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Sauer MV. Assisted reproduction and pandemics: lessons learned from HIV are worth remembering while battling COVID-19. F S Rep 2021; 2:362-363. [PMID: 34661174 PMCID: PMC8511650 DOI: 10.1016/j.xfre.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Mark V Sauer
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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2
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Ninive C, Ferraretto X, Gricourt S, Llabador MA, Lepage J, Gauché-Cazalis C, Epelboin S, Peigné M. [Assisted reproductive technologies in HIV patients: Which results and which strategy in France in 2019?]. ACTA ACUST UNITED AC 2019; 47:362-369. [PMID: 30753900 DOI: 10.1016/j.gofs.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Indexed: 01/22/2023]
Abstract
With the use of antiretroviral therapy, HIV transmission from mother to fetus and between sexual partners has been significantly reduced, successively allowing pregnancy, then assisted reproductive technologies, and targeted unprotected sex among couples living with HIV. Since first French Morlat report in 2013, natural procreation is now possible under certain conditions for these couples living with HIV and the use of assisted reproductive technologies is increasingly limited to the treatment of infertility. While the results of intrauterine insemination seem satisfactory for serodiscordant couples living with HIV, in vitro fertilization results appear to be unfavorable when the woman is infected with HIV. In vitro fertilization results appear to be comparable to those in general population when only the man is infected with HIV. It can be assumed that ovaries are impacted by the treatment and/or the HIV in infected women.
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Affiliation(s)
- C Ninive
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - X Ferraretto
- Service de biologie de la reproduction, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - S Gricourt
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - M A Llabador
- Service de biologie de la reproduction, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - J Lepage
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - C Gauché-Cazalis
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - S Epelboin
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - M Peigné
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France.
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Sones JL, Merriam AA, Seffens A, Brown-Grant DA, Butler SD, Zhao AM, Xu X, Shawber CJ, Grenier JK, Douglas NC. Angiogenic factor imbalance precedes complement deposition in placentae of the BPH/5 model of preeclampsia. FASEB J 2018; 32:2574-2586. [PMID: 29279353 DOI: 10.1096/fj.201701008r] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Preeclampsia (PE), a hypertensive disorder of pregnancy, is a leading cause of maternal and fetal morbidity and mortality. Although the etiology is unknown, PE is thought to be caused by defective implantation and decidualization in pregnancy. Pregnant blood pressure high (BPH)/5 mice spontaneously develop placentopathies and maternal features of human PE. We hypothesized that BPH/5 implantation sites have transcriptomic alterations. Next-generation RNA sequencing of implantation sites at peak decidualization, embryonic day (E)7.5, revealed complement gene up-regulation in BPH/5 vs. controls. In BPH/5, expression of complement factor 3 was increased around the decidual vasculature of E7.5 implantation sites and in the trophoblast giant cell layer of E10.5 placentae. Altered expression of VEGF pathway genes in E5.5 BPH/5 implantation sites preceded complement dysregulation, which correlated with abnormal vasculature and increased placental growth factor mRNA and VEGF164 expression at E7.5. By E10.5, proangiogenic genes were down-regulated, whereas antiangiogenic sFlt-1 was up-regulated in BPH/5 placentae. We found that early local misexpression of VEGF genes and abnormal decidual vasculature preceded sFlt-1 overexpression and increased complement deposition in BPH/5 placentae. Our findings suggest that abnormal decidual angiogenesis precedes complement activation, which in turn contributes to the aberrant trophoblast invasion and poor placentation that underlie PE.-Sones, J. L., Merriam, A. A., Seffens, A., Brown-Grant, D.-A., Butler, S. D., Zhao, A. M., Xu, X., Shawber, C. J., Grenier, J. K., Douglas, N. C. Angiogenic factor imbalance precedes complement deposition in placentae of the BPH/5 model of preeclampsia.
