Fears for HIV Motherhood Hopes

A small study presents more evidence that HIV-positive women find it far more difficult to conceive, but it offers brighter news to HIV-positive men who want to father a child. The research, carried out in France, found that only one in ten HIV-positive women given fertility treatment managed to get pregnant.

The precise reason why this is happening is unclear, but experts say a variety of factors could be at work. They say that women who have other STDs such as gonorrhea or chlamydia, which can harm fertility, may be more vulnerable to catching HIV when they have sex with an infected partner. The virus itself -- or perhaps antiretroviral drugs taken to keep it under control -- may also be having a detrimental effect on fertility.

Dr. Jeanine Ohl, of the Centre d'AMP de Strasbourg, and colleagues carried out assisted reproduction techniques on 57 couples in which at least one partner had HIV. Sperm from the HIV-positive men was "washed" to virtually eliminate the chance of HIV being transmitted. A third of the 39 couples in which the man was HIV-positive managed to conceive a baby this way. However, only one of the HIV-positive women became pregnant, even though standard and normally highly successful in vitro fertilization techniques were used. The full study, "Assisted Reproduction Techniques for HIV Serodiscordant Couples: 18 Months of Experience," is published in the June issue of Human Reproduction (2003;18(16):1244-1249).

"Some research has found evidence of premature ovarian failure in infected women although this would need confirming in a larger study," Ohl said. "On the other hand, in developing countries young infected women become pregnant easily. We have to determined whether the virus has created an additional negative factor."

Dr. Simon Gregson, from Imperial College-London, has studied the fertility of HIV-positive women and says there is now firm evidence that they find it harder to conceive. "Some studies have suggested that fertility is reduced by as much as 30 percent to 40 percent," Gregson said.

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