One study also assessed the effect of viral load (VL) on sperm parameters and found a negative correlation with sperm motility and morphology [14]. Our early analysis again suggested a more consistent effect, with a significant
positive correlation observed between CD4 cell count and sperm concentration, total count, progressive motility and post-preparation concentration and a significant negative correlation with normal sperm morphology of both raw and post-preparation samples. At the numbers then available, no correlation was observed between VL, years since diagnosis, use of antiretrovirals or duration of antiretroviral use and any sperm parameter [18]. The aim of the present study was to present a decade of data from the SWP programme in the UK to demonstrate the effect of markers of HIV disease progression and treatment on seminal parameters. The pretreatment Pexidartinib manufacturer work-up SRT1720 chemical structure has been discussed fully elsewhere [19]. In brief, a full fertility and sexual health screen is performed
on both partners to define the optimum treatment modality, exclude HIV coinfection and treat any genital lesions or infections that may increase the risk of viral transmission [20]. Our recommendations are that all patients should receive careful preconceptual counselling, both together and individually, before embarking on treatment [21], where the nature and risks of sperm washing, the impact of possible treatment failure, the issues involved in coping with a child when one parent is
HIV positive, and the possibility of having to cope as a single parent are discussed. In particular, it is mandatory that both partners understand sperm washing to be a risk-reduction method and not a risk-free method as, technically, the virus could still be present in the washed sample at a titre below the detection limit of the HIV assay. Although there have been no reports of seroconversion in the female partner when semen has been correctly processed in the 3315 cycles published thus far by the Centre for Reproductive PAK6 Assisted Techniques for HIV in Europe (CREAThE) network [22], the possibility of viral infection of the woman and subsequent child still exists, and the alternative risk-free option of donor insemination should be discussed and appropriate consent obtained from both partners, including confirmation of this information. Raw and post-preparation semen parameters from 439 samples used for cycles of IUI were correlated with markers of HIV disease (CD4 cell count and VL), use of HAART, duration of disease and duration of HAART. HIV history was confirmed using a questionnaire at the initial visit and the most recent CD4 cell count and VL, as well as the medication history, were confirmed at the time of the production of a sample for treatment.