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Affiliation(s)
- Jennifer L Sones
- Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Audrey A Merriam
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Angelina Seffens
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Dex-Ann Brown-Grant
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Scott D Butler
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA; and
| | - Anna M Zhao
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Xinjing Xu
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Carrie J Shawber
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Jennifer K Grenier
- RNA Sequencing Core, Center for Reproductive Genomics, Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Nataki C Douglas
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
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Mataró D, García D, Coll O, Vassena R, Rodríguez A. Lower endometrial receptivity in HIV-infected women receiving oocyte donation: a comorbidity of HIV infection? Hum Reprod Open 2017; 2017:hox019. [PMID: 30895233 PMCID: PMC6276669 DOI: 10.1093/hropen/hox019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/22/2017] [Accepted: 10/07/2017] [Indexed: 01/13/2023] Open
Abstract
STUDY QUESTION Are the reproductive outcomes of HIV-infected donor oocyte recipient women comparable to those of non-infected women? SUMMARY ANSWER HIV-infected women have lower clinical pregnancy and live birth rates than non-infected women. WHAT IS ALREADY KNOWN The literature on the effect of HIV infection on reproductive outcome is scarce at best; the only report to date comparing oocyte donation cycles in HIV-infected women versus non-infected controls found no differences in pregnancy rates between the two groups. However, this study was performed nearly a decade ago and did not evaluate the effect of immuno-virological characteristics of oocyte recipients or the HIV antiretroviral therapy effect. STUDY DESIGN SIZE, AND DURATION This is a matched-cohort study including 514 oocyte donation cycles, 257 from HIV-infected women and 257 non-infected controls, performed between April 2004 and November 2014. PARTICIPANTS/MATERIALS, SETTING, AND METHOD Each cycle of an HIV-infected woman (n = 257) was matched with a cycle of a non-infected woman (1:1). Biochemical pregnancy, clinical pregnancy, ongoing pregnancy and live birth in the two groups were compared using a multivariate logistic regression analysis. The effect of antiretroviral treatment options on pregnancy outcomes of HIV-infected women was analyzed using a logistic regression model adjusted for time elapsed from diagnosis, and CD4 levels and viral load prior to embryo transfer. MAIN RESULTS AND THE ROLE OF CHANCE Cycles of HIV-infected patients receiving oocyte donation presented lower pregnancy and live birth rates than matched non-infected controls. Treatment options and infection parameters analyzed do not seem to affect the reproductive results in HIV-infected women. The variable most influencing pregnancy outcomes was the number of transferred embryos; lower pregnancy rates were obtained after single embryo transfer. LIMITATIONS REASONS FOR CAUTION Patients with HIV infection have specific health issues, such as infection/treatment side effects, which makes it impossible to find a matching control group of non-infected patients for these variables. WIDER IMPLICATIONS OF THE FINDINGS HIV-infected women receiving donated oocytes present lower pregnancy rates when compared to non-infected controls, regardless of the antiretroviral treatment followed. The complexity of the treatments (both in medication types and combinations) makes it difficult to define whether any one treatment option is better than the others in terms of pregnancy outcomes in oocyte recipients. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Daniel Mataró
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Désirée García
- Fundació Privada EUGIN, Travessera de Les Corts 314, Barcelona 08029, Spain
| | - Oriol Coll
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Rita Vassena
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Amelia Rodríguez
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
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Lights and Shadows about the Effectiveness of IVF in HIV Infected Women: A Systematic Review. Infect Dis Obstet Gynecol 2015; 2015:517208. [PMID: 26778910 PMCID: PMC4686718 DOI: 10.1155/2015/517208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/06/2015] [Accepted: 11/12/2015] [Indexed: 01/20/2023] Open
Abstract
Background. HIV infected women have higher rates of infertility. Objective. The purpose of this literature review is to evaluate the effectiveness of fresh IVF/ICSI cycles in HIV infected women. Materials and Methods. A search of the PubMed database was performed to identify studies assessing fresh nondonor oocyte IVF/ICSI cycle outcomes of serodiscordant couples with an HIV infected female partner. Results and Discussion. Ten studies met the inclusion criteria. Whenever a comparison with a control group was available, with the exception of one case, ovarian stimulation cancelation rate was higher and pregnancy rate (PR) was lower in HIV infected women. However, statistically significant differences in both rates were only seen in one and two studies, respectively. A number of noncontrolled sources of bias for IVF outcome were identified. This fact, added to the small size of samples studied and heterogeneity in study design and methodology, still hampers the performance of a meta-analysis on the issue. Conclusion. Prospective matched case-control studies are necessary for the understanding of the specific effects of HIV infection on ovarian response and ART outcome.
