Infertility treatment for HIV-positive couples: far from immaculate conception.

Journal of Family Planning and Reproductive Health Care 2003: 29(4) Introduction The issue of infertility diagnosis in human immunodeficiency virus (HIV)-positive couples is medically and ethically complicated. Studies show that although many in vitro fertilisation (IVF) units in the UK screen patients for HIV, only a handful are prepared to treat couples if one or other partner tests positive for the virus.1 The Human Fertilisation and Embryology Act 1990 requires the welfare of the child to be taken into account before treatment starts, but it does not exclude any category of woman from being considered for infertility treatment. In the case of HIV the primary concerns are shortened life expectancy of the infected parent(s) and the risk of viral transmission to either the uninfected partner or offspring.1 Even if the virus is not transmitted the consequences may be devastating, since the child may lose one or both parents prematurely to acquired immunodeficiency syndrome (AIDS), and the emotional and financial resources of the family are often depleted. The ethical dilemmas these issues raise have provided sufficient grounds for most units offering assisted conception to close their doors to patients infected with HIV.1 Clearly not all patients infected with HIV will be suitable for infertility treatment, but whether couples are offered assisted conception in the UK is still very much a lottery.