AMP and HIV care, step by step, in the case of HIV infection in women

Medically assisted reproductive technology (ART) in HIV-positive for the AIDS virus (HIV) woman is carried out according to three stages, phase balance, AMP itself and monitoring of pregnancy, presented the The team of specialists at Cochin Hospital in Paris.

Due to the severity of the HIV infection and the risk of maternal-fetal transmission, unwanted pregnancy has long been infected women. She is always in patients whose infection is not stabilized despite treatment or in which access to anti-retroviral drugs during pregnancy is difficult or impossible.

If AMP concrétisable, it has some characteristics that necessitate a specific circuit comprising three phases.

1 / The assessment phase

It lies in a gynecological consultation with an exploration of fertility (tubal ovarian function, ovulation, uterus) and the possible correction of anomalies (medical treatment of infections, surgical treatment).

This initial consultation is an opportunity to get in touch with the doctor who follows the patient for HIV to know the immunological and virological status of the latter, anti-retroviral treatment and the opportunity to evaluate and a pregnancy. This exchange allows adapting antiretroviral treatment regulatory requirements set by ministerial decree of 10 May 2001, as well as data on known potential toxicities of treatment for the fetus.

The couple must also consult on the one hand, a reproductive biologist who will explore the sperm parameters and testicular function, on the other hand, a psychologist, maternity, following positive pregnant women. It anticipates them with any difficulties that pregnancy can emerge and that the threat of contamination of the child may pose.

2 / Phase AMP

At the end of the record, the record is examined in a multidisciplinary meeting to decide whether to undertake attempts to AMP and specify the practicalities (insemination, IVF with or without sperm microinjection).

The couple will then see a pediatrician if he wants to discuss the first weeks of a child's life, marked by uncertainty about the contamination and the need antiretroviral treatment during the first 4 weeks of life of the child .

3 / monitoring of pregnancy

Throughout pregnancy, regular contact is maintained between the obstetrician and the physician follows the woman to her infection. This will césarisée if elements are suspect long work during childbirth.

The experience at the Cochin hospital on the GPA for women with HIV began in 2002. In total, 15 children were born on 58 pairs supported and 177 AMP cycles were performed.