The HIV Positive female

The prevalence of HIV infection in reproductive-aged women is significant and continues to increase. Despite the effectiveness of antiretroviral therapy, HIV seropositive women are precluded from natural efforts at conception by the persistent risk of horizontal transmission to their partner. It is imperative to verify medical and psychosocial reproductive fitness prior to proceeding with attempts to conceive. While simple auto-insemination synchronized with ovulation is sufficient for some HIV seropositive women, the reproductive potential of many women is affected by concomitant tubal disease and/or compromised oocyte quality/quantity. In these cases, assisted reproduction, in the form of IUI or IVF/ICSI, is advised. There are no documented cases of vertical transmission of HIV after assisted reproduction. IVF/ICSI outcomes are slightly diminished in HIV seropositive women, but these outcomes may be skewed by fewer embryos transferred and/or co-existing risk factors, such as smoking or fibroids, with a high prevalence in HIV seropositive women.