| Artificial reproductive techniques (ART) are currently offered in various centers worldwide to couples with HIV-1 infection and the desire to conceive to reduce the risk of viral transmission. In the Netherlands, this technology has recently become available in the AMC. Some centers, including the AMC, favor intra uterine insemination (IUI) with processed semen that is screened for the presence of HIV before insemination. Other centers advocate the use of intra-cytoplasmic sperm injection (ICSI) in which a single sperm is injected directly into an oocyte. Despite heavy debates, there is currently no consensus as to which technique is safest. In the Netherlands, the use of ICSI for HIV-1 infected couples is forbidden, because of the theoretical danger of producing a new endogenous retrovirus in the human genome and possible infection of the embryo (www.nvog.nl). However, this restriction is solely based on theoretical grounds and is so far without any scientific evidence. This is a significant clinical problem, because currently 33% of HIV-1 infected men are excluded from IUI programs due to insufficient semen quality. For these men ICSI is the only available method to father genetically own offspring. In the current study we aim to directly examine whether human oocytes can become infected with HIV via intracytoplasmic injection thereby addressing the question whether ICSI can and should be safely offered to HIV-1 infected couples or not. |