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Barnes A, Riche D, Mena L, Sison T, Barry L, Reddy R, Shwayder J, Parry JP. Efficacy and safety of intrauterine insemination and assisted reproductive technology in populations serodiscordant for human immunodeficiency virus: a systematic review and meta-analysis. Fertil Steril 2014; 102:424-34. [DOI: 10.1016/j.fertnstert.2014.05.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/27/2014] [Accepted: 05/01/2014] [Indexed: 02/05/2023]
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Nurudeen SK, Grossman LC, Bourne L, Guarnaccia MM, Sauer MV, Douglas NC. Reproductive Outcomes of HIV Seropositive Women Treated by Assisted Reproduction. J Womens Health (Larchmt) 2013; 22:243-9. [DOI: 10.1089/jwh.2012.3855] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sahadat K. Nurudeen
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lisa C. Grossman
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lawton Bourne
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Michael M. Guarnaccia
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Mark V. Sauer
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Nataki C. Douglas
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
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Savasi V, Mandia L, Laoreti A, Cetin I. Reproductive assistance in HIV serodiscordant couples. Hum Reprod Update 2012; 19:136-50. [PMID: 23146867 DOI: 10.1093/humupd/dms046] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Three quarters of individuals infected with human immunodeficiency virus (HIV) are in their reproductive years and may consider pregnancy planning. Techniques have been developed which can minimize the risk of HIV transmission in these couples, and the current literature on this topic is reviewed here. METHODS We reviewed the literature for the following topics: risk of HIV transmission, effects of HIV infection on fertility, reproductive assistance in industrialized and low-income countries, pre-exposure chemoprophylaxis (PrEP) and timed intercourse in HIV-discordant couples for both male and female positivity. Relevant publications were identified through searches of the EMBASE Medline and PubMed databases, the Google-indexed scientific literature and periodic specialized magazines from the on-line Library Service of the University of Milan, Italy. RESULTS In serodiscordant couples in which the man is positive, the primary method used to prevent HIV transmission is 'sperm washing', followed by IUI or IVF. Data show that sperm washing in HIV-positive men has not produced seroconversion in women or their offspring; however, the evidence is limited. Recently, increasing evidence describing PrEP for HIV prevention has been published and PrEP could be an alternative to ART for fertile couples. Usually HIV-infected women undergo self-insemination around the time of ovulation. Few studies have been published on IVF outcome in HIV-infected women. CONCLUSIONS Assisted reproduction programmes should be integrated into global public health services against HIV. For HIV serodiscordant couples with infected men, sperm washing should be the first choice. However, timed intercourse and PrEP for HIV prevention has been reported. Recent data highlight the possible impairment of fertility in HIV-infected women. Efforts to design a multicentric study should be strengthened.
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Affiliation(s)
- V Savasi
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences, Hospital L. Sacco, University of Milan, Via G. B. Grassi, 74, 20157 Milan, Italy.
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Kushnir VA, Lewis W. Human immunodeficiency virus/acquired immunodeficiency syndrome and infertility: emerging problems in the era of highly active antiretrovirals. Fertil Steril 2011; 96:546-53. [PMID: 21722892 DOI: 10.1016/j.fertnstert.2011.05.094] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 05/31/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review the effects of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in terms of its associated comorbid conditions and the side effects of antiretroviral treatment on fertility. DESIGN PubMed computer search to identify relevant articles. SETTING Research institution. PATIENT(S) None. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) None. RESULT(S) Biological alterations in reproductive physiology may account for subfertility in patients infected with HIV. Psychosocial factors in patients with HIV infection may affect their reproductive desires and outcomes. Antiretroviral medications may have direct toxicity on gametes and embryos. Available evidence indicates that fertility treatments can be a safe option for couples with HIV-discordant infection status, although the potential risk of viral transmission cannot be completely eliminated. CONCLUSION(S) Because their potential reproductive desires are increasingly becoming a concern in the health care of young HIV-infected patients, additional data are needed to address the effect of HIV and its treatments on their fertility and reproductive outcomes.
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Affiliation(s)
- Vitaly A Kushnir
- Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia 30312, USA.
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