There's no justification for denying treatment to parents who are HIV positive
- Carole Gilling-Smith (cgs@chelwest.nhs.uk), director and consultant gynaecologist,
- J Richard Smith, consultant gynaecologist,
- Augusto E Semprini, honorary consultant gynaecologist
- Assisted Conception Unit, Chelsea and Westminster Hospital, London SW10 9NH
No established guidelines exist for defining access to fertility care for individuals infected with HIV. Although many in vitro fertilisation units in the United Kingdom screen patients for HIV, only a handful are prepared to treat couples if one or other partner tests positive. A premise of offering assisted conception treatment is a consideration for the welfare of any child born or affected as a result of treatment. In the case of HIV the primary concern is over the life expectancy of the infected parent and the risk of viral transmission to either the uninfected partner or offspring. 1 2 The ethical dilemmas these issues raise have, until now, provided sufficient grounds for most units offering assisted conception to close their doors to patients infected with HIV who ask for help or who test positive in their preliminary investigation.3
Combination antiretroviral therapy has produced radical improvements in life expectancy and quality of life for both children and adults infected with HIV in developed countries. Current estimates suggest that …
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