoplasmic sperm injection (ICSI): Microinjection of a single sperm into an oocyte to overcome severe male factor infertility.

Viral suppression: Reduction of plasma HIV RNA to undetectable levels, minimising risk of transmission.

References

1. Strategies for Preventing HIV Infection Among HIV-Uninfected Women Attempting Conception with HIV-Infected Men — United States. MMWR Morbidity and Mortality Weekly Report (2017).
2. Empowering HIV-infected women in low-resource settings: A pilot study evaluating a patient-centered HIV prevention strategy for reproduction in Kisumu, Kenya. PLOS ONE (2019).
3. A Successful Pregnancy Outcome in a Human Immunodeficiency Virus Serodiscordant Couple in a Single Cycle of In Vitro Fertilization/Intracytoplasmic Sperm Injection: A Case Report. Cureus (2022).
4. Еffectiveness and safety of the in vitro fertilization program for HIV infection in men. HIV Infection and Immunosuppressive Disorders (2021